Marc Zimmet, president and CEO of Zimmet Healthcare Services Group, said a report in JAMA that estimated the operating capacity of skilled nursing facilities (SNFs) in the U.S. has declined some 5 percent since 2019 is right to note the variations in capacity around the country, and the challenges attached to these differences.

The report said rural counties experienced operating capacity declines of 15 percent or more, a much higher number than the national average.

“I give JAMA credit for recognizing that there are nuances to different areas of the country, but there's a structural issue policymakers ignore,” he said. “Government is both regulator and payer and does not move at the speed of business. SNFs can't keep up with whatever the market throws at them. They're forced to absorb the pain [or largess] until the state issues their one-size-fits-all adjustment to events that happened two years earlier.”

Further, Zimmet said even though added funding may buy another year for a facility at risk of closing, the fact is unless there are properly timed and targeted solutions, the SNF market will not self-correct. 

“SNFs can't do much of anything at the macro level. . .things are done to them,” he added.

Report Targets Staffing

The JAMA report said localities with larger declines in SNF capacity had more frequent reports of facility staffing shortages and larger increases in hospital length of stay.

When the pandemic was at its worst, SNF capacity had shrunk by 14.7 percent on a national basis, then recovered to around 5 percent below 2019’s benchmark by the end of 2024.

Titled, “Changes in U.S. Skilled Nursing Facility Capacity Following the COVID-19 Pandemic,” the report is the work of researchers affiliated with the University of Rochester, Brown University, UCLA, and Harvard.

What Does it Mean?

These researchers said the results of the study suggest that SNF capacity has shrunk since the start of the pandemic, likely related to staffing shortages, and these declines may reduce older adults’ access to SNF care and disrupt hospital discharges.

“Results suggest that SNF operating capacity declined following the pandemic and these declines were larger than the observed declines in licensed SNF bed counts, potentially because of staffing shortages,” the authors said. “Greater loss of SNF capacity was associated with longer hospital stays and increased travel distances to SNFs, suggesting that declines in operating capacity may be impairing access to care.”

Access the report via https://tinyurl.com/dhc6j79f.

Question or comments? Contact Patrick Connole at pconnole@parkplacelive.com.