Despite predictions for an ever-increasing need for nursing homes, many nursing home owners struggle to keep beds full and payments rolling in. Part of the reason may be an insistence on attracting and retaining private-pay patients. Many nursing home operators labor under the mistaken notion that Medi-Cal/Medicaid is for low-income clients, time-consuming and provides only partial payment.

Yet, consider the case of one southern California nursing home operator with 15 years experience who avoided Medi-Cal/Medicaid,...