Acuity creep

Definition

Residents needing more care over time without the fee moving to match it.

Why It Matters

The fee half is a margin question and the assessment half is a compliance one. Washington requires a full assessment for every resident at least annually, and a focused one whenever the resident departs from their customary range of functioning, whenever the negotiated service agreement no longer addresses current needs, and whenever an injury needs a practitioner. The agreement itself is completed within thirty days of moving in and updated within a reasonable time after any change. So a building where nobody has changed level in two years is not simply leaving money on the table, it is potentially in breach of a named rule, and the assessment records are the artifact that says which of the two it is. Read them against the fee schedule before believing a stable revenue per resident.