The Promise of AI Companions in Memory Care | <p><img src="/Articles/PublishingImages/2025/AI_memory.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:200px;" /><span></span></p>Artificial intelligence (AI) continues to redefine health care, offering tools that address complex challenges with precision and scalability. Among its most promising applications is the use of AI companions in memory care. Designed to engage residents with Alzheimer’s or dementia, these companions blend emotional intelligence with advanced data analytics, offering personalized support and actionable insights to caregivers. A recent pilot program featuring "Kathy," an AI companion, has showcased the transformative potential of this technology.<p></p><h3>The Need for Innovation in Memory Care</h3><p>Memory care involves addressing the nuanced needs of residents facing cognitive impairments such as Alzheimer’s or vascular dementia. These conditions often diminish residents' ability to articulate their needs, leaving caregivers to rely on intuition and observation. As memory disorders progress, care requirements become more complex, demanding innovative solutions to enhance communication, emotional well-being, and care planning.</p><p>AI companions represent a breakthrough in this space. Powered by natural language processing and machine learning, these digital companions offer consistency, patience, and adaptability—qualities critical for memory care residents. They provide companionship while simultaneously gathering and analyzing data about residents’ behaviors, moods, and preferences, enabling caregivers to offer more personalized care.</p><h3>Pilot Program Findings</h3><p>A pilot study conducted by Pacific Living Centers in collaboration with CloudMind deployed "Kathy," an AI companion, across six memory care communities in Oregon. Over 65 days, 18 residents aged 70-90, all with dementia diagnoses, interacted with Kathy. The study aimed to evaluate three core questions:</p><ol><li>Can AI companions improve the lives of memory care residents?</li><li>Can they support caregivers in their daily responsibilities?</li><li>Do they present a viable business opportunity?</li></ol><p>The findings were promising. Residents engaged with Kathy for an average of 47.8 minutes daily, with some residents logging as much as 59 minutes per day. The AI companion's ability to detect and respond to emotional cues through sentiment analysis was a highlight. By providing daily reports on residents' emotional states, health concerns, suggested actions, and engagement levels, Kathy empowered caregivers to make informed decisions and intervene proactively.</p><h3>Case Studies: Transformative Resident Experiences</h3><p>Two participants in the pilot program illustrate the potential impact of AI companions:<br></p><ul><li>Carrie, a resident with mild dementia and anxiety, interacted with Kathy for short daily sessions. These engagements reduced her anxiety episodes by over 50 percent during the study period. Kathy's recommendations about environmental adjustments, such as lighting and temperature, further improved Carrie’s comfort and quality of life.</li><li>Barbara, a resident with moderate dementia and social withdrawal, displayed remarkable engagement with Kathy, spending over three hours per session discussing scripture and singing hymns. Her reliance on caregiver interventions decreased significantly, highlighting the AI companion's ability to foster emotional connections and reduce caregiver workload.</li></ul><h3>Benefits for Caregivers and Families</h3><p>Beyond supporting residents, AI companions offer substantial benefits and augmentation for caregivers. By automating routine tasks and gathering critical behavioral data, they free caregivers to focus on high-value activities such as personalized care. Kathy’s real-time reporting capabilities alerted caregivers to potential health concerns, enabling earlier interventions that prevented complications.</p><p>For families, AI companions serve as a bridge, keeping them informed about their loved ones' conditions. Features such as daily conversation summaries or facilitating video calls add transparency and connection, fostering trust and collaboration in care delivery.</p><h3>Challenges and Ethical Considerations</h3><p>Despite their promise, implementing AI companions in memory care raises several challenges. Data privacy, the risk of overreliance on technology, the need for caregiver training, and managing family expectations are critical considerations. Ensuring that AI solutions respect residents' autonomy while balancing personalization with ethical data use remains a priority for developers and care providers.</p><h3>Future Directions</h3><p>The success of Kathy highlights the potential for broader adoption of AI companions in memory care. Future enhancements may include multimodal interaction, robotics integration, and predictive analytics to further personalize care. Expanding these capabilities while addressing ethical concerns will be essential for maximizing their impact.</p><p>This pilot represents just the beginning. Future studies will further explore how AI companions like Kathy can foster meaningful social interactions among residents, alleviate caregiver workloads, and reassure families through real-time updates and insights. By gathering more data and exploring diverse resident profiles, these initiatives aim to uncover new ways AI can enrich memory care, ensuring compassionate, personalized, and effective support for all stakeholders.</p><p>As the technology evolves, AI companions could transform not only memory care but also other domains of elder care, offering scalable solutions for a growing aging population.</p><p>The pilot study with Kathy demonstrates that AI companions can enhance the quality of life for memory care residents while reducing caregiver strain. By fostering meaningful interactions, automating routine tasks, and providing actionable insights, these digital companions represent a promising frontier in compassionate and innovative care delivery.<br></p><h4><span class="ms-rteStyle-References">References</span><br class="ms-rteStyle-References"><ul><li><span class="ms-rteStyle-References">Alzheimer's Association. (2023). Understanding Alzheimer’s Disease and Memory Care. Retrieved from https://www.alz.org</span></li><li><span class="ms-rteStyle-References">Smith, J., & Doe, A. (2022). AI in Health care: Transforming Elderly Care. Journal of Health care Innovations, 15(4), 33-45.</span></li><li><span class="ms-rteStyle-References">Pacific Living Centers. (2024). Pilot Study on AI Companions in Memory Care.</span></li><li><span class="ms-rteStyle-References">CloudMind. (2024). AI Companion Applications in Elder Care Facilities.</span></li><li><span class="ms-rteStyle-References">Javed, M., & Kumar, P. (2021). Ethical AI: Balancing Innovation with Privacy. Ethics in Technology, 8(2), 21-30.</span></li><li><span class="ms-rteStyle-References">Yuste, R., & Goering, S. (2017). Ethical challenges in the application of AI in health care. Nature, 551(7682), 159-163.</span></li><li><span class="ms-rteStyle-References">Miller, T., & Brown, R. (2020). Emotional AI and its role in elder care. Journal of AI & Society, 35(1), 45-60.</span></li><li><span class="ms-rteStyle-References">American Geriatrics Society. (2021). Advancements in Memory Care Technologies. AGS Research Series.</span></li></ul></h4><p><em><br></em></p><p><em>Dr. Christian A. Mason is President and CEO of Senior Housing Managers. Dr. Monica Tsai is co-founder and CEO of CloudMind Software. Tim Fields is founder of CloudMind Software. Carl Mason is president and chief operating officer of Senior Housing Managers. Michele Nixon is vice president of operations for Pacific Living Centers.<br></em></p><span><p><strong>About Pacific Living Centers</strong><br>Pacific
