| Optimizing Medications for Fall Injury Patients | <p><img src="/Articles/PublishingImages/740%20x%20740/fall_risk.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:300px;height:300px;" />According to the National Council on Aging, an older adult suffering a fall-related injury is seen in an emergency department <a href="https://www.ncoa.org/article/get-the-facts-on-healthy-aging/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Get the Facts on Healthy Aging">every 11 seconds</a>. When patients arrive at a skilled nursing facility after breaking a bone in a fall, the focus is naturally on rehabilitation: physical therapy, pain management, wound care, and getting the patient mobile again. What often doesn’t happen is a careful review of the medications that may have increased their risk of falling in the first place, or a conversation about medications that could help prevent the next fall. This is the gap <a href="https://sites.duke.edu/prism/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">PRISM</a>—or Prevention of Injury in Skilled Nursing Through Optimizing Medications—hopes to close.<br><br>An ongoing study funded by the Patient-Centered Outcomes Research Institute (PCORI) and led by teams at Duke University School of Medicine and Harvard Medical School/Hebrew SeniorLife, PRISM revolves around a simple idea: that the days or weeks a patient spends in a SNF after a fall-related fracture is a rare, underutilized opportunity to rethink their medications. That might mean weaning off medications that increase fall risk, perhaps by causing drowsiness or dizziness; or it might mean adding treatment for osteoporosis, an often-undetected underlying condition that can increase the risk of fracture.<br><br>Forty-two SNFs have volunteered to participate. Working with a PRISM-provided fracture nurse consultant, who reviews medications and makes recommendations to the patient and patient’s care team, these SNFs are helping to answer the question about whether this approach improves patient outcomes. SNFs’ involvement after a simple onboarding process is critical to making this study succeed. <br></p><h2>“A Great Leverage Point”</h2><p>“Skilled nursing facilities are a really great leverage point to reach these patients,” said Cathleen Colón-Emeric, M.D., Professor of Medicine and Chief of the Division of Geriatrics at Duke University and PRISM’s principal investigator. “Sixty percent of these folks spend two weeks or so in post-acute care and in skilled nursing facilities receiving care, and that’s an opportune time to optimize their medications to improve their outcomes.”<br><br>“Taking the time to really think about those medications carefully and talk about them with a patient and family and make the decision to taper some of them is really important but takes a lot of provider time” she added. “We're trying to support the providers in doing that in a more efficient way.”<br><br>At San Francisco Center for Jewish Living, one of the participating SNFs, physician James Deardorff, sees PRISM as a way for SNFs to bring even more value to their patients by initiating needed conversations about appropriate prescribing. “Patients are here for an acute event, and so they’re more likely to be receptive to either de-prescribing or prescribing medications,” he said. “In this case, they’ve had a fracture that might be related to a fall and could be related to a medication adverse effect. I think this is a good time period to have these conversations.”<br><br>“We know that many people have underlying osteoporosis and don't receive treatment,” he added. “A lot of times, the decision to start a medication like a bisphosphonate ends up getting deferred from person to person. If we’re able to start these medications at a skilled nursing facility, it can benefit patients who have recently had a fracture and have an indication for these medications.”<br></p><h2>Treating the Overmedication Epidemic</h2><p>The data behind PRISM tell a sobering story. As a recent CDC fact sheet <a href="https://www.cdc.gov/falls/data-research/facts-stats/?CDC_AAref_Val=https://www.cdc.gov/falls/facts.htm" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Facts About Falls">explains</a>, roughly one million seniors are hospitalized for fall-related injuries every year, with almost 319,000 specifically experiencing hip fractures. Although more than 25% of older adults suffer falls every year, less than half of these falls are reported. Crucially, every fall increases the risk of another: per the CDC, “falling once doubles your chances of falling again.”<br><br>Making matters worse is the fact that many seniors are on a cocktail of medications with under-examined risks. According to a <a href="https://www.wsj.com/health/healthcare/americas-seniors-are-overmedicated-f397bb1d?st=37iWQh&reflink=desktopwebshare_permalink" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="America's Seniors Are Overmedicated">recent analysis</a> by the <em>Wall Street Journal,</em> “one in six seniors enrolled in Medicare’s drug benefit were prescribed eight or more medications at the same time.” Of this group, more than 3.9 million were on 10 or more drugs at the same time, and more than 419,000 were on 15 or more. These medications included sedatives and muscle relaxants that are already considered dangerous for seniors when taken by themselves, let alone in combination with other medications that impact the patient’s central nervous system. <br><br>The rising tide of overmedication is what PRISM aims to address. “Older adults accumulate more and more chronic diseases, they go to lots and lots of different providers for those different diseases,” Colón-Emeric said. “They get prescribed lots of different things focused on those diseases, but nobody’s kind of stepping back and looking at the whole picture or periodically reassessing to say, ‘Hey, is the risk of this medication still worth the benefit that the patient’s getting from it?’ They take, on average, 12 in skilled nursing facilities. Many are taking over 20, and a lot of those interact with each other.”<br><br>“After an injury, a fall, or a fracture, it’s a really important time to do a careful risk-benefit assessment of an older adult’s medications,” she added.<br></p><h2>A Light Touch</h2><p>PRISM is designed to make things as easy as possible for SNFs, adapting to their existing workflows rather than disrupting them. Participating communities designate a “facility champion”—typically a nurse—who serves as a liaison with the program. The champion’s duties are light; other than a short weekly check-in with PRISM, the job mostly involves coordinating paperwork between PRISM staff and the facility’s clinicians. <br><br>“It’s easy and smooth,” attested Sarah Fennimore, champion at Hudson Bay Health and Rehab in Vancouver, Washington. “Our building is between 75 and 80 people, and it probably takes five minutes per person.” Once she was onboarded into the process, she added, the main operational change was explaining to clinicians that a third party would be looking at fracture patients and making recommendations. “I feel like our doctors agree with their recommendations 95% of the time.” <br><br>From there, PRISM’s fracture nurse consultants take the lead. Working remotely with the support of an interprofessional team of geriatricians, osteoporosis specialists, and pharmacists, they review each patient’s chart and develop a “medication optimization plan”—a concise, one-page set of recommendations for the facility’s provider. The consultant reaches out to the patient and family to discuss the plan, relieving the facility of time-consuming conversations. When the patient transitions back to the community, PRISM nurses continue following up with them and their primary care providers, coordinating care and providing additional resources as needed.<br><br>The study compares three evidence-based approaches to medication optimization. Enrolled facilities cycle through all three in a randomized sequence, spending approximately six months on each: one focused on treating osteoporosis, one focused on deprescribing medications that increase fall risk, and one combining both strategies simultaneously. Facilities participate for 18 months, with the study involving minimal cost increases (typically from adding osteoporosis medication) or even cost reductions (from deprescribing existing medications).<br><br>“What we’re really trying to understand is whether focusing on osteoporosis medication management, deprescribing all those fall risk-increasing drugs, or doing both at the same time, results in better outcomes for patients and families,” Colón-Emeric said. “Facilities get all three of those focus areas in random sequence. They’ll get six months focused on osteoporosis, six months of de-prescribing, and six months of both.”<br></p><h2>Putting Patients First</h2><p>As PRISM fracture nurse consultant Rachel Passman-James explained, her role is to put the patient’s needs front and center. “We share our recommendations, but first we hear about what matters most to them so that we can use that to individualize the recommendations,” she said. “Making changes to your medication is a big deal, so there’s no pressure. We follow up with them at one month, so often they talk to their PCP before deciding on changes or just have more time to make a decision.”<br><br>Another important part of her job is ensuring that the program’s workflow is tailored to each facility’s unique profile. “Their needs vary depending on their geography, patient populations, whether they’re in a big city or rural area, if their patients are coming from big teaching hospitals or community hospitals,” she explained. At one Texas facility serving a predominantly Spanish-speaking population, for instance, her team learned to route recommendations through the physician first before speaking with patients. “They are more likely to accept a recommendation if a provider has already agreed on it,” she said. “So normally we come up with a plan, conduct shared-decision making, and then send it to the provider of the facility. But for this facility, I send it to the provider first and make sure they agree, and then I talk to the patients.”<br><br>For Deardorff, the PRISM onboarding process was a fairly simple matter: after identifying the right facility champion, his team and PRISM’s undertook an iterative process of finding the most efficient workflows. “We piloted putting the medication optimization plans in binders for different clinicians to look at, and the nurse champion would follow up with them and see if they have any questions about the recommendations,” he said. “The hard part is communication with clinicians. We’ve had to do repeated reminders around making sure they’re aware of what’s going on, so that when they see these sheets, they’re not like, ‘What is this and why do I need to sign it? Where is this recommendation coming from?’”