State Cuts Suggest SNF-to-Home Diversion Is Still Going Strong

At least in one state, the diversion of patients from skilled nursing facilities (SNFs) to home-based care appears still be going strong.

In Connecticut, state officials have targeted nine under-performing nursing homes for millions of dollars in Medicaid funding cuts, partly citing large numbers of empty beds as the reason why, the Hartford Courant reported Thursday. Overall, there are at least 3,000 empty nursing home beds in Connecticut — and nearly 70 facilities have closed up shop since 1995.

Funding cuts are estimated at roughly $6 million in 2019 alone.


While some have argued the nursing homes should be given a chance to raise their occupancy rates and turn operations around, state officials reportedly believe in-home care is Connecticut’s preferred means of long-term care moving forward.

Pennsylvania-based Genesis Healthcare owns five of the nine nursing homes set to lose funding. It’s a group that includes the Arden House in Hamden, Connecticut, the state’s largest nursing home, according to the Hartford Courant.

The 350-bed Arden House was roughly one-third vacant as Sept. 30, 2018, the news outlet reported.


The shift away from nursing homes and into the home — or SNF-to-home diversion — has been an ongoing topic in the long-term care world for the past several years.

In 2009, there were 1,808 SNF days per 1,000 Medicare fee-for-service beneficiaries, a March 2018 analysis from consulting firm Avalere Health found. That fell to 1,539 days per 1,000 fee-for-service beneficiaries in 2016.

Still, some industry executives had believed the diversion wave had passed.

“Whether it’s bundled payment programming, whether its accountable care, whether its managed care penetration, I think those things have reached a point of equilibrium and we’re beginning to see some margin growth in total census,” Genesis HealthCare (NYSE: GEN) CEO George Hager said in March at the Barclays Global Healthcare Conference. “I’m less concerned about migration out of our setting or diversion away from our setting.”

In Connecticut, state officials have reportedly said there would be no immediate closings due to funding cuts.

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