If you thought the past few years were a roller-coaster for long-term care, wait until you see the challenges in 2017. Yet, within each of the primary challenges lies a silver lining that will improve the industry as a whole—and could give a distinct market advantage to those who get on board early.
The main elephant in the room is what will happen to the Affordable Care Act (ACA). Time will tell, although most experts believe parts of it will be redone and parts of it will remain in a rebranded form. The silver lining in that relies on the insurance industry—some companies have left the long-term care insurance market and some have stayed, but they are all intrinsic drivers of the insurance marketplace and how it will serve those for whom Medicare/Medicaid is not enough and those who cannot afford anything else. For healthcare in the senior years, it may be a “pay now or pay more later” situation; I’m not sure.
Also, no matter where your politics lie, the Trump Administration has infused the healthcare industry with a sense of insecurity and wariness that could affect everything from new construction ventures to property acquisitions. The silver lining is that savvy senior care businesses will be taking a harder look at the smartest ways to invest by re-evaluating their markets and taking a much more detailed look at what really matters to their customers, now and in the future. The Centers for Medicare & Medicaid Services (CMS) is getting a lot of pressure these days to add customer satisfaction to the Five-Star ratings equation. (Have you re-evaluated your customer service outreach lately?)
Operating a senior care business in 2017 is more complex than ever. Administrators need to juggle multiple quality initiatives, truckloads of federal and state regulatory compliance issues and fresh service line marketing in a fiercely competitive environment of consumer choice, especially in assisted living and memory care. The silver lining is that the old days of “let’s just reassign our SNF-to-memory care bed ratios” are waning, and providers are focusing on introducing service lines that really matter and will become true business differentiators in their local markets.
Like it or not, clinical processes are now business processes. The Director of Nursing is now a key part of the executive team since quality care compliance is intrinsic to overall business success. In the past two years, CMS has expanded its mandates to include much more than reducing unnecessary hospital readmissions. The administration of antipsychotics, the inclusion of a formal infection control program and a whole list of new regulations on how residents with memory impairments are treated are all among the business responsibilities now.
In short, a clinical focus on avoiding F-Tag deficiencies and then “hoping for the best” during survey time doesn’t cut it anymore. The silver lining: Deliberate and meaningful investments in clinical staff training, clear down to the Certified Nursing Assistants and the direct-care staff. Everybody on the staff now needs to know why they’re doing what they’re doing. But here’s another silver lining: Staff members who understand how their job roles fit into the greater picture of quality care delivery and feel respected by their administrators are often more engaged in their jobs and tend to stay.
As for me, I welcome these changes—and look forward to seeing how the smart senior care operators embrace them.