Living Centers offers memory care homes for older adults focused on
comfort, personalized care, and enjoyable moments. With a focus on
providing personalized quality care and maintaining communication with
families, we offer the peace of mind families need and deserve. Pacific
Living Centers is proudly managed by Senior Housing Managers, serving
seniors and their families since 1990.<br></p><p>To learn more about Pacific Living Centers, visit their website at <a href="https://pacificlivingcenters.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">https://pacificlivingcenters.com/</a><br></p><p><strong>About CloudMind</strong><br>At
CloudMind, our mission is to enhance the quality of life for elderly
individuals facing memory challenges. Through our AI companion,
BRiGHTPATH, we aim to alleviate loneliness, stimulate cognitive
engagement, and provide personalized support. At the same time, we
empower caregivers with tools and resources to better assist their loved
ones, fostering a comprehensive ecosystem of care and connection.<br></p><p>To learn more about CloudMind, visit their website at <a href="https://cloudmind.me/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">https://cloudmind.me/</a> or contact them at <a href="mailto:contact@cloudmind.me" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">contact@cloudmind.me</a>.</p></span><p><br></p> | 2025-02-18T05:00:00Z | <img alt="" src="/Articles/PublishingImages/2025/AI_memory.jpg" style="BORDER:0px solid;" /> | Technology | AI continues to redefine health care, offering tools that address complex challenges with precision and scalability. Among its most promising applications is the use of AI companions in memory care. |
Modern Care for a Modern World | <p><strong class="ms-rteForeColor-2" style="">ADVERTORIAL</strong></p><p><br></p><p>At its most basic, health care has not changed much—a skilled clinician diagnosing and treating ailments is as old as time. But everything else has changed, and nowhere is that more apparent than in the skilled nursing industry.</p><p><a href="http://tapestryhealth.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><img src="/Articles/PublishingImages/2025/TapestryHealth.png" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:100px;" /></a>Today’s nursing homes are expected to accept higher acuity patients with multiple co-morbidities, more psychiatric patients, and more patients that a few years ago would not even be considered for discharge. And if they are unable to provide the necessary care and the patient is re-hospitalized, there are fines and reputation issues that can impact the facility for years. Add to that more regulatory and compliance issues than ever before, along with the cost of maintaining a modern facility, and it is easy to see why America is losing skilled nursing facilities at a frightening pace.</p><p>One solution can be found in technology, and the pressure is mounting from all sides for SNFs to upgrade their technological capabilities. Patients, families, and, most importantly, hospitals are placing more weight on the level of advanced technology available to ensure the highest level of care.</p><p>Every facility in the country has been forced to look at technology not as an advancing foe but as the potential savior. Yet adoption is still dangerously slow. In many facilities, half-measures provide the illusion of advanced technology while never fully embracing it.</p><p>An administrator needs look no further than their electronic health records (EHRs). While you may have a computerized system, that system is only as good as the data that populates it. Are your nurses taking vital signs and then entering them into the system at a later time? Are all those entries accurate? How often is Patient A’s data entered as Patient B? And what are you doing with the data? Who is looking at it? Who is turning that data into usable directions that will improve care and boost efficiency among the nursing staff?</p><p>Telemedicine is another valuable tool that too often passes for a facility’s primary technology. Assuming that your telemedicine provider is keeping up with the latest technology, it can be a valuable, even life-saving, tool. But it is no longer enough.</p><p>In the current health care environment, a skilled nursing facility needs the most advanced technology available. Most facilities conflate that with the most advanced technology they can afford, and that may be one of the biggest reasons for failing to take advantage of what is available.</p><p>The other is simply fear. Learning something new can be difficult. And new technologies can be surpassed by even newer ones. If your nurses need a 10-year-old to program the TV (and many of us do), they might not be quick to embrace technology. It is incumbent on the facility to research and install technology that is both advanced, simple to use, and one that will stay current. Companies like TapestryHealth that know the SNF industry and have been at the forefront of vetting and incorporating technology specifically geared for the day-to-day operations of a SNF are delivering exactly that.</p><p>Technology, like continual patient monitoring, not only eliminates human error—no more heart rates written on a notepad for later entry into the EHR—but collects data non-stop and can alert a nurse to any sudden change that might indicate the need for medical intervention.</p><p>TapestryHealth is one company that utilizes that data and similar data from thousands of patients in hundreds of facilities from coast to coast to create a pool of information, treatment data, and outcomes that can be used to power predictive modeling programs. These advanced systems can predict with startling accuracy potential outbreaks of dangerous infections and other conditions that often lead to hospitalizations and sometimes even to the death of a patient, as much as 72 hours in advance of any visible symptoms. That has been proven to be enough in many cases to prepare the facility and the patient and avoid any acceleration of the issue and potential hospitalizations. Moreover, advances in radar wave technology assure complete privacy and 100 percent contactless monitoring.