What Service Lines 5 Nursing Home Leaders Plan to Invest In For the Future

With data suggesting that more than 400 nursing homes could close in 2022 and pandemic-related federal funding coming to an end, SNFs are increasingly having to find ways to solidify their role in the post-acute care continuum moving forward.

For nursing home leaders, this means identifying what types of investments will move the needle forward for their companies.

Some operators continue to expand their in-house dialysis services, while others have looked to expand their home health and hospice offerings to match current patient preferences.

To get a better understanding of where nursing home companies are headed, Skilled Nursing News asked leaders in the space to tell us about the service lines they want to invest in — or are already investing in — and why it’s important for their businesses.

Ray Thivierge, chief strategy officer, SavaSeniorCare

We’ve looked at renal care, in-house dialysis, because I think that there’s always going to be a demand for that in the population we serve.That’s been an area of focus for us. We also continue to look at dementia care and dementia programming, because, again, there’s always going to be that population of folks that require long-term care in an institutionalized setting in order to get the care they need.

Aside from that, the programming is being driven by local markets and by where we feel we need to enhance the services that are being offered with our acute care partners. We’re looking at our partners, both upstream and downstream for hospitals, and then our home care and perhaps sometimes our hospice providers, to ensure that we’re filling in the continuum.

I think dialysis is an example of a service or need that SNFs can provide that for some patients is not possible to be provided in the home. That population is always going to be there and end-stage renal disease is one of the fastest growing segments of the population – and I think it’s going to continue to be something that we’re going to deal with.

I think the industry in general is seeing this as well. You can look at the number of companies that are coming up just to support the industry. Folks like Concerto [Renal Services] and DaVita and others who are expanding into SNF care, it’s because there is a recognition that the population will require skilled care and extended stay.

I think the industry as a whole is really looking at that and considering how we can be a better provider of care to those residents who had traditionally been sent out to the dialysis clinics.

Neil Pruitt Jr., chairman and CEO, PruittHealth

We are continuing with our PruittHealth Family First initiative and we’re proceeding to get licensed in Georgia and are still waiting for approval.

We opened another home health agency in Charlotte that will begin seeing patients and I just found out that we were awarded our hospice CON in Tennessee so we’ll be expanding our hospice services to select counties in Tennessee. Overall, we continue to invest not only in our own skilled nursing facilities, but in other service lines.

We have expanded into community care services programs (CCSP) in a number of counties in Georgia, meaning that we now can offer more care management services to Medicaid recipients that keep them out of nursing homes. We have really concentrated on this effort and it’s been a big initiative for us.

Charlene Everett, CEO, Odd Fellow Home

We are looking at service lines like bariatric care, which historically have been an issue in long-term care for a long time. We are looking at perhaps investing some money in one of our closed wings to make it bariatric compatible, but then you look at the workers’ compensation injuries that occur with bariatric care and it’s always more than it seems to be. In order to maintain safety for my staff, so that people are not injuring themselves, I think you would have to put in a ceiling lift. If you don’t have the proper lifting equipment then people are going to hurt themselves trying to move bariatric residents.

Transitional care or dialysis are the two things that excite us with our closed unit.

The other thing is ventilator units. There’s never enough ventilator beds for accident victims. But for that, we need to have piped in oxygen in the walls. I’ve seen it be about a $500,000 conversion to do in some nursing homes to open a ventilator unit.

Still, we’re looking at partnering with a hospice and opening a hospice unit, opening a dialysis unit and putting in dialysis equipment because we spend an outrageous amount of money transporting people back and forth to dialysis when they come in for other reasons.

Wesley Rogers, president and CEO, Brickyard Healthcare

We have a partnership with Fresenius [Medical Care] at one of our buildings for in-house dialysis. We’ve been doing that in one of our care centers in Indianapolis and that’s been a good niche for us with all the challenges that existed with transportation back and forth to dialysis.

We’ve been doing a lot of work with managed care organizations, hospital systems and ACOs to understand what the needs are. As we talk to hospital partners and other commercial payers, behavioral health is one of the biggest challenges and opportunities that are out there.

We had a discussion last week with a hospital partner and they said the top two most challenging discharges for them would be dialysis and behavioral health patients. So we’re working with some professionals in the behavioral health industry to build some education and training protocols to identify some potential opportunities for us to provide those services in some designated care centers that we have here.

Stuart Lindeman, CEO, Mission Health Communities

We went to the hospitals that were our main referral sources, looked at the data and spoke to physicians and we started training staff with specialized programs.

We rolled out a new breathing program, we rolled out a new IV program, we had a new sepsis program. That was huge for us. Not only did that help us with PDPM, it really helped us through Covid.

We were able to keep our residents and patients in place and we ended up taking residents and patients from other places because we had upgraded the skilled level of our staff. We will continue to do that where it makes sense and we’re doing specialized programs in most of our buildings.

We have also looked to add Parkinson’s programming, a cardiac program among others.