Thursday, July 16, 2015

Snapshot of Drivers of Healthcare Mergers and Acquisitions Activities

Healthcare Mergers and Acquisitions activity and resulting industry consolidation is surging.  Why?

Below is a snapshot of the drivers of healthcare mergers and acquisitions activities, particularly real-estate based services.
  • Low Interest Rates and Availability of Capital
  • Favorable Demographics/Need-based Industry
  • Cost Pressures as Public & Private Insurers Increasingly Contain or Reduce Provider Reimbursements:   - Network Formation/Bundled Payments Model Rewards Integrated Healthcare Systems that Lower Costs and Improve Quality
  • Fragmented Industry Ripe for Consolidation:  - Consolidation Increases Revenues, Economies, Efficiencies and thus Profitability; Diversifies Revenue Mix & Strengthens Balance Sheet (lowers borrowing costs).   Single-site, Standalone facilities cannot attain the economies of scale necessary to survive and compete.
  • Ability to Leverage the Real Estate – (enables low blended cost of capital and high collateralization)
  • High Regulatory, Reimbursement & IT Compliance Hurdles Cause Consolidation
  • Sellers’ Market Conditions
  • Mergers and Acquisitions is Contagious

Thursday, July 2, 2015

Using Essential Oils in Skilled Nursing and Assisted Living Facilities

Using Essential Oils in Skilled Nursing and Assisted Living Facilities
by Tammi Davis, MD

Essential oils are aromatic volatile compounds that are found in many plants. In nature, plants use these oils to ward off pests, protect against viral, bacterial and fungal infections, and to attract insects for pollination. Essential oils have a very strong aromas that interact with our olfactory system to influence the part of the brain responsible for mood, emotions, and memory. Different oils have different chemical constituents that activate the brain in various ways For example, citrus essential oils such as orange, grapefruit, lemon, and bergamot can be very uplifting to the mood. Lavender essential oil is often used to create a feeling of relaxation and may be beneficial to aid in sleep.

Generally, in order to affect mood, the essential oils are diffused into the air with a small ultrasonic or nebulizing diffuser that distributes the particles into a fine mist. The use of aromatherapy is becoming more common. Many hospitals offer aromatherapy as a complementary treatment especially in oncology centers, and they have been used in hospital ERs to reduce the stress level of the staff. Many of the oils have antiviral and antibacterial properties and act to purify the air. The oils can also be added to a carrier massage oil and offered as a massage to induce relaxation.

Unfortunately, we often find people in nursing homes that are agitated, depressed, anxious, or suffering from insomnia. Diffusing various essential oils could help uplift the mood of some of the skilled nursing facility residents, may help calm agitated residents, and could promote relaxation and sleep. Many elderly have decreased hearing, sight, and taste. Aromatherapy can add another dimension to their daily routine of a skilled nursing or assisted living facility by awakening another sense. Some patients with dementia may have decreased sense of smell and they may benefit from massage with essential oils, particularly in the new emphasis on development of "memory-care" assisted living facilities.  Many essential oil companies test their oils with gas chromatography and mass spectroscopy to ensure that there are no adulterants or impurities in the oil. Oils that are not pure are associated with a higher risk of skin irritation and skin sensitivity when applied topically.

It seems very logical to me that a nursing home that smells of wild orange, lemon, bergamot, or lime would be very pleasing indeed! In addition, this could be a very effective marketing tool in attracting new residents and patients. Furthermore, improving the quality of care can improve the health outcomes and contribute to a better bottom line and business valuation for skilled nursing and assisted living facilities.

Tammi Davis, MD, is a Board-Certified Family Physician, based in Baltimore County, MD, whose practice include alternative medicine, medical acupuncture, supplements and aromatherapy.   Her website is http://www.tammidavismd.com.