</p><p>TapestryHealth’s technology solutions are vetted by nursing home professionals—doctors, nurses, administrators, and operations executives from within the industry, who are uniquely suited to evaluate each one and make sure it delivers solutions specific to the needs and the environment of a nursing home. And TapestryHealth doesn’t charge the facility anything for its services. Everything they provide is covered by public or private insurance. What’s more, TapestryHealth guarantees to keep its customers updated with their latest services at no cost.</p><p>While these devices and services may sound terribly complicated and may even sound like nurses are being asked to learn a whole new health care language, the fact is that the learning curve is dramatically short and easy. Health care in nursing homes is not what is changing; it still comes down to a skilled, compassionate clinician providing bedside care to an elderly patient. What technology has done is elevate the quality, effectiveness, and timing of that care to a lifesaving level.</p><p>To understand more about technology in skilled nursing facilities, and how it can impact the level of care, reputation, and profitability, contact TapestryHealth at (203) 721-6822 or visit <a href="https://tapestryhealth.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">TapestryHealth.com</a>.<br></p> | 2025-02-06T05:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/0820_News2.jpg" style="BORDER:0px solid;" /> | Caregiving;Telemedicine | In the current health care environment, a skilled nursing facility needs the most advanced technology available. |
5 Steps to Reconfigure Skilled Nursing Facilities to Assisted Living Facilities | <p><img src="/Articles/PublishingImages/2025/SkaalenCBRF-1.jpg" alt="Resident room with comfortable space with more windows" class="ms-rtePosition-2" style="margin:5px;width:200px;height:200px;" />Staffing has long been one of the most pressing challenges in the long-term care industry. Chronic shortages are a persistent issue, and the new Centers for Medicare & Medicaid Services (CMS) regulations, which increase staffing requirements, have only added to the complexity. As providers grapple with these demands, one strategy gaining traction is the reconfiguration of skilled nursing facilities (SNFs) into spaces with less intensive staffing needs, such as assisted living facilities (ALFs). This approach not only reduces operational costs but also revitalizes the care offerings of long-term care campuses. Here’s a guide to successfully transition a skilled nursing facility to an assisted living model.</p><p><strong>Step 1: Define Program Goals and Engage Stakeholders</strong><br>The first step is to set clear program goals and define the elements you want to incorporate into the new environment. To ensure a resident-centered and operationally efficient design, include input from both residents and staff.</p><p>Key considerations:<br></p><ul><li>Target Resident Demographics: What level of care will the facility provide? Will it cater to residents with early cognitive impairments or focus on general assisted living?</li><li>Licensing Requirements: Collaborate with state authorities to understand the licensing processes and requirements for transitioning your building(s).</li><li>Operational Balance: Work closely with staff to align care and service offerings. For instance:</li><ul><li>How will food service staff interact with residents and colleagues?</li><li>What meal delivery methods will be used, and will residents participate in cooking activities?</li><li>How can efficient layouts minimize staffing needs?</li></ul></ul><p>Collaborating with an architect to address these elements is crucial. Owners should clearly outline expectations for critical systems such as wander management; nurse call systems; heating, ventilation, and air conditioning (HVAC); and emergency power backup. Additionally, plans for new safety procedures, including updated fire safety protocols, must be established to ensure compliance during construction.</p><strong><img src="/Articles/PublishingImages/2025/SkaalenCBRF-2.jpg" alt="bump-outs, accent lighting, and resting areas in corridors " class="ms-rtePosition-2" style="margin:5px;width:200px;height:200px;" />Step 2: Assess the Current Facility</strong><p>To make informed decisions, conduct a thorough evaluation of the existing facility or campus to determine its suitability for the new use. Building codes and design requirements for assisted living differ significantly from those for skilled nursing facilities.</p><p>Structural Modifications:<br></p><ul><li>Corridor Widths: Assisted living facilities do not require the 8-foot-wide corridors mandated for SNFs. Explore opportunities to repurpose this space to enhance unit layouts.</li><li>Kitchenettes: Adding kitchenettes to units is a common upgrade. Plan how to reconfigure existing spaces to accommodate these features along with living and dining areas.</li><li>Property Layout: Aim to move away from the institutional feel of SNFs by introducing design elements to enhance the architectural rhythm, such as wall bump-outs and accent lighting in corridors to create a warm and inviting atmosphere.</li></ul><p>Safety and Compliance:<br></p><ul><li>Fire Protection: Unlike SNFs, community-based residential facilities (CBRFs) often require smoke detectors connected to a central alarm system in each resident-occupied space. Address any gaps to meet these requirements.</li><li>Evacuation Standards: Depending on the physical and cognitive capabilities of a resident’s ability to self-evacuate, assisted living facilities may require residents to be ambulatory and capable of self-preservation during emergencies. Adjustments to window operation, door hardware, and resident room layouts may be necessary to meet these standards.</li><li>Lighting and Ventilation: Evaluate the need for additional windows or daylighting to create a comfortable environment for residents in shared spaces.</li></ul><p>Compliance with building codes is paramount. States often adopt the International Building Code (IBC) but may also have unique requirements. Engage an architect familiar with local codes to navigate these complexities and consult with the authority having jurisdiction (AHJ) early in the process.</p><p><strong>Step 3: Avoid Common Pitfalls</strong><br>Transitioning a skilled nursing facility to an assisted living model is a complex process with potential obstacles. Here are some key pitfalls to watch for:<br></p><ul><li>Licensing and Timeline Oversights: Ensure that licensing requirements are well understood and that submissions to the AHJ are timely to avoid construction and licensure delays.</li><li>Resident Disruptions: Minimize disruptions during renovations by creating viewing areas, offering guided tours, and maintaining operational support spaces. Consider temporarily relocating residents who may struggle with the changes because of physical challenges or emotional distress.</li><li>Mechanical, Electrical, and Plumbing (MEP) Systems: Understand how these systems are integrated throughout the building. Proper planning is essential to keep them operational in occupied areas during construction.</li><li>Lack of Coordination: Engage with the AHJ early to confirm requirements, seek variances where needed, and secure consensus with code officials on the overall plan.