Understanding the healthcare needs of residents of senior housing communities and nursing homes is imperative to best serve the population. In order to garner a better understanding of these healthcare needs and associated spending, NORC at the University of Chicago on behalf of NIC conducted a landmark study. Many residents use high-cost healthcare services including emergency rooms, acute inpatient hospitalization, and post-acute care, and across nearly every dimension analyzed, the data indicates frail and high healthcare cost residents. These factors all highlight an opportunity for value-based care organizations to partner with senior housing and skilled nursing operators.
Rising operating expenses now surpass staffing challenges as the most frequently cited response to the question from Wave 44 which asks about “the biggest challenge facing my organization today.” Employee turnover and attracting community and caregiving staff (which have traditionally been cited as the top challenges among survey respondents) are now coming in as the 2nd and 3rd biggest challenges organizations are confronted with. That said, a promising sign of relief to the long-standing labor market issues may be that 15% of responding organizations anticipate their staffing challenges will improve in the second half of 2022 and half of respondents (47%) anticipate their staffing challenges will improve in the first half of 2023.
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.