<br><br><span><em><img src="/Articles/PublishingImages/2023/SethSimons.jpg" alt="Steve Manning" class="ms-rtePosition-2" style="margin:5px;width:170px;height:170px;" /></em></span>He added that PRISM’s own resources were helpful in facilitating that process—especially a one-page pocket card explaining the rationale for its recommendations. “The pocket card was super helpful,” he said. “Their website is great in terms of resources for deprescribing, bone health, and dosing recommendations.”<br></p><p><em>Steve Manning is a journalist based in New York City.</em></p><p><span style="font-family:aptos, arial, helvetica, sans-serif;font-size:12pt;"><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">Provider<span class="Apple-converted-space"> </span><em>magazine includes information from a variety of sources, such as contributing experts. The views expressed by external contributors do not necessarily reflect the views of<span class="Apple-converted-space"> </span></em>Provider<em> magazine and AHCA/NCAL.<span class="Apple-converted-space"> </span></em></span><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#96607d;"><em><a href="/About/Pages/Submit-Article.aspx" title="https://www.providermagazine.com/About/Pages/Submit-Article.aspx" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="color:#96607d;margin-top:0px;margin-bottom:0px;">Learn how to submit an article.</a></em></span><br></span></p> | 2026-04-16T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/fall_risk.jpg" style="BORDER:0px solid;" /> | Clinical;Falls | According to the National Council on Aging, an older adult suffering a fall-related injury is seen in an emergency department every 11 seconds. When patients arrive at a skilled nursing facility after breaking a bone in a fall, the focus is naturally on rehabilitation. |
| Standardize Unit Turnover to Meet Rising Demand | <p><img src="/Articles/PublishingImages/2026/improvement.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:300px;height:300px;" />It's no secret that the Baby Boomers have changed the cultural landscape of the United States since their first arrival following WWII. The generation that caused rapid growth in suburbs and school districts and later in adulthood influenced business and industry, is now an aging population who will once again influence services meant for seniors.</p><p>Boomers today are roughly between the ages of 62 and 80 and are looking to downsize from the homes where they raised their families and move into senior living facilities, where maintenance is handled for them, safety features are adapted specifically for their needs, and a community is at the ready to welcome them in.</p><p>Because of this steady and growing trend, senior living facilities are becoming more popular. <a href="https://www.nic.org/news-press/occupancy-rate-for-senior-living-communities-increased-in-2025-as-construction-stalled/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="NIC research">Research conducted by NIC,</a> shows that a combination of high-demand facilities and limited new construction drove occupancy across all senior living property types in the fourth quarter of 2025. Independent living occupancy was above 90 percent, and assisted living occupancy was 87.7 percent.</p><p>Senior living properties that are able to meet this demand by quickly turning over units and placing new residents in vacant apartments will not only provide excellent customer service in an industry where wait lists can be long, but will also positively impact their bottom line. Quickly filling vacant apartments means less gaps in revenue. </p><h3>Standardization Is Key</h3><p>The key to success is standardization. The ability to turn over units is not just a customer service issue, helping seniors move into their new home more quickly, but also a business issue—the faster senior living communities can turn over vacated units, the better for the bottom line. Facilities managers should focus on standardizing the turnover process to eliminate redundancies. Using a checklist for all unit turns ensures all elements are addressed, eliminates guess-work, and keeps the team working as efficiently as possible. </p><h3>Maintenance</h3><p>As soon as a unit is vacated, the facilities team should conduct a thorough inspection to determine any maintenance that needs to be completed. One technique standardizes property inspections by having the team take a systematic approach by starting at the front door and following the left wall completely around the unit as a way to ensure 100 percent of the property is inspected and all needed repairs are identified. This reduces the need for multiple return trips to the unit.</p><p>Not only does this ensure a thorough sweep of the unit but inspecting units for repair the same way each time helps create an efficient system to identify any potential issue. </p><h3>Safety</h3><p>Every property manager should use a checklist to inspect the safety items needed in each unit to prepare for the next tenant. The facilities team should:<br></p><ul><li>Ensure smoke detectors and carbon monoxide detectors are functioning properly.</li><li>Check that a fire extinguisher is available in the kitchen and still current.</li><li>Ensure all appliances are working. </li><li>Test unit’s intercom system to ensure next resident can reach out in an emergency.</li><li>Confirm non-slip surfaces are still in place and functional.</li><li>Make sure grab bars in bathrooms and other key areas are secure.</li></ul><h3>Aesthetics</h3><p>It is important that facilities managers remember that their teams aren’t just turning over a unit for the next resident—they are preparing a property that will become someone’s home. The look and feel of the space are important factors that drive demand for senior living properties. Baby boomers don’t want to leave their long-term residences for sub-par apartments. Small details like the quality of the carpet and the look and feel of the kitchens and bathrooms make large impacts on future residents.