</li><li>Construction Oversights: Obtain approvals and inspections at critical milestones. For example, ensure equivalent construction ratings are maintained and avoid exceeding allowable building areas.</li></ul><p><strong>Step 4: Foster Clear Communication and Collaboration</strong><br>Effective communication is the cornerstone of a successful transition. Establish clear lines of communication among owners, architects, construction managers, and code officials to:<br></p><ul><li>Clearly define licensing requirements and building modifications.</li><li>Manage cost issues and set realistic budgets.</li><li>Document responsibilities to avoid misunderstandings and overlaps.</li></ul><p>Owners play a pivotal role in leading these efforts, ensuring all parties are aligned and focused on meeting project objectives.</p><p><strong><img src="/Articles/PublishingImages/2025/Julie-Heiberger.jpg" alt="Julie Heiberger" class="ms-rtePosition-2" style="margin:5px;width:200px;height:200px;" />Step 5: Set Yourself Up for Success</strong><br>Transforming a skilled nursing facility into an assisted living model is a multifaceted endeavor that requires careful planning and execution. By defining program goals, assessing the facility’s capabilities, avoiding common pitfalls, and fostering collaboration, you can navigate the complexities of this process with confidence.</p><p>This transition offers a unique opportunity to create a modern, resident-centered care environment while addressing staffing challenges and operational efficiencies. With thoughtful planning and execution, providers can successfully reimagine their care offerings and meet the evolving needs of their communities.<br><br><em>Julie Heiberger, AIA NCARB LEED AP, is a senior project architect and the senior living market leader for <a href="https://www.hoffman.net/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Hoffman Planning, Design & Construction, Inc. </a>with more than 30 years of experience. A member of the American Institute of Architects and the National Council of Architectural Review Boards, Julie received her Master of Architecture from the University of Wisconsin–Milwaukee. She can be reached at <a href="mailto:jheiberger@hoffman.net" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">jheiberger@hoffman.net</a>.</em><br></p> | 2025-01-30T05:00:00Z | <img alt="" src="/Articles/PublishingImages/2025/SkaalenCBRF-2.jpg" style="BORDER:0px solid;" /> | Assisted Living;Management | As providers grapple with new demands, one strategy gaining traction is the reconfiguration of skilled nursing facilities into spaces with less intensive staffing needs, such as assisted living facilities. |
How to Structure Your Compliance Program | <p><img src="/Articles/PublishingImages/2025/nurse_paperwork.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:200px;" />Nursing, assisted living, and post-acute facilities have long been an area of scrutiny by the Office on Inspector General (OIG) as they are high-risk areas. It is important that an organization have a formal compliance program as proactive and preventive; a structure to address issues; and as a mitigating factor should compliance violations be identified by regulatory agencies.</p><p>OIG recognizes a common structure for compliance programs centered around seven elements. They are:<br></p><ul><li><strong>Written policies, procedures, and standards of conduct</strong></li></ul><ol><li>How accessible are they to all employees?</li><li>How often are they reviewed?</li><li>What is the process/procedure for review and approval?</li><li>Are they written in understandable language?</li></ol><p>As an example, every policy is subject to review every three years. However, they can be revised at any time. Front-line employees who actually work with the policies should be free and encouraged to make revision recommendations. As policies may impact areas outside of the department owner, an interdisciplinary committee can review them to avoid conflicts and also provide ideas to strengthen them.</p><ul><li><strong>Designated compliance officer and compliance committe</strong>e</li></ul><ol><li>Does the compliance officer report to the CEO directly with independent access to the board?</li><li>The compliance officer should not lead or report to the entity’s legal or financial functions.</li></ol><p>A compliance committee of designated Board members meets on a quarterly basis with a standing agenda. The only member of management present is the compliance officer or its staff so that issues can be presented and openly discussed without management interference or filters.<br></p><ul><li><strong>Effective training for success</strong></li></ul><ol><li>Identify required training by regulatory and accrediting bodies.</li><li>What training is required? What should be conducted for all employees annually?</li><li>How is effectiveness measured?</li></ol><p>Compliance can also develop custom-designed training to address specific reoccurring issues in identified departments. An example is one for Health Insurance Portability and Accountability Act (HIPAA) incidents with identification of their root cause and corrective/preventive actions. The staff usually appreciate the effort and attention shown to help them.<br></p><ul><li><strong>Effective lines of communication</strong></li></ul><ol><li>Have a variety of reporting mechanisms that can be used to report concerns or incidents.</li><li>How are the lines communicated? Are employees aware of them?</li></ol><p>A hotline incident management reporting system can help the compliance officer track, manage, assign, quickly access and review cases and develop metrics of where to place compliance priorities. This should have an anonymous reporting feature and be available to the public for reporting access.<br></p><ul><li><strong>Enforcing standards: consequences and incentives</strong></li></ul><ol><li>They should be publicized and made available.</li><li>Consistently applied and enforced.</li></ol><p>Adherence to compliance standards can be a rated factor in performance evaluations.<br></p><ul><li><strong>Internal auditing and monitoring</strong></li></ul><ol><li>Be proactive and reactive.</li><li>Communications and approach should be working as a business partner with managers for quality and process improvements.</li></ol><p>Compliance should work as a team member with other departments in identifying and monitoring, through audits, opportunities for process improvements that can mitigate risks, make employees’ jobs easier, and increase revenue. One example, in an ambulatory care setting, is improving patient wait times.<br></p><ul><li><strong>Responding to detected offenses and developing corrective action initiatives</strong></li></ul><ol><li>Processes and resources should exist to address them.</li><li>Investigations, corrective actions, and resolutions should be prompt</li></ol><p>Standard timelines should be developed for investigations to be completed. Points-of-contacts in departments should be identified to whom incidents should be sent.