Overview:
The purpose of this extended seminar is to provide an overview of the issues that propel nursing home value. It will couple reading and discussion with abbreviated case-study problems to illustrate the material. The material will be presented in an order that follows the steps of a self-contained appraisal report. While spreadsheet applications are used to make certain calculations in the material, use of computers is not essential to the understanding of the principles and problem-solving results presented in this course. To perform the calculations for the case studies, a financial calculator should suffice. This seminar will count for seven or nine hours of CE for states, and nine hours of CE for AI members.


Syllabus:
Module 1: Types of Long-Term Care Facilities
Module 2: History of the Nursing Home Industry
Module 3: Ownership and Interest Appraised Issues
Module 4: Regional and Neighborhood Analyses
Module 5: Property Data
Module 6: Market Analysis - Supply and Demand Factors
Module 7: Market Analysis - Payor Mix Analysis and HBU
Module 8: Revenue Development - Private Medicaid
Module 9: Revenue Development - Medicare and Managed Care
Module 10: Income Approach - Operating Expense Analysis
Module 11: Income Approach - Capitalization
Module 12: Sales Comparison Approach
Module 13: Cost Approach and Allocation of Value

Learning Objectives:

• Develop an understanding for the history of the nursing home industry as it goes through dramatic shifts in a short period of time, driven by government health care programs and changes in family and social structures.
  
• Identify various types of nursing home facilities, and the kinds of services that are provided in each type.
• Identify issues in ownership and interest appraised in nursing homes.
• Recognize the importance of the regional and neighborhood aspects that impact nursing home valuation issues.
• Identify specific physical characteristics in a nursing home property and learn how physical qualities affect competition for patients, management of operating costs, and Medicaid and Medicare reimbursements.
• Discover techniques to identify and estimate supply and demand factors that impact the competitive market and current or future occupancy, payer mix, and rates of the appraised facility.
• Examine issues relating to the income capitalization approach, including the variance between Medicaid and Medicare reimbursement issues, ancillary revenue, operating expenses, and capitalization techniques.
• Use the sales comparison analysis to measure the economic aspects of a facility, and examine factors such as differences in payer mixes, occupancy levels, and reimbursement rates to develop objective value indications from comparable sales.
• Recognize issues concerning the cost approach relating to obsolescence and allocation of real estate value.

AI CE Credit for Designated members, Candidates for Designation and Practicing Affiliates
This program is approved for 1 hour of Appraisal Institute CE credit for every hour taken.