</p><p>It is not unusual to need to replace carpeting and other flooring between tenants. It is important to choose durable materials that are quickly available and easy to install. High-quality vinyl flooring and stain resistant surfaces extend the lifespan within the unit. One of the most common refreshes in unit turns is repainting. It is one of the easiest ways to give a space a total facelift, making the unit look fresh, new, and ready to become a home. </p><h3>Leaning on Technology for Efficiency </h3><p>Facility managers work with many vendors to quickly turn over units. Today, it is becoming more common for service vendors to leverage technology to automate the administrative tasks associated with the job—pricing, scope of work and contracts can all be managed using automation.</p><p>Working with technology enabled vendors, like plumbing, electrical, flooring installation, or paint contractors with easy-to-use apps for booking, helps streamline workflows and ensure units can be quickly turned over for the next occupant.</p><p>Here is how it can work for painting vendors: the facilities manager works with the painting contractor to enter the schematics for each unit into the automated system. Pricing for the standard scope is agreed for each unit type, based on layout, number of bedrooms, and detail work that might be an add-on or vary by unit. When it comes time for one or more units to be painted, the facilities manager simply selects the location, the scope of work needing to be painted, and date for completion.</p><p>The system instantly alerts the paint contractor’s project manager, contracts are auto-generated, and a crew is scheduled and can be onsite within days—often as fast as within 24 hours.  Working with service vendors that use technology to automate the administration of paperwork, estimates, work orders, and contracts means that units can be quickly repaired, refreshed, and maintained in a streamlined manor that ensures the next tenant is able to move in quickly. </p><h3>The Bottom Line</h3><p><img src="/Articles/PublishingImages/2026/Richard%20Kilgannon.jpg" alt="Richard Kilgannon" class="ms-rtePosition-2" style="margin:5px;width:175px;height:175px;" />Baby Boomers are driving demand for senior living facilities. The locations that offer a luxurious ambiance will be highest in demand, with potentially long wait lists. Facilities managers can have lasting impact on the property’s bottom line by quickly and efficiently turning over units between residents. Using standardized processes and checklists will ensure streamlined maintenance, safety, and ambiance management. Partnering with vendors that have invested in technology to streamline the administrative side of work orders will ensure that units are turned quickly and ready to become home for the next resident. <br><br><em>Rich Kilgannon is the president and CEO of Arch Painting.</em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;"><br></span></em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">Provider<span class="Apple-converted-space"> </span><em>magazine includes information from a variety of sources, such as contributing experts. The views expressed by external contributors do not necessarily reflect the views of<span class="Apple-converted-space"> </span></em>Provider<em> magazine and AHCA/NCAL.<span class="Apple-converted-space"> </span></em></span><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#96607d;"><em><span style="text-decoration:underline;"><a href="/About/Pages/Submit-Article.aspx" title="Submit an article" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="color:#96607d;margin-top:0px;margin-bottom:0px;">Learn how to submit an article.</a></span></em></span><br></em></p> | 2026-04-07T04:00:00Z | <img alt="" src="/Articles/PublishingImages/2026/improvement.jpg" style="BORDER:0px solid;" /> | Caregiving | Senior living properties that are able to meet this demand by quickly turning over units and placing new residents in vacant apartments will not only provide excellent customer service in an industry where wait lists can be long, but will also positively impact their bottom line. |
| Senior Living Trends for 2026 and Beyond | <p><img src="/Articles/PublishingImages/2026/dr-meeting.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:430px;height:286px;" />For years, the senior living industry referred to the silver tsunami as a distant force approaching the horizon. In 2026, that wave is no longer theoretical. The oldest Baby Boomers are now in their seventies, and the next cohort is approaching retirement with longer life expectancies, strong consumer expectations, and a clear vision for how they want to live.</p><p>Through conversations and research, we’ve noticed that senior living providers are shifting from cautious observation to decisive action. Across the country, organizations are moving away from a “wait and see” approach and are instead acting on strategic initiatives that strengthen market position, modernize assets, and align communities with the preferences of a new generation of residents.</p><h3>A Return to Data-Driven Decision Making</h3><p>A renewed emphasis on market intelligence is shaping investment decisions. After several years of capital restraint, providers are commissioning market studies and reassessing competitive positioning to understand future demand more clearly. Many now recognize that existing facilities may not meet the expectations of younger Boomers, whose housing, travel, and lifestyle choices have long been defined by customization and quality.