</p><p><img src="/Articles/PublishingImages/2025/Robert-Rohr.jpg" alt="Robert Rohr" class="ms-rtePosition-2" style="margin:5px;width:175px;height:175px;" />This model provides a recognized structure for preventing, addressing, and resolving compliance issues in an organization. It is flexible in how organizations choose to develop programs to address them within available resources.</p><p>An annual compliance plan should be developed with the activities and their goals to support each element. An excellent guide for ideas can be found in <em>Measuring Compliance Program Effectiveness: A Resource Guide,</em> HCCA-OIG Compliance Effectiveness Roundtable Meeting: January 17, 2017.<br><br><em>Robert Rohr, J.D., M.A, CHC, SPHR is the director of corporate compliance for Sun Life Health, a federally qualified health center, with 14 locations in southern Arizona. He can be reached at <a href="mailto:robert.rohr@slfhc.org" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">robert.rohr@slfhc.org.</a></em><br></p> | 2025-01-21T05:00:00Z | <img alt="" src="/Articles/PublishingImages/2025/nurse_paperwork.jpg" style="BORDER:0px solid;" /> | Management;Policy | It is important that an organization have a formal compliance program as proactive and preventive; a structure to address issues; and as a mitigating factor should compliance violations be identified by regulatory agencies. |
Health Plan Focused Value-Based Care in Nursing Homes | <p><strong class="ms-rteForeColor-2">ADVERTORIAL</strong><br></p><p>Provider Partners is a value-based care (VBC) company singularly focused on nursing homes, assisted living facilities (ALF), and personal-care homes. Provider Partners offers services in three lanes: I-SNP, IE-SNP, and ACO-REACH. From my perspective as the founder of Provider Partners, the VBC model creates a real opportunity to better align the wants and needs of residents, their families, nursing home operators, the health plan, and CMS. That’s a tough combination of constituencies to please at the same time.</p><h3>What Makes VBC Models Work?</h3><p><img src="/Articles/PublishingImages/740%20x%20740/0120_News1.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:200px;" />Models of care that align success metrics with outcomes create powerful incentives to keep individuals well and reduce the need for costly services. A typical inpatient hospitalization costs Provider Partners $8,000 - $15,000. A complex stay, such as with a trach and ventilator, can cost over $100,000.</p><p>VBC models are successful when they identify and deal with issues early. It certainly costs a lot more to provide the staffing and enhanced level of intense services that can identify ailments as they are germinating, yet still minor. We employ a team of nurse practitioners and RN case managers who supplement those services provided by the attending physician, specialists, and nursing facility team. It’s an expensive proposition to hire, train, teach, and monitor the activities of this large group. We don’t bill for their services and their activities do not conflict with those of a primary care physician.</p><p>Trying to monitor every individual to achieve early detection and intervention requires close attention to leading indicators of changes of condition. A tool that is essential to this oversight is one that delivers targeted data analytics, such as Real Time Medical Systems. Obtaining clear concise data in real time is a key early warning signal that helps us reduce admissions and readmissions in skilled nursing facilities.</p><h3>What Does This Accomplish?</h3><p>Frequent hands-on interaction that complements and enhances that of the primary care team provides a dramatically greater opportunity to catch those changes in condition early before they reach critical mass. Our model doesn’t revolve around decisions about whether to approve services—it focuses on making many high intensity services unnecessary by dealing with illness at that earlier stage.</p><p>This approach has been proven by Provider Partners and other VBC entities to improve outcomes and quality of care. Nursing home and ALF residents and their families experience much higher satisfaction for two simple reasons—greater interaction with the clinical team and fewer urgent trips for emergency services. Overall costs are significantly reduced. Not only are direct medical costs reduced but so are the affiliated costs such as transportation expenses. All of this is measurable.</p><h3>What Are Some Challenges? </h3><p>Provider Partners is owned and managed by former owners and operators of nursing home and assisted living facilities. We partner with facilities as a true value-added service. We must communicate and coordinate with the facility operator, primary care physician, administrator, director of nursing, and medical director.  This is our true secret sauce. Building rapport at all levels and really knowing our members is what makes this work. That requires training, reinforcement, and support from the facility and Provider Partners leadership.</p><h3>What About Non-Hospital Services?</h3><p>Trends in nursing home care over the past decade clearly demonstrate a need for non- hospital services that can be provided, when possible, in the facility. Nursing home administrators and directors of nursing covet relationships with behavioral health providers, wound care specialists, and therapy vendors. Those vendors want to attain a certain level of service utilization to make it worth their while to come to a facility. </p><p>One of the challenges to managing a VBC model is attaining a balance between “routine” follow-up visits and reasonable medical necessity criteria. There is a significant degree of excessive “routine” specialty visits for nursing home residents who are quite stable or have disorders that would no longer benefit from ongoing regular follow up. Efforts to address these “affordability” issues create the ongoing need for monitoring and engagement by VBC health plans. This process greatly reduces the frequency of Medicare fraud, waste, and abuse issues.</p><h3>Summary</h3><p>Experienced clinicians working in the value-based care environment are fully committed to creating a high standard of care for our most vulnerable populations. We strongly believe that this model provides the best opportunity to align incentives in order to do right by our members. Provider Partners is dedicated to working with long term care providers to improve quality and allow them to participate in the share of savings that is created.</p><p><img src="/Articles/PublishingImages/740%20x%20740/ScottRifkin.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:200px;" />Learn more at <a href="http://www.partnerwithpphp.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">partnerwithpphp.com</a> or reach us at <a href="mailto:info@pphealthplan.com" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">info@pphealthplan.com</a>.<br><br><em>Scott Rifkin, MD, is the founder of Provider Partners and has 30 years of long term care experience as a medical director, attending physician, and as an owner of 23 skilled nursing facilities. He has spoken extensively at conferences on the topics of value-based care and regulatory issue reduction. Dr. Rifkin has served on the boards of the Pennsylvania Health Care Association, The Health Facilities Association of Maryland, and Maryland’s LifeSpan. </em><br></p> | 2025-01-16T05:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/0120_News1.jpg" style="BORDER:0px solid;" /> | Caregiving | The VBC model creates a real opportunity to better align the wants and needs of residents, their families, nursing home operators, the health plan, and CMS. |
