Specialization, Hospital Partnerships Can Boost Rural Skilled Nursing Facilities

For rural skilled nursing facilities, specialization and collaboration can be key ingredients to success, according to a recent webinar from Health Dimensions Group (HDG), a senior living consulting company.

“People don’t quite understand how challenging it is and the amount of work that rural providers do to care take care of an entire community with very little resources and fewer partnerships than other bigger communities have,” said Erin Hennessey, executive vice president of consulting at HDG, who presented the November 2017 webinar.

Unique Challenges


While the skilled nursing industry is facing all sorts of challenges, rural SNFs have some obstacles unique to their situation. For one thing, while SNFs in metropolitan settings are competing with other post-acute providers to get a foot in the hospital door, SNFs in rural areas are directly competing with critical access hospitals (CAHs).

“Rural health providers are competing with their local hospitals so in one meeting you may be discussing… the care that you both provide and how to integrate,” Hennessey said. “And then sometimes [the hospitals will] be having discussions about them competing with you and filling up their own swing beds with patients that you would very much like in your post-acute venue. So it’s a unique type of competition that happens when you’re competing with your referral source.”

Other challenges particular to rural SNFs include access to physician services and specialty services; geographic isolation that can stymie everything from referrals to marketing; and value-based payment delays, as not as much information is available for rural providers.


Providing Value

But it’s not all bad news. In fact, Hennessey explained that a rural SNF’s location can be one of its strongest assets.

“You are in the town, you are near people’s family and friends. You are near their primary physician, you are near their hospital… their resources,” she said.

Rural SNFs can overcome the lack of hospital partners by pouring resources into one or two advanced specialties, Hennessey said. Such a narrow focus can provide value to rural hospitals, which are also strapped for resources on the specialty front in terms of both doctors and equipment.

This isn’t as easy for urban SNFs that can have a dozen or more hospitals in a given area. In a similar vein, clinical integration and the opportunity to develop a continuum of care are both areas where rural SNFs can stand out.

“We have seen some communities who have become smaller through population and skilled nursing use develop assisted living and independent living or even home health on their campus, and expanding their continuum to be a one-stop shop for senior services in the community — instead of being known as the county home or the rural nursing home,” Hennessey said.

Written by Maggie Flynn

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