</p><p>Property evaluations increasingly determine whether communities can be repositioned through renovation or expansion, or whether full redevelopment is necessary. Rather than delaying decisions, providers are using data to clarify risk, prioritize investments, and plan for long-term viability.<br></p><h3>Independent Living Takes Center Stage</h3><p>The market continues to tilt toward independent living. While higher-acuity services remain essential, Boomers are delaying entry into senior living until they desire lifestyle benefits rather than care support. This shift is intensifying demand for detached living options, particularly for middle-income seniors who currently remain underserved.</p><p>In higher-end markets, providers are investing in Active Adult Plus models that resemble resort-style communities while incorporating infrastructure to layer in home health services as residents age. At the same time, organizations are exploring creative development strategies that make middle-market housing financially feasible without sacrificing quality or dignity.<br></p><h3><img src="/Articles/PublishingImages/2026/Arlington-12%20copy.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:450px;height:300px;" />Rising Expectations: Amenities as Lifestyle</h3><p>The incoming generation is not simply seeking housing; they are selecting a lifestyle. Communities designed for 2026 increasingly reflect hospitality driven environments rather than institutional models. Multiple dining venues, demonstration kitchens, wine storage, and high-quality recreational amenities are becoming standard features rather than premium upgrades.</p><p>Wellness has taken center stage. Traditional rehab gyms are giving way to holistic wellness centers that include hydrotherapy, yoga studios, strength training spaces, and outdoor meditation areas. These environments support vitality and well-being while reinforcing a lifestyle centered on health rather than physical decline.<br></p><h3>The Shift Toward Micro-Campuses</h3><p>Development patterns are evolving. New construction is trending away from isolated, sprawling campuses and toward integrated micro-campuses located within walkable urban or suburban town centers. Residents increasingly want to remain connected to the cultural energy and intergenerational activity they have long enjoyed.</p><p>Proximity to restaurants, arts venues, parks, and retail creates continuity rather than separation from community life. Partnerships with universities and cultural institutions are also expanding, offering access to lectures, performances, and lifelong learning opportunities that reinforce intellectual engagement and social connection.<br></p><h3>Renovation Over Replacement</h3><p>Economic pressures continue to shape development strategies. With interest rates and labor costs remaining elevated, renovations currently outpace new construction. Many providers are investing in targeted upgrades to lobbies, dining spaces, and common areas to modernize aesthetics and reposition their brand.</p><p><img src="/Articles/PublishingImages/2026/Skaalen%20CBRF%20main%20dining%203.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:450px;height:300px;" />However, superficial updates are no longer sufficient. Renovations must reflect fundamental lifestyle expectations, including larger residences, flexible living spaces, and integrated smart-home features that support independence and convenience.</p><h3>Mergers, Acquisitions, and Strategic Scale</h3><p>Mergers and acquisitions are on the rise, but the emphasis has shifted toward quality rather than scale. Buyers are pursuing Class A properties and assets with strong value-add potential instead of distressed portfolios.</p><p>At the same time, smaller single-site nonprofit providers are increasingly affiliating with larger regional systems to gain access to capital and operational resources needed for modernization. This consolidation allows organizations to invest in infrastructure improvements and remain competitive in an evolving marketplace.</p><h3>Designing for the Workforce</h3><p>Workforce challenges are influencing design in new ways as well. In a tight labor market, the physical environment has become a recruitment and retention tool. New projects prioritize back-of-house functionality and aesthetics, incorporating ergonomic workspaces, efficient layouts that reduce caregiver fatigue, and staff break areas with natural light and outdoor access.</p><p>Some communities are introducing amenities such as on-site childcare, flexible scheduling support areas, and staff wellness spaces. When the built environment supports employee well-being and efficiency, providers gain a meaningful advantage in attracting and retaining talent.</p><h3>Technology as Invisible Infrastructure</h3><p>Boomers entering senior living in 2026 are the most technologically fluent generation to date, and seamless connectivity is now a baseline expectation. High-speed Wi-Fi throughout a campus is essential infrastructure.<br>Communities are also integrating unobtrusive technologies such as AI-driven fall detection, passive health monitoring, smart-home controls, and circadian rhythm lighting systems. These innovations enhance safety and comfort while remaining largely invisible, allowing environments to feel residential rather than clinical.