TABLE 5.
Administrators expressed concerns regarding the fragility of the nursing home industry.
| Concept | Representative quote, nursing home characteristics |
|---|---|
| Decreased census, increased costs associated with staffing, PPE, testing | “It's been a tough year financially. Obviously, our dip in census overall that happened was hard. At the same time we were losing census, we had to increase our staffing to make sure we were appropriately meeting the needs of our residents. Financially, on top of that, the costs associated with our PPE supplies we were getting and our testing supplies we were getting, was hard to account for. We did not make any profit in the last year.” S7N1.4, June 2021, South, <100 beds, Star rating 4, Not for profit |
| Decreased census resulted in decreased revenue | “Number one, the census has been just up and down, up and down, and I think in many ways patients are choosing to go home from the hospitals if they were to have a choice. If they were to have a choice of, ‘Hey, you can go to a nursing home, stay there for two weeks to get PT, OT, or antibiotics or what have you, or you can go home, and we'll hook you up with a home health and have you just simply go home.’ We're seeing a consistent trend of having less, less occupancy, even before the pandemic we are seeing the occupancy rate drop in the nursing home world. That's one, we are seeing that, so that obviously impacts us financially.” S8N3.4, July 2021, West, 151+ beds, Star rating 5, For profit |
| Unsure future, sustainability concerns | “So, it's crippling. I mean I honestly… I do not know what the future of our facility is and we are a high end… We're in, I think the most densely populated area for nursing home residents in the country. There's 70 of these facilities in our county. I expect some to go belly up from this. It's already a tough business and very minimally profitable and all that. I'm seeing the losses. It's not that we are not making enough money, it's that we are losing money and that's not sustainable over a long period.” S6N2rep.4, December 2021, South, 100–125 beds, Star rating 5, For profit |
| Long‐standing media portrayal | “And it's easy for them to do because there are bad players out there. All they have to do is pick one of the bad players and talk about the deficiencies and how horrible the place is and pressure sores and people die and blah blah blah and that's the entire industry. We're all painted like that. So the reality is the media is not our friend. I do not think the media has ever been our friend just because, pretty much for the last 20 years, it's been a real big push for home and community‐based services. And, I'm fully in favor of that. The right care at the right time at the right level. But unfortunately, I'm going back to the government, many people in government look at nursing homes and say, ‘Oh, these people can be taken care of at home. Look at that little old lady. She's walking around with just a walker.’ What they do not realize is that little old lady was at home and was on her death bed because she wasn't eating right, her meds were all screwed up, home care wasn't showing up. She ends up in the hospital. She comes to the nursing home. Her meds all get straightened out. She gets therapy. She's up. She's walking around. She's with people. She's being socialized. She rebounds.” S1N5.4, July 2021, Northeast, <100 beds, Star rating 4, For profit |
| Media worse during COVID‐19 | “Nursing homes in general had a pre‐negative stigma to begin with, but COVID has just driven that wedge between the trust, and again this is my opinion, the trust of the general community, in the health care community has driven a wedge further down and divided that even more.” S2N3.3, April 2021, Northeast, 151+ beds, Star rating 1, For profit |