Post-Acute Market Reports

Post-Acute Market Reports

Market At-A-Glance
Despite the pandemic-fueled shift to home care, the post-acute care market continues to grow slowly. Before the pandemic, the market was valued at $208.5 billion, and in 2022, the market is projected to reach $220.4 billion.

Although the nation has an expanding senior population, in 2021 many skilled nursing and senior housing facilities operated at a financial loss. That trend is expected to continue throughout 2022—even for those skilled nursing facilities (SNF) with optimal occupancy recovery rates. By 2030, 1 in 5 Americans is projected to be 65 years old and over, which will have a direct impact on skilled nursing and senior housing facilities that care for many seniors’ major comorbidities.

Occupancy Levels Are Rising But Continue To Fall Short Of Pre-Pandemic Levels
Roughly 436,100 patients were admitted to SNFs in the third quarter of 2021, only a slight increase from the pandemic low of 430,000. In 2021, 25% of skilled nursing providers reported having reduced their number of beds in the previous two years.

Several factors are at play. Just over a third of facilities are generating occupancy leads at the same volume as before the pandemic, with the rest lagging. Staffing shortages are also suppressing occupancy. In 2021, the labor crisis drove nearly 75% of long-term care operators to limit admissions, and 60% expect the same in 2022.

Staffing Crisis Continues, Fueled By Competition From Healthcare And Non-Healthcare Sectors
Just 1% of nursing homes report being fully staffed, with the majority experiencing extreme shortages. In 2021, the portion of multi-property senior housing organizations that struggled with turnover dramatically increased—from 53% in mid-June to 70% in November. The shortage disproportionately affected facilities cited as lower-quality in Centers for Medicare & Medicaid Services (CMS) rankings.

When recruiting talent, post-acute care and senior living providers report facing the most competition from other senior care organizations and from hospitals and health systems. Providers are also competing with hotels, restaurants, retail, and “gig economy” services. Nursing home worker wages are on the rise, but many continue to earn less than counterparts in other settings of care.

Vaccination Rates Are High, But Booster Rates Vary
Nursing homes generally have a high rate of vaccination among both residents and staff and a high rate of booster doses among fully vaccinated residents. Less than half of fully vaccinated staff, however, have received a booster dose.

Medicaid Reimbursement Rises, While Medicare Advantage Vs. Fee-For-Service Disparity Widens
During the pandemic, Medicaid reimbursement for SNFs has increased at a faster rate than usual in many states. Among Medicare, Medicare Advantage plans reimburse post-acute care at a lower rate than fee-for-service Medicare. The difference grew by roughly 20% from the beginning of the pandemic to the third quarter of 2021.

Executive Summary
Post-Acute Overview
Pandemic Continues To Hurt Post-Acute Profit Margins
SNF Admissions Fall Significantly Short Of Pre-Pandemic Rates
One Quarter Of Providers Reduced Skilled Nursing Beds During Pandemic
Staff Turnover In Senior Housing Increased Sharply In 2021
Providers Face Recruitment Competition From Many Sectors
Staffing Shortages To Continue Suppressing Occupancy In 2022
Pandemic Drives Up Nursing Payroll Even As Hours Decline
Most SNFs Anticipate Adding Services Within A Year
The Majority Of SNFs May Return To Pre-Pandemic Activities In 2022
Pandemic Drives Increases In Medicaid Reimbursement For SNFs
Growth Of Medicare Advantage Plans Squeezes SNF Profits
States Advance Long-Term Care Insurance Programs
Pandemic Accelerates Shift To Home Care And Inpatient Rehabilitation
CMS Renews Push For Enforcement At Nursing Homes
Senior Housing And Care Consolidations Remain Low, But Value Has Recovered
Medicare Spending On Inpatient Rehabilitation Declines 8%
Number Of LTAC Cases And Facilities Continues To Decline
Assisted Living Continues Seven-Year Decline In Operating Margin
Dementia Greatly Increases Costs And Volume Of Care
Alzheimer’s Drug Approval May Boost Demand For Infusion Nurses
CCRCs Continue To Fall Short Of Pre-Pandemic Occupancy
Clarivate Lists Top Post-Acute Products Sold Through Distribution

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