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What Lenders are Looking for in the Post-Pandemic Landscape

As we recover from COVID-19, most SNF providers continue to struggle with low census and high costs. Looking ahead, Financial Lending Partners are working diligently to help providers gain access to needed capital resources. Lenders understand the financial consequences of the pandemic and are evaluating providers’ loan requests based on key historical pre-COVID utilization metrics and their current operational strategies to return to previous performance levels. Concept Rehab connected with Brad Granger and Talel Aissi from Lument Financial and Kenn Daily from Elder Care Systems Group to explore exactly what lenders are considering when determining loan application approval as well as what challenged providers can do today to increase the likelihood for future lending eligibility.


Although relief funds were critical for survival during the pandemic, lenders cannot attribute these disbursements as income for loan underwriting consideration because it is not standard reoccurring revenue source. Instead, lenders look at a combination of strategic operational and data-driven measures to understand how individual facilities have managed the pandemic, examining pre and post pandemic performance and strategies.

Strategic Operational Indicators Supporting Loan Approval

  • A strategic plan with implemented strategies in place to return census levels

  • Executed tactics for reengaging and strengthening hospital partnerships

  • Positive headline/media news demonstrating consumer confidence

  • Experienced leadership and positive past operational performance

  • Physical plant is in good condition and facility provides up-to-date photos, and ongoing maintenance records

Data-Driven Indicators Supporting Loan Approval

  • Vaccination rates – Resident and staff vaccination rates are above peer averages compared to local, state and national percentages

  • Current and Past Active COVID Rates – Case counts and mitigation strategies are considered to understand lending risk

  • Census Stability & Case Mix - Lenders find it’s often difficult to see positive net income without a mix of payor sources. With mix dramatically changing during COVID, lenders are most concerned about case mix status pre-COVID and a providers’ ability to reach pre-COVID status in the future.

  • Financials - Lenders typically review a 3-year annual look back of income and balance sheets and monthly data for the last 12-24 months. Outside financial obligations (leases or contracts) as well as liability insurance and claims are also considered. Overall, lenders evaluate trends to ensure the longevity of projects/trends versus a single benchmark.

  • 3rd Party Reports –Appraisals or assessments from engineering firms and outside contractors are necessary for evaluating risk and eligibility.

  • Plans of Correction – For facilities with survey issues, lenders require access to plans of correction and associated actions to evaluate progress towards resolution.

  • Star Rating –Most lenders prefer a 3-Star or above quality rating and/or performance trending consistently in a positive direction. For providers with a 1 or 2-Star rating, it’s challenging but not impossible to receive loan approval; read on for what you can be doing now to position your facility for loan approval.

Not a candidate for a loan? Take action today.

  1. Focus on profitability; largely through revenue (census) versus cost channels.

  2. Work to refine labor variables such adequate staffing and cost-effectiveness.

  3. Establish relationships with lenders today. Reach out to future lenders to establish a roadmap for accessing future capital by addressing pitfalls and communicating progress over time.  Many lenders are eager to develop long-term relationships and partnership plans for financial success.

  4. Evaluate vendor partnerships and avenues for maximizing reimbursement and efficiency, and cost control.

Partnerships that Optimize Financial Performance

For all facilities working towards pre-pandemic operating levels and targeting growth for the future, demonstrating profitability and forward trends is key for access to external financial capital. Facility partnerships can play a valuable role in optimizing financial performance and at Concept Rehab, we have specific solutions to support our SNF partners. This includes new hands-on dedicated resources to assist with census recovery, staffing solutions, and financial optimization strategies through revised contracting methods and pricing structures. Contact us today to explore customized partnership models to drive your SNF success.

To connect directly with the advisors at Lument, contact Brad Granger at



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