</p><h3>Meeting the Moment</h3><p>Taken together, these trends signal a decisive shift in industry posture. The senior living sector is moving from defensive positioning toward proactive growth and reinvention. While new construction remains expensive, the increase in property evaluations and renovation initiatives indicates that providers are no longer ignoring aging facilities or outdated models.</p><p><span><span><img src="/Articles/PublishingImages/2026/Mike-Edwin.jpg" alt="Mike Edwin" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" /></span></span>The resident emerging in 2026 does not view senior living as a last resort. Instead, it is a carefully chosen lifestyle emphasizing independence, wellness, connectivity, and meaningful engagement. Communities that align with these expectations will not merely absorb the coming wave of demand; they will help influence and define the future of aging.</p><p>The silver tsunami is no longer approaching. It has arrived. The defining question for providers now is whether they are prepared to meet this moment with environments, services, and strategies designed for a generation that is redefining what it means to be a senior adult in America.<br><br><span><em><img src="/Articles/PublishingImages/2026/Julie-Heiberger.jpg" alt="Julie Heiberger" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" /></em></span><em>Mike Edwin is a senior consultant – senior living and religious markets with Hoffman Planning, Design & Construction, Inc. He can be reached at <a href="mailto:medwin@hoffman.net" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">medwin@hoffman.net</a>.</em></p><p><em>Julie Heiberger is a senior project architect and the senior living market leader for Hoffman Planning, Design & Construction, Inc. She is a member of the American Institute of Architects, the National Council of Architectural Review Boards, and the Board of Directors of the Society for the Advancement of Gerontological Environments. 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> | 2026-03-31T04:00:00Z | <img alt="" src="/Articles/PublishingImages/2026/dr-meeting.jpg" style="BORDER:0px solid;" /> | Management;Caregiving | Across the country, organizations are moving away from a “wait and see” approach and are instead acting on strategic initiatives that strengthen market position, modernize assets, and align communities with the preferences of a new generation of residents. |
| Balancing Building Access with Safety and Security | <p><img src="/Articles/PublishingImages/2026/nurse_security.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:400px;height:400px;" />Senior living facilities need to blend residential comfort, medical readiness, hospitality, and security into a single integrated ecosystem designed around the well-being of older adults. As these communities continue to evolve—from traditional assisted-living homes to sprawling, campus-style continuing care retirement communities—their operational demands have become increasingly complex.</p><p>At the heart of these complexities lies the need for reliable, intuitive, and integrated access control systems. These systems must balance safety and security with accessibility, and regulatory compliance with an atmosphere that still feels like home. Understanding the intricacies of senior living means recognizing the delicate interplay between human needs and the technologies that support them, particularly in controlling who can move where, when, and under what conditions.</p><h3>Diverse Access Needs</h3><p>One of the foundational challenges in senior living is the diversity of resident needs. A single facility may include independent-living apartments, assisted-living units, and memory care wings. Each of these environments comes with its own risk factors and considerations for freedom of movement. Residents in independent living expect near-total autonomy, often with minimal restrictions, whereas memory care residents require more structured mobility boundaries to mitigate risks such as wandering or elopement.</p><p>Integrated access control systems must therefore be capable of granular zoning, where doors, elevators, and outdoor spaces can enforce customized permissions based on the cognitive, physical, and medical profiles of individual residents. In addition to resident access, safe access and permissions can be granted for back-of-house offices, including administrative office spaces, medical and storage closets, and recordkeeping areas.</p><p style="text-align:left;">At the same time, senior living facilities are dynamic environments that welcome not just residents but families, caregivers, contractors, medical personnel, volunteers, delivery services, and third-party providers. This constant flow introduces unique security challenges. Facilities must track and manage a variety of credentials without inhibiting community engagement. Integrated, modern access control solutions, therefore, rely on cloud-based credentialing, visitor management software, and time-bound access credentials to streamline entry while maintaining auditability.</p><p style="text-align:left;">For example, a visiting nurse may receive a credential valid only for specific hours and areas. In contrast, family members may be granted privileges suited to their loved ones’ locations and care plans. This approach reduces administrative time and effort associated with traditional sign-in logs while providing real-time oversight and data analytics that support compliance and operational efficiency.