In a new question in the Wave 43 survey, suggested by Wave 42 participants, respondents were asked how their organizations’ property insurance and professional liability insurance have changed, as compared with before the pandemic started. Across all care segments – independent living, assisted living, memory care, and nursing care – about 50% indicated their professional liability insurance has increased slightly, with an additional 30% of nursing care respondents indicating it has increased significantly. The findings are similar for property insurance, with approximately 50% indicating property insurance has increased slightly and between one-quarter and one-third indicating property insurance has increased significantly. Among the reasons cited for the increases are lack of competition in local markets, COVID concerns and litigation, increased frequency of natural disasters, and a nationwide increase in frequency and severity of claims.
With the highly contagious omicron variant seemingly behind us and senior housing occupancy recovery continuing for the third consecutive quarter through Q1 2022, there is waning optimism regarding operating margins. In the Wave 42 survey, almost 60% of survey respondents expect margins to increase in the next six months, although this is down from 75% of respondents in the Wave 38 survey. Rising operating expenses limit the degree to which operating margins will grow in the next six months. Staffing challenges remain top of mind. Only 20% of respondents indicate that staffing challenges will improve in the next year, while 20% indicate it will take until 2024 to see improvement, and 30% signal staffing issues will not improve until 2025 or later. The most effective method cited for attracting new community staff is increasing wages (65%), followed by flexible schedules (15%), and hiring bonuses (5%). Staffing and a slowdown in lead conversions are affecting the pace of move-ins, which slowed for memory care and nursing care properties, but remained consistent for assisted living and independent living properties.
In a new question in the Wave 41 survey, respondents were asked whether they found the acuity of new resident move-ins to have increased, decreased, or stayed the same as compared to before the pandemic. Significantly, move-in acuity has increased for 71% of the respondents with assisted living, and for more than 60% of respondents with memory care units and nursing care beds. In independent living settings, 41% of respondents report acuity having increased since before the pandemic. The shares of organizations reporting acceleration in nursing care move-ins continued to increase – from 21% in Wave 37 conducted in January 2022 to 68% in Wave 41. This marks the fourth consecutive wave where the pace of nursing care move-ins has increased from the prior wave. Over one-half of respondents to the Wave 41 survey (53%) reported lead volumes above pre-pandemic levels in May – a noteworthy increase from the Wave 38 survey reflecting results in February (33%).
Updated November 23, 2021 (original blog posted June 29, 2021). The primary tool CMS has for enforcing care standards at skilled nursing properties are civil monetary penalties (CMPs), which are essentially fines for facilities found to be out of compliance with CMS care standards. Based on a national average, CMS penalties for skilled nursing properties had been on the rise from 2016 to the third quarter of 2019.