Medicare fee-for-service (FFS) admissions increased among skilled nursing facilities by 5.8% in 2022, while other care settings saw a decrease in this metric, and as SNF utilization rates increased nationwide.
However, quarterly skilled nursing admissions still decreased faster than FFS enrollment.
That’s comparing 2019 and 2022 directly, according to Trella Health’s annual industry trend report issued on Monday. Trella provides health care data analytics to skilled nursing organizations, along with home health and hospice providers.
“This data means the latest year-over-year increases in 2022 don’t compensate for the substantial decrease in SNF admissions amid the height of the pandemic – further illustrating the long-term impact of the Covid-19 pandemic on the SNF industry,” authors said in the Trella report.
Home health, by contrast, saw an 8.6% decrease in FFS admissions, while hospice saw a minor decrease of 0.1% in 2022.
Photo courtesy of Trella HealthOverall, year-over-year admissions for the skilled nursing sector increased by 5.8% in the third financial quarter of 2022, 4.1% in Q2 of 2022, and 7.9% in 2022 Q1, according to the Trella report.
Increases can be attributed in part for inpatient discharges being instructed to receive skilled nursing care, authors said.
“Further, compared to the height of the pandemic in 2020 and 2021, staffing challenges seem to have eased in 2022 – further explaining why 2022 skilled nursing admissions increased year-over-year,” according to the Trella report.
National SNF utilization increased from 21.5% for the rolling four quarters ending 2021 Q3 to 22.7% for the rolling four quarters ending 2022 Q3. Trella authors believe this increase is due to a changing attitude from SNFs as a Covid “hotspot” at the height of the pandemic, and a better understanding of the sector within the wider care continuum.
Authors also suggested geographic variation in SNF utilization could mean expansion opportunities for operators. South Carolina and Georgia may offer expansion opportunities given their utilization rates are lower than the national average at 17.3% and 17.6%, respectively.
“Low skilled nursing utilization rates indicate markets with unmet demand for skilled nursing services and, thus, an opportunity for facility expansion,” said Trella report authors.
Meanwhile, the Trella report found that Medicare Advantage enrollment continues to inch closer to encompassing half of Medicare-eligible beneficiaries at 46.2% as of late 2022, potentially going over 50% by 2024.
That doesn’t mean that SNFs were admitting MA beneficiaries, though. Between 2019 and 2020, Trella found a 12.1% decrease in MA skilled nursing admissions. Authors note this data reflects the impact the Covid-19 pandemic had on a facility’s ability to service MA patients adequately.
Another finding from the Trella report – skilled nursing adherence to discharge instructions needs improvement to reach pre-pandemic benchmarks. This is despite an increase in discharge instruction adherence from the previous reporting period.
“I encourage you to leverage the findings presented in this report to inform your strategic planning and decision-making processes – with the goal of driving positive outcomes for your organization and the well-being of the patients you serve,” Trella Health CEO Scott Tapp said in a foreword within the report.
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