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Insights and Trends

Expected nursing home closures in 2022: Its impact on your hospital

Over 300 nursing homes have closed since the beginning of the pandemic, and roughly 400 more are projected to close this year, according to a new report from the American Health Care Association (AHCA) and National Center for Assisted Living (NCA). This adds up to more than 1,000 nursing homes closing since 2015, requiring 45,000 nursing home residents to find alternative forms of care.1

Additionally, significant changes in reimbursement, as well as the enactment of several state bills lowering daily patient therapy requirements, has pushed patients to seek other care settings as they recover from medically complex conditions. Further, infection control safety concerns highlighted during the pandemic, in addition to the reduction of therapy, has led many patients to seek care outside of SNFs.

What impacts may be occurring at your hospital due to nursing home closures?

  • Increased medical surgical length of stay
  • Re-authorization for payment challenges
  • Case Management frustration
  • Decline in patient and family satisfaction

Further compounding the SNF crisis is additional legislation being put into place on the state level. One example of this is Florida House Bill 1239.

Florida House Bill 1239: A new standard set to negatively impact nursing home patient outcomes

Prior to HB 1239, Florida certified nursing assistants (CNAs) were required to provide a minimum of two and a half hours of direct care per resident daily. However, the HB – that was signed in early April – has lowered staffing requirements to two hours per day and also takes into account time other workers, including therapists, have spent with residents. It further poses a threat to nursing home and long-term care resident quality outcomes.2

Representatives of AARP and the Service Employees International Union, which represents nursing home workers, shared their concern about the new bill – stating that this will reduce valuable time spent with nursing home residents by 20 percent.2

This could ultimately lead to longer care stays and additional strain to an already sparse nursing workforce.

Alternative care options

Inpatient rehabilitation is uniquely equipped to care for patients often treated by SNFs and help them reach their recovery goals. It is the only service line that provides daily intensive multi-disciplinary therapy, allowing hospitals to effectively treat complex aging patient needs, especially for those who require aggressive interventions to regain function.

Getting patients the rehabilitation care they need to reach their recovery goals can be difficult if initial patient screenings are not completed early. When early screenings are implemented, patients can more easily be admitted to a care setting that is best equipped to address and treat their unique needs. The specialized care provided within inpatient rehabilitation through an acute rehabilitation unit (ARU) or inpatient rehabilitation facility (IRF) has proven to generate positive long-term outcomes both during and after a patient’s hospital stay.

Additional benefits inpatient rehabilitation offers to acute hospitals:

  • Increased clinical and quality effectiveness. Inpatient rehabilitation is known for producing exceptional clinical and quality outcomes and reducing hospital readmission rates – benefiting the hospital as a whole.
  • Streamlined interdisciplinary team approach. Specialized care requires expertise from specialized clinicians, including highly-trained medical directors. Having the expertise within the hospital’s care continuum reduces the opportunity for errors while improving care consistency and transitions.
  • Improved patient throughput management. Having inpatient rehabilitation services available within a system’s care continuum helps ensure that patients receive the right form of care at the right time in their care journey. This frees up needed staff and acute bed space and allows patients to efficiently and effectively make progress in their recovery.

Contact us to discuss the closures in your area and how optimizing inpatient rehabilitation may positively benefit patients and your hospital’s outcomes.


  1. The American Health Care Association and National Center for Assisted Living. (2022, April 21). Nursing Home Closures: By the Numbers.
  2. News Service of Florida. (2022, April 7). DeSantis signs Bill Making Nursing Home Staffing changes. Tampa Bay Times. Retrieved June 23, 2022, from