While it is good for a skilled nursing facility to be on the ACO’s “A List” of skilled nursing home providers, skilled nursing facilities need to carefully review their contracts with ACOs to make sure they are not taken advantage of or subject to increased liability. For example, recently one skilled nursing facility relationship with its ACO was so strained that it fired its ACO due to problems with patient care. See Alex Spanko, “How One Skilled Nursing Operator Navigates The Occasional Single ‘Dictatorship’ of ACOs,” Skilled Nursing News, October 16, 2019. In some cases, there were reports that ACOs are placing too much pressure on skilled nursing facilities to discharge residents earlier than indicated, or forcing facilities to provide less care in order to reduce ACO costs, often times to the detriment of residents.
ACOs are here to stay and we encourage our clients to partner with ACOs accordingly in their communities. However, skilled nursing facilities must beware that often times this partnership can become toxic, to the point where ACO partnerships can affect quality of care or even adversely affect patient outcomes if a skilled nursing facility is not watching carefully. Ultimately, a successful ACO-skilled nursing facility relationship is one in which both sides can contribute meaningfully to protocols and processes for patient care. Relationships that give too much power to the ACO can result in compromised care for patients, often times imposing increased liability on the skilled nursing facility.