Long Term Care 2025 Trends and Outlook | <p><img src="/Articles/PublishingImages/740%20x%20740/nurse_patient.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:200px;height:200px;" />Long term care services are in greater demand than ever. Given that the oldest Baby Boomers will turn 80 next year, the industry has responded by improving operations, leveraging technology, monitoring legislation, and focusing on wellness. These efforts will show in 2025 as the industry addresses needs, capitalizes on growing trends, and continues to deliver the best care to those in need and their families.</p><p>“Long term care is ever-changing: we continue to innovate, find new approaches to quality care, assess our regulatory environment, and seek ways to improve it,” Clif Porter, president and CEO of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), said. “We are a profession that continues to evolve and welcome change. One thing that hasn’t changed—and never will—is our commitment to quality for our residents. By leading with quality, the skilled nursing profession will be poised for success.”</p><p>Porter said assisted living continues to grow steadily, demonstrating its value and satisfaction among seniors. Skilled nursing care continues to be critical to the nation’s health care continuum. He also noted that despite these signs of growth, workforce challenges remain a top challenge, impacting nearly every skilled nursing facility nationwide.<span><img src="/PublishingImages/Headshots/ClifPorter.jpg" alt="Clif Porter" class="ms-rtePosition-2" style="margin:5px;width:150px;height:184px;" /></span></p><p>“We have yet to return to our pre-pandemic workforce levels by a deficit of more than 100,000 workers. This is not about a lack of trying to hire more caregivers: nearly every nursing home in the nation is doing everything possible to fill open positions and recruit more workers,” said Porter. “The reality is that there simply aren’t enough nurses and nurse aides to meet the demand, and we desperately need meaningful workforce solutions to grow our pipeline of qualified caregivers. We remain resolved to offer those solutions on Capitol Hill and to defeat impractical ones, like the federal staffing mandate, which I’m optimistic we can achieve next year.”</p><h3>Growing Needs in Assisted Living</h3><p>A foreseeable challenge facing assisted living will be managing the growing needs of a population that is entering assisted living with more chronic conditions, said LaShuan Bethea, executive director of NCAL.</p><p><img src="/PublishingImages/Headshots/LaShuanBethea_2022.jpg" class="ms-rtePosition-2" alt="LaShuan Bethea" style="margin:5px;width:150px;height:150px;" />“Assisted living communities must adapt to help residents manage these chronic conditions. As seniors age, they increasingly focus on health and wellness to maintain independence. Population health management will be essential in helping seniors stay healthy and enabling providers to offer more personalized and preventative care for seniors requiring assisted living services,” she said.</p><p>Integrating technology, such as wearables, can play an important role in helping providers monitor chronic conditions while helping residents remain independent and minimize the likelihood of health decline, she said.</p><p>Additionally, Bethea said, a critical challenge will be maintaining regulation at the state level.</p><p>“State regulations allow for a more tailored approach that reflects the unique needs of each community,” she said. “Preserving this at the state level will ensure that regulations remain flexible and responsive to the realities of providing care in diverse settings.”</p><h3>Addressing Staffing Shortages </h3><p>Leaders must be prepared to invest in competitive wages to recruit and retain while balancing these demands with inflationary pressures on expenses, according to Brian G. Lawrence, LNHA, CPA, MBA, president and CEO, FellowshipLIFE.</p><p>“We are exploring opportunities to recruit talent from abroad,” he said. “This decision has been assessed through a careful financial lens because of the time it may take for foreign recruitment to take shape. It’s crucial to involve financial experts in human resources and operational planning to ensure the organization can invest in quality staffing.”</p><p>Additionally, leaders cannot rely solely on compensation to retain high-quality employees. </p><p>“Today’s workforce expects an environment with a strong workplace culture that prioritizes their personal and professional development,” Lawrence said. “To retain skilled workers, leaders must be able to articulate the benefits of employment outside of compensation. They must also be willing to build longer onboarding periods, mentorship programs, and more personal skill development opportunities to demonstrate the organization’s investment in each employee.”</p><h3>Mentorships and Apprenticeships Support Staffing</h3><p>More programs involving various nursing homes with mentorship support are planned for 2025, according to James Chang, workforce development manager at New York-based organization, 1199SEIU Training and Employment Funds (TEF), which provides CNA mentorship training through its long term care, community-based organization, and pharmacy division for certified nursing assistants working with CNA apprentices.</p><p>“As a result of the implementation of the projects, the overall post-graduation retention rate of these CNA apprentices with their existing employers has been approximately 90 percent,” Chang said. “The mentorship training teaches the mentors about empathy and compassion, which helps them to build trust with their apprentices. They learn to coach the apprentices on how to practice active/reflective listening skills and learn to respect others in the workplace.”</p><h3>Pay and Benefits a Top Factor for Employees</h3><p>As for employee preferences, the JLL 2024 Employee Perspective on Healthcare Real Estate reports that pay and benefits are the top factors in choosing an employer. However, flexibility, specific roles, and location are important in employee attraction and retention.</p><p>Additionally, generational preferences vary for these workplace factors. Baby boomers prioritize flexibility, with 15 percent ranking it as their top factor, while Gen Z values workplace culture.</p><p>The greatest impact of a facility's location on employee experience is its safety, convenience, and proximity to affordable housing. Employee spaces like break rooms and offices received lower ratings than patient care areas for newness, maintenance, and sound privacy, affecting employee experience. </p><h3>Credentialing Changes</h3><p>Credentials will continue to play an important role in training and hiring. Doug Helman, COO, The Kendal Corporation, foresees a resetting of nursing and caregiver professional credentialing and a continued increase in physician extenders and telemedicine.