</p><p>Emergency preparedness also plays a vital role in the design of access control systems in senior living. Access control must integrate with life-safety systems so that doors unlock or lock in accordance with the emergency scenario. </p><h3>Human-Centered Access</h3><p>Equally important is the human-centric aspect of system design. Residents in senior care communities often experience mobility impairments, vision limitations, or cognitive challenges that make traditional mechanical keys impractical. Access points must be intuitive, physically accessible, and often hands-free. Mobile-friendly technologies, facial identification systems, and automated doors help remove barriers and maintain residents’ independence.</p><p style="text-align:center;"><span><img src="/Articles/PublishingImages/2026/Rooney2.jpg" class="ms-rtePosition-4" alt="" style="margin:5px;width:799px;" /></span> </p><p style="text-align:left;">Change can be hard, especially for seniors. They become used to a particular process or behavior patterns. When implementing new technologies and solutions, significant consideration must be given to the existing processes and to technologies that residents feel comfortable using. For example, many seniors may not use a smartphone; they may still use a flip phone or feel uncomfortable with either. If a facility decides to implement a visitor-entry system that requires telephone approval or authorization from a resident, the new system must support both digital and analog communications.</p><p>For example, when the existing door hardware at some senior public housing facilities began failing, the housing complex sought to modernize the facilities' security by integrating advanced systems that would also accommodate residents' preferences. The selected solution needed to support card access security, audio and video intercom communication, cloud-based management, and residents' ability to answer door calls via landline or cellular phones via updated IP-based door stations.</p><p>Each resident was provided with a rights-managed key fob, an app for the video intercom, and a telephone intercom with caller ID identifying the intercom as “Front Door.” From their phones or intercoms, residents could temporarily unlock the front door to let guests inside. Additionally, resident-approved family members can be granted mobile keys through a cloud-based access control system and the video intercom app to access the building and the apartment door. Ongoing operating costs were reduced by eliminating nine dedicated PSTN phone lines, and each building now has a future-proof, low-maintenance, easy-to-use door security system.</p><h3>Analytics and Maintenance</h3><p>From a management perspective, data and analytics are increasingly valuable. Cloud-based platforms provide administrators with detailed reports on door events, staff movements, resident patterns, and system health. These insights can inform staffing decisions, maintenance planning, risk assessments, compliance audits, and even clinical strategies.</p><p>Finally, the implementation and ongoing maintenance of access control systems must account for the realities of senior living budgets, regulatory scrutiny, and staffing capabilities. Systems should be scalable as the community grows, easy for staff to administer, and backed by strong vendor support. Training is a continuous necessity, especially in settings with frequent staff changes. The most successful implementations are those where the technology fades into the background, supporting safety and efficiency without diminishing the warmth and sense of community that residents expect from their home.</p><p><img src="/Articles/PublishingImages/2026/Michael-Rooney.jpg" alt="Michael Rooney" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" />The intricacies of access control in senior living facilities extend far beyond locking and unlocking doors. They encompass a careful blending of safety, autonomy, compliance, clinical support, operational efficiency, and resident experience. The best systems acknowledge the nuanced needs of aging populations and the professionals who care for them, creating environments where technology quietly supports dignity, independence, and well-being.</p><p><em>Michael Rooney is the director of business development multifamily for ASSA ABLOY with over 20 years of experience in the access control and contract hardware distribution industries.</em></p><h4><span class="ms-rteFontSize-1" style="font-family:aptos, sans-serif;color:#212121;">Provider<span class="Apple-converted-space ms-rteFontSize-1"> </span><em>magazine includes information from a variety of sources, such as contributing experts. The views expressed by external contributors do not necessarily reflect the views of<span class="Apple-converted-space ms-rteFontSize-1"> </span></em>Provider<em> magazine and AHCA/NCAL.<span class="Apple-converted-space ms-rteFontSize-1"> </span></em></span><span class="ms-rteFontSize-1" style="font-family:aptos, sans-serif;color:#96607d;"><em><span style="text-decoration:underline;"><a href="/About/Pages/Submit-Article.aspx" title="https://www.providermagazine.com/About/Pages/Submit-Article.aspx" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="color:#96607d;margin-top:0px;margin-bottom:0px;">Learn how to submit an article.</a></span></em></span><br></h4> | 2026-03-24T04:00:00Z | <img alt="" src="/Articles/PublishingImages/2026/nurse_security.jpg" style="BORDER:0px solid;" /> | Caregiving;Management | Senior living facilities need to blend residential comfort, medical readiness, hospitality, and security into a single integrated ecosystem designed around the well-being of older adults. |
