Recently when it comes to thinking about the present state of the SNF industry, I’ve found myself thinking more about the upcoming year than ever before. This isn’t something I’ve always done during my 46 trips around the sun, so I am not sure why it is happening now.

I guess it’s more common to look retrospectively and say “wow, look at how many things have changed in the past year,” rather than “these exciting things are going to happen during 2019.” It would be easy to turn this conversation into one just about PDPM, but I find myself thinking about things at a more macro level.

The questions I frequently ask myself are:

1. How much more pressure can the Medicaid payment system sustain before it breaks? Deficits in daily reimbursement in many states are nearing that point. It seems to be getting worse, not better.

2. How many of the 16,000 SNFs in America are truly equipped to care for the increasing number of medically complex patients?

3. Is the industry appropriately funded to survive, and will PDPM mean the beginning of the end for some who are just fighting to stay open? PDPM is being tabbed as budget neutral, but that really means there will be winners and losers

.4. If SNFs with a 1-star rating are unable to make the improvements they need to compete, how will they survive? What about you? If you are an LTC professional, what do you ask yourself?  Will we know these answers a year from now?  Each of these questions is a discussion on its own and we just might do that to keep our brains working over the winter.  If we were to fast-forward one year, what would we see? In upcoming editions of our blog, we will be providing more insight into these questions.

If you’d like to share a comment or thought, scroll down to the comment field.  I’d love to hear your ideas