</p><p>“The health  care workforce shortage has become very real,” he said. “Many health care and medical professionals elected to leave the field or away from direct patient care following the pandemic. While the Baby Boomer demographic is encouraging from a consumer perspective, it has conversely further contributed to the health care workforce shortage. This will translate to resetting credentialing requirements for all licensed health care workers.”According to Helman, “Many state nursing and medical boards will reevaluate their credentialing requirements to address the shortage. This will result in more certified medication aides to support the nursing shortage and more nurse practitioners or physician assistants to support the family medicine and geriatrician shortage.”</p><h3>Wellness as Part of Person-Centered Care</h3><p>Alice Bonner, director of the Moving Forward national coalition, said nursing homes “aren’t just sites of care. They are people’s homes. Residents need to not only direct their care but have a say in the function and communal life of the nursing home,” Bonner said. “Empowering resident councils is vital to ensuring residents have that voice.”</p><p>Erin Caswell, COO, Revel Communities, said her company prioritizes listening to the voices of its independent living residents. Their feedback aligns with 2025 industry trends, highlighting the importance of autonomy and easy access to comprehensive health and wellness services.</p><p>Revel partners with personal trainers, physical and occupational therapists, concierge health care providers, primary care physicians, and mental health specialists to deliver multidimensional care directly to residents in the comfort of their homes and communities. </p><h3>Wellness Accentuated Through Interior Design</h3><p>A facility’s design can lead to healthier living environments, according to Johnny Dagher, director of senior living design, Baker Barrios Architects.</p><p>“Wellness has long been a central focus in the design of senior living facilities,” Dagher said. “Designers and owners have consistently prioritized elements like natural lighting, outdoor spaces, fitness areas, indoor air quality, and accessible design features. While many of these aspects are guided by building codes and shaped by lessons from the pandemic, the current emphasis has shifted toward leveraging wellness as a key selling point.”</p><p>Dagher also anticipates seeing design models that better accommodate individuals who fall between different care levels, such as those transitioning from assisted living to memory care or from independent living to assisted living.</p><p>“There’s a clear need for middle-ground services that offer more support than typical assisted living without requiring memory care,” Dagher said. “Similarly, there will be a demand for options that allow residents more independence while still having access to all the services provided in traditional assisted living.”</p><h3>Technology and AI Help Communities Optimize Efforts </h3><p>Companies are examining the requirements for value-based care models, which may require specific health information technology (HIT) capabilities (e.g., health information exchange) to enhance and improve care delivery by 2030. Technology is a key component for optimizing communities’ efforts to stay ahead.</p><p>However, Gregory L. Alexander, PhD, RN, FAAN, FACMI, FIAHSI, Helen Young CUPHSONAA Professor and Informaticist, Columbia University School of Nursing, said there are significant structural technology disparities among US nursing homes may lead to greater disparities in value-based care, such as poorer patient outcomes and lower quality of care with greater costs. Many of these problems may be exacerbated by a facility's rurality or size, he said.</p><p>“Document-sharing systems for nursing homes are receiving more attention as leaders realize that technology is here to stay and may provide important benefits, like more timely access to critical resident information when a resident’s condition changes,” Alexander said.</p><p>Experts identified AI, robotics, and virtual reality as important emerging capabilities that integrate technological components into care delivery and should provide new opportunities to address the challenges of caring for older adults in new ways. </p><p>“Corporate long term care companies with IT departments may be the first to take advantage of these capabilities because they have the departments and infrastructure to support them,” said Alexander. “There’s much promise in these emerging technologies, but leaders must approach their use cautiously.”</p><p>One example of increased adoption of AI is at Maplewood Senior Living, with communities across the Northeast. Resident-focused innovations include AI-enabled life story platforms that allow residents and families to upload cherished memories, providing easy access to life highlights; wearable, predictive health monitoring systems for early detection of health issues and real-time updates; and machine vision AI safety systems for fall detection and prevention.</p><p>Maplewood also employs operational AI enhancements such as automated financial processing tools and AI-driven planning systems for sustainable and accurate operations and streamlined resident transition platforms to enhance the move-in experience.</p><p>These advancements will continue to provide tangible benefits, offering peace of mind, enhanced safety, and personalized care for residents while reducing burnout and improving job satisfaction among frontline staff, according to Brian Geyser, vice president of enterprise intelligence at Maplewood.</p><p>“Looking to 2025 and the years ahead, AI is positioned to revolutionize how we deliver resident care,” he said. “Our goal is to ensure that innovation enhances—rather than replaces—the personal connections that are the foundation of exceptional senior care.”</p><p>Doug King, vice president emeritus of health care at PMA, said new technology has made it easier for seniors to live independent lives.</p><p>“From the wide adaptation of telehealth to the increasing use of wearables that can track health indicators, monitor for red flags and even alert the proper authorities in the event of a fall or accident,” King said. “In 2025, we will see even broader adoption of these tools and services in the world of senior living. For example, many health care providers are developing digital twins of patient bodies, which can be used to predict and optimize health outcomes through advanced analysis and modeling.”</p><h3>Affordability Still a Challenge</h3><p><img src="/PublishingImages/Headshots/PaulBergeron.jpg" alt="Paul Bergeron" class="ms-rtePosition-2" style="margin:5px;width:150px;height:150px;" />Affordability remains broadly unsolved, though new design trends are emerging, according to Zach Bowyer, executive managing director, Cushman & Wakefield.</p><p>“With middle-income seniors projected to double by 2029, over half of this segment will not have adequate finances to afford conventional senior living and care,” he said. <br></p><p><em>Paul Bergeron is a freelance writer based in Herndon, VA.</em><br></p> | 2025-01-14T05:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/nurse_patient.jpg" style="BORDER:0px solid;" /> | Caregiving | Long term care services are in greater demand than ever. The industry has responded by improving operations, leveraging technology, monitoring legislation, and focusing on wellness. |
