Skilled Providers Can No Longer Be Independent Players, Executives Believe

A majority of skilled nursing and seniors housing executives believe skilled nursing providers can no longer be independent players in the post-acute care continuum — and almost 20% see integration as a necessity.

According to a survey conducted by real estate lending, investment, and advisory company Greystone and administered by Marc Zimmet of Zimmet Healthcare Services Group, 63% of survey respondents believe that skilled nursing operators can no longer continue to be independent players in the continuum of post-acute care, while 18% see integration as a necessity.

Greystone and Zimmet Healthcare Services Group have an ongoing collaboration, and Zimmet also serves as a managing director at Greystone.


Most of the survey respondents held positions equivalent to CEO, president, chairman or owner. In addition, the majority of respondents – at 64.71% — were involved with privately owned facilities.

The survey, released Wednesday, found that bridge financing is “critical” to the acquisition strategy of 81% of the respondents.

“With 35% of SNF providers willing to take on an underperforming asset in a portfolio with intent to close it in order to protect other existing facilities, complex acquisition strategies must be approached with an experienced advisor in hand,” Zimmet said in a statement announcing the findings.


Greystone’s bridge lending platform has seen a 150% surge in year-to-date originations over the year prior, with support from a debt fund that closed earlier this year to provide increased capacity of up to $3 billion. Skilled nursing facilities have accounted for the majority of the company’s health care bridge lending program through September, the company announced last month.

Executives are also expecting ongoing changes in the reimbursement environment, the survey found. Most of the respondents, at 54%, believe that managed care plans will control both Medicare and Medicaid benefits for dual-eligible skilled nursing patients in less than five years. In addition, most respondents are likely to use or are already using “risk-based” payment models as part of their existing and future payor mix.

Written by Maggie Flynn

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