Steve Flatt

Still recovering from the pandemic, and amid a wave of consolidation in the industry, senior living providers are still prepping for a massive shift in demand by 2030. Home health is positioned to play a growing role in keeping up — but there still aren’t enough clinicians. 

Senior care facilities are strategizing future business deals around providing a wider spectrum of skilled nursing services to patients, especially as hospital operators (those with referral power) buy up home health divisions themselves. But even as occupancy sits 20 percentage points below pre-pandemic levels in most assisted living facilities and nursing homes, industry leaders believe demand will rebound — quickly — and say home health will provide a wider safety net to take care of lower-acuity patients. 

“When you use look at the demographic trends, I think all of the senior care service lines of business are going to be able to not just survive, but prosper,” said Steve Flatt, CEO of Murfreesboro-based National HealthCare Corp., which operates 100 skilled nursing and assisted living communities, as well as a behavioral health hospital and 35 home care agencies.

“If you look at the numbers, the vast majority of our patients are 80 to 84 years old. In 2020, there were 6.4 million of them. In 2025, there are going to be 8 million of those aged 80 to 84 years old, and in 2030, there are going to be 10.5 million. And so, when you get right down to it, it’s the old adage: ‘The rising tide’s going to lift all the boats.’”

Flatt estimated occupancy at NHC properties to rebound by 2022. In the years following that, he expects to see a shift in how patients are admitted to long-term care. For example, senior living companies may employ home health more often for lower-acuity patients while reserving beds in nursing facilities for the sickest. 

Still, workforce shortages were only exacerbated by the pandemic, and the industry will have to grow clinicians to scale with services by 2030. 

“Over the next year or two, workforce is going to become the key priority in terms of coming up with strategies to help us bolster the workforce. I think that strategy will include increasing the number of domestic and foreign workers,” he said.

“It’s one thing if McDonald’s can’t get enough workers to keep their restaurant open, but it’s a completely other thing if you have an assisted living and skilled nursing facilities that can’t get enough workers to keep people safe and alive. This is absolutely critical.”

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