Polypharmacy Is a Problem in Senior Care | <p><img src="/Articles/PublishingImages/740%20x%20740/medications_4.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:200px;height:200px;" />Polypharmacy, the concurrent use of multiple medications by a patient, is a growing concern in senior care. As the elderly population continues to grow, so too does the prevalence of chronic conditions that require pharmaceutical intervention. However, while medications can be life-saving, the indiscriminate use of multiple drugs often leads to adverse effects, drug interactions, and diminished quality of life for seniors.</p><p>Addressing polypharmacy is not just a medical issue; it's a critical aspect of providing holistic, patient-centered care that respects the complexities of aging.<br></p><h3>The Complex Challenges of Polypharmacy</h3><p>I've seen firsthand the challenges that polypharmacy presents. The traditional approach to treating multiple conditions often results in a fragmented care model, where specialists focus on individual diseases without fully considering the cumulative impact of their prescriptions. This lack of coordination can lead to seniors taking an overwhelming number of medications, sometimes without a clear understanding of their purpose or potential side effects. The result is a cycle where one drug's side effects are managed by another, compounding the problem rather than addressing the root cause. The complexity of managing multiple medications is already overwhelming for seniors and their caregivers, but this can increase issues with adherence, incorrect dosing, and confusion about the purpose of each drug.</p><p>Polypharmacy also heightens the risk of adverse drug reactions (ADRs), which can be both severe and difficult to diagnose. Seniors are often more vulnerable to side effects due to age-related changes in metabolism and organ function, so the likelihood of experiencing negative interactions between medications rises exponentially with each additional drug. This can lead to a cascade of health problems, including cognitive decline, falls, and hospitalizations, which not only compromise the quality of life for seniors but also place a significant strain on health care resources.<br></p><h3>How Can We Tackle the Issues Presented by Polypharmacy?</h3><p>The solution lies in a multifaceted approach that brings together health care professionals, patients, and caregivers. Addressing the challenges of polypharmacy requires a proactive and collaborative approach that begins with comprehensive medication reviews. These reviews, conducted regularly by health care professionals, involve evaluating all of a patient’s medications to ensure that each one is necessary, effective, and safe. This process optimizes the medication regimen and provides an opportunity to engage in meaningful conversations with patients about their treatment goals and preferences, ensuring that their care aligns with their overall well-being.</p><p>The industry must also promote deprescribing initiatives. Deprescribing involves the intentional and systematic reduction of medications, particularly those that may no longer be beneficial or that carry a higher risk of adverse effects. This is not about withdrawing care but refining it to better meet patient needs, improve their quality of life, and minimize the risks associated with polypharmacy.</p><p>Education and empowerment of both patients and caregivers are also essential. Seniors and their families should be equipped with the knowledge and tools to actively participate in medication management. This includes understanding the purpose and potential side effects of each medication, recognizing signs of adverse drug reactions, and knowing when to seek help. Creating a more transparent and supportive environment within the senior care space, where medication decisions are made collaboratively, empowers seniors to take an active role in their care and have more confidence and autonomy in managing their health.<br></p><h3>The Role of Technology in Managing Polypharmacy</h3><p>Technology plays a transformative role in addressing the complexities of polypharmacy by enhancing the accuracy and efficiency of medication management. Electronic health records (EHRs) are at the forefront of this revolution, offering a centralized platform where all medication data is recorded and updated in real-time. This integration allows health care providers to access comprehensive medication histories, identify potential drug interactions, and avoid duplicative prescriptions. As a result, health care professionals can make more informed decisions, reduce the risk of adverse drug reactions, and streamline the medication review process.</p><p>Medication management apps and digital platforms further support this effort by providing both patients and health care providers with real-time insights into medication regimens. These tools can send reminders for medication adherence, track usage patterns, and provide easy access to information about drug interactions and side effects. Some apps even offer features that allow users to scan their medications and receive immediate feedback on potential issues.</p><p>Additionally, technology helps facilitate better communication and coordination among health care teams. Platforms that enable secure messaging and data sharing among different providers ensure that all members of the care team are aware of each patient’s medication regimen. This is particularly important in managing polypharmacy, as it helps to prevent conflicts between prescriptions from various specialists.</p><p><img src="/Articles/PublishingImages/2023/MelissaPowell.png" class="ms-rtePosition-2" alt="" style="margin:5px;width:129px;height:147px;" />Championing a comprehensive approach to polypharmacy allows us to revolutionize senior care. Embracing these practices not only enhances treatment safety but also reaffirms our commitment to elevating the quality of life for our elderly population, paving the way for a more compassionate and effective health care future.</p><p><em><em>Melissa Powell is </em><em>president and COO of The Allure Group, which manages six eldercare centers in New York City.</em></em><br></p> | 2025-01-07T05:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/medications_4.jpg" style="BORDER:0px solid;" /> | Clinical | Addressing polypharmacy is not just a medical issue; it's a critical aspect of providing holistic, patient-centered care that respects the complexities of aging. |