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Nursing Facilities - Long Term Care

Market Trends...
  • Assisted living firms like Genesis Healthcare, HCR ManorCare, Five Star entering the long term care ( LTC ) / skilled nursing facility ( SNF) sector; ongoing consolidation in this fragmented marketplace changing marketing strategy
  • Heavy investment in facility upgrades, IT / IoT / IoHT; conversely, telemedicine may reduce enrollment in the sector
  • Increasingly monitored / regulated by State and Federal agencies for quality of care






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Nursing facilities (also referred to as Long Term Care (LTC) or Skilled Nursing Facility (SNF) ) are heavily regulated and standards continue to demand more from caregivers. There is substantial ongoing growth in this market segment. At least 70% of persons age 65 and over will require some sort of care from long term care or assisted living providers. The average age of patients is over 80 years of age and about 70 percent of them are female. There is a greater number of professional medical staff on premises than assisted living facilities.  

Most of the reimbursement is through Medicaid (about 65%) or Medicare (15%), the remainder is self-pay or through insurance plans which cover nursing facility care. Some of the larger entities in this segment also operate long term acute care hospitals (LTACs), assisted living facilities, rehabilitative centers and other specialized care providers. Long term care costs on average increase approximately 4.45% annually.

Many families seek the assistance of LTC for older family members or younger relatives with disabilities. It is very difficult to anticipate and plan for LTC, demand can be highly variable and may have to be used over a period of several years. Economic challenges associated with caregiving can be substantial, whether it is through care family members or by paid assistance from personal care, homemaker services, adult daycare, home healthcare, assisted living or nursing home care.

With the aging of the Baby Boom Generation, this trend is ramping up. Of 10 million Americans currently needing some sort of LTC, over 5 million are ages 65 or older --over 1.7 million are ages 85 or older. These numbers are expected to double through the next thirty years, the resources required to provide even the current level of services will triple by 2040. This assertive growth curve is due to the rapid increase of the population ranging 85 or older plus the longevity of younger people with physical disabilities or intellectual disabilities.

While the LTC population is steadily increasing, economic concerns are rising about it as well. The Center for Retirement Research estimates the percentage of future retirees not be able to maintain 80 percent of their last wage in retirement will increase from around 50 percent today to over 60 percent by 2035. Pensions and retiree benefits are being phased out, resulting in more out-of-pocket cost burden placed on individuals. Many individuals assume LTC is covered by Medicare and in most cases, it does not. LTC insurance is not something individuals prioritize and is often considered an "accessory" to other insurance they already have and/or supplemental to what they assume Medicare provides.

Moving forward, the LTC marketplace can be expected to change. It is already undergoing rapid consolidation. Insurers in the past have attempted to bundle LTC insurance with other coverage in policies and that may be revisited as a way to better market it to the Baby Boomer generation. Long term care facilities are becoming more diverse and featuring more "at home" feel to them as persons are living longer. Facility operators are competing against each other and would like to extend the continuum of care for its residents to earlier ages. Home and Community Based Services (HCBS) are also being fortified so long term care does not necessarily have to be facility-focused which may be less expensive and more easily welcomed by patients and their families.

One of the leaders in this sector, Kindred Healthcare, is exiting the skilled nursing facility side of its business based on large financial losses. In October '16, it announced it is seeking to refocus its home care, rehabilitation and long-term acute care segments. Kindred is also reducing its long-term care hospitals (LTACs or LTACHs), planning to make it about one-quarter of the company’s business. The company used to be one of the largest U.S. skilled nursing chains with about 300 skilled nursing facilities, it now operates less than 100.

Telehealth is an emerging care and technology segment that is rapidly growing can have a positive impact in the long term care sector.  It enables patients to be cared for / monitored remotely via mobile technology and other digital means. For fragile, high care patients living within long term care facilities, clinician staff and the patient's primary care physicians can get ongoing insights as to the condition of the patient via telehealth resources. For some patients, telehealth can enable them to be remotely monitored while at home and reduce the need for the patient to be cared for in a long term care setting.  From this perspective, telehealth may be a competitive force if it is administered via a care providing organization apart from a long term care entity such as a healthcare system / integrated delivery network ( IDN ).


... These are leading organizations involved with Aging and Senior Care ...
... This is a list of leading Nursing Facilities and Long Term Care (LTC) providers; scroll down for presentations and Long Term Care trends ...
<img src="200252890-001.jpg" alt="nurse helping patient walk in a long term care facility">
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Healthcare Marketing
Digital Marketing 
Managed Care Marketing
... Nursing facilities and long term care have not been ignored by advanceds in technology.  The sector is investing heavily in IT and IoT resources to better care for patients and lower costs.  As patient monitoring capabilities advance via mobile, wearable and other devices, more patients may be able to reside at home.  Clinicians can monitor them and administer care as needed via home care solutions which may be less expensive and more convenient for the patient ...
... The Nursing Facilities / LTC / SNF sector is highly specialized; requiring its own market access strategy for healthcare product / healthcare service companies to successfully engage key customer accounts, payers, GPOs, trade partners and other stakeholders. The presentation below provides market access strategy insights for success in specialized healthcare business sectors like Nursing Facilities / LTC / SNF ...
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