Norcross, Ga.-based nursing home operator PruittHealth has taken a $260 million revenue hit since the early days of the COVID-19 pandemic in March 2020 – but saw a 19% boom in demand for its home health services.

That’s according to a new report released last week, which also highlighted an estimated $102.1 million in Medicaid underfunding for the family-owned company.

An independent audit conducted by accounting and advisory firm Mauldin & Jenkins showed Medicaid shortfalls of $58 million in Georgia and $25 million in South Carolina for PruittHealth, among others.

PruittHealth’s occupancy bottomed out at about 69% during the throes of Covid – a far cry from its 89% occupancy level pre-pandemic. Census currently sits at around 72%.

More specifically, PruittHealth served 9,286 skilled nursing and assisted living patients pre-Covid, and by the end of 2021 it was serving 7,778 – a 1,508 patient loss, according to the report.

PruittHealth also lost 3,200 employees to finish the year with about 11,600 staff.

CEO and Chairman Neil Pruitt Jr. told Skilled Nursing News that while there are challenges ahead – specifically pointing to declined skilled nursing admissions and “chronic” Medicaid underfunding – he remains optimistic about the company’s future.

“Things are moving in the right direction, we just have a long way to go,” he told SNN.

1,000 international nurses on their way to PruittHealth

One way PruittHealth has tried to combat the industry-wide staffing shortage is by hiring as many as 1,000 international nurses and certified nursing assistants. 

Pruitt Jr. said the first wave of new staff could arrive as soon as this month. In addition, the company has also “beefed up” its talent acquisition department – revamping its technology and tripling the size of the team.

Recruitment was previously done at the facility level, and many of those employees were also tasked with other jobs, Pruitt Jr. said.

Since March 2020, PruittHealth has spent $23.4 million in workforce retention, and another $38 million on other staffing costs such as sick leave, hazard pay and agency staffing.

Part of PruittHealth’s workforce retention costs were associated with vaccination efforts, some of which included bonuses, goodie bags, cash raffles and grand prizes.

The staff vaccination rate at PruittHealth sits at 96%, according to the report.

Pruitt Jr. said overall labor costs are up 27% since before the pandemic, and raw wages are up 16%.

“We’re hopeful that stable management will mean a stable workforce within the building.” he told SNN.

Looking ahead, Pruitt Jr. said the goal is to have agency staff out of all buildings in the next 120 days, even if that means limiting admissions.

“They just are not good for the culture, they’re not good for patient care, and we really need to have our own Pruitt employees taking care of Pruitt patients,” he said.

What’s ahead

PruittHealth intends to plan its future around the shift toward long-term care settings that look more like home.

The Georgia-based operator will soon launch PruittHealth Family First, its own SNF-at-home type of service. The program will start as a 10-county pilot in the company’s home state. 

PruittHealth Family First will present new opportunities for PruittHealth patients to be cared for in their own home. State licensing for the program is currently being reviewed and the pilot should start any day now, he said.

He also noted the company’s significant investment in its home health service line, and it has paid off. PruittHealth @ Home had 379 more patients at the end of 2021 compared to 2019, the report noted. 

One thing that may stand in the way of recovery for SNF operators like PruittHealth, according to Pruitt Jr., is Biden’s proposed industry reforms. He said, as evidenced in their company report, the industry needs a helping hand not a “hand slap.”

“The president’s State of the Union and the imminent proposals that he is proposing is almost like a punch in the gut, and it’s ill timed,” he told SNN.

Pruitt Jr. said while he is open to the idea of minimum staffing standards, there needs to be a way to pay for it.

“In this report, we have $102 million in Medicaid under funding, and that’s just with existing staff. So if you add a requirement on top of that, what are the financial proposals to help pay for it? Second, where are we going to get the nurses,” he said.