| Setting Up Systems to Prevent Weight Loss | <p>
<img src="/Articles/PublishingImages/2026/iStock-1294520948.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:450px;height:300px;" />Unplanned weight loss in long term care is more than a clinical concern; it’s a leadership concern. It impacts resident wellbeing, family satisfaction, survey risk, and quality outcomes. Yet many facilities respond the same way: add a supplement, document the intervention, and hope the scale stabilizes.</p><p>But organizations that consistently perform well know the truth: supplements don’t prevent weight loss, systems do.</p><p>Weight loss is rarely about one missed tray. It usually reflects breakdowns in workflow, observation, communication, and follow-through. If the interventions exist only on paper, resident decline will continue. Preventing weight loss requires a shift in mindset—from “adding calories” to building reliable daily care systems.</p><h3>Weight Loss Is a Symptom of a Process Gap</h3><p>When a resident begins to lose weight, the root cause is often found in the daily routine—not the dietary order. Common contributors include:<br></p><ul><li>Inconsistent meal setup or feeding assistance.</li><li>Missed snacks due to staffing patterns or competing priorities.</li><li>Lack of meaningful observation about barriers (pain, fatigue, swallowing).</li><li>Delayed escalation when intake declines.</li><li>Care plan interventions that are not happening consistently at the bedside.</li></ul><p>In other words, weight loss often reveals the facility’s reality gap: what the care plan says should happen versus what does happen on the unit.</p><center><table cellspacing="0" class="ms-rteTable-9" style="width:69%;"><tbody><tr class="ms-rteTableHeaderRow-9"><th class="ms-rteTableHeaderEvenCol-9" rowspan="1" colspan="1" style="width:710px;"><h4 class="ms-rteElement-H4B" style="text-align:center;">
<span class="ms-rteFontSize-2 ms-rteThemeForeColor-1-0">Red Flag Triggers (Don’t Wait for the Monthly Weight)</span> </h4></th></tr><tr class="ms-rteTableOddRow-9"><td class="ms-rteTableEvenCol-9" style="width:710px;">Escalate immediately when you see:<br>
<ul><li>Intake < 50 percent of meals for 2 consecutive days.</li><li>Intake < 25 percent for 24 hours.</li><li>New coughing, choking, throat clearing, or pocketing.</li><li>Increased fatigue or sleeping through meals.</li><li>New refusal pattern: “says food tastes bad” or “not hungry.”</li><li>Constipation, abdominal discomfort, nausea, new pain complaints.</li><li>Sudden mood shift, withdrawal, or depression indicators.</li></ul></td></tr></tbody></table><p></p><div style="text-align:left;">
<span>
<h3>Treat the Dining Room Like a Clinical Unit</h3>
<p>Many facilities unintentionally treat dining as a hospitality function. In truth, dining is one of the most critical “clinical environments” in long term care. Residents at risk for weight loss require the same level of structure and monitoring as those at risk for falls or pressure injuries.</p>
<p>Leaders should evaluate meal service the way they would assess a treatment pass:<br></p>
<ul><li>Is the environment calm, organized, and supportive?</li><li>Are high-risk residents seated for success (not convenience)?</li><li>Are meal assistance assignments clear and consistent?</li><li>Does staff have time to cue, assist, and monitor intake?</li></ul>
<p>If dining is chaotic, delayed, or inconsistent, no supplement order can compensate for the lost opportunity.</p>
<h3>CNA Workflow Is the Missing Link</h3>
<p>Nursing assistants are the frontline defense against weight loss. Yet their workflow is often built in a way that makes nutritional failure predictable.</p>
<p>During mealtimes, CNAs are frequently expected to manage toileting, transfers, call lights, and interruptions, while also providing cueing, feeding, and documentation. This leads to rushed assistance, missed snacks, and inaccurate intake recording.</p>
<p>Facilities with strong outcomes do two things differently:<br></p>
<ol><li>They design a meal workflow that protects staff time, rather than squeezing meals into a chaotic shift.</li><li>They assign responsibility clearly, especially for high-risk residents.</li></ol>
<p>When no one is clearly accountable for meal assistance and observation, the result is predictable: tasks fall through the cracks and decline becomes “unexplained.”</p></span> </div><p></p><table cellspacing="0" class="ms-rteTable-9" style="width:69%;"><tbody><tr class="ms-rteTableHeaderRow-9" style="text-align:center;"><th class="ms-rteTableHeaderEvenCol-9" rowspan="1" colspan="1" style="width:710px;"><h4 class="ms-rteElement-H4B" style="text-align:center;">
<span class="ms-rteThemeForeColor-1-0 ms-rteFontSize-2">5 Questions for Leaders</span></h4></th></tr><tr class="ms-rteTableOddRow-9"><td class="ms-rteTableEvenCol-9" style="width:710px;"><ol><li>Who is accountable for high-risk meal assistance every meal, every shift?</li><li>Are CNAs protected from competing priorities during peak mealtimes?</li><li>Do we have standard triggers for intake decline, or do we wait for weight loss?</li><li>Are care plan interventions audited for follow-through, not just completion?</li><li>Is the dining room structured for success—or set up for chaos?</li></ol></td></tr></tbody></table><div style="text-align:left;">
<span>
<h3>Observation Is a Clinical Skill</h3>Preventing weight loss depends on what staff notice and report early—not just what gets documented after the fact. CNAs are often the first to recognize barriers, but only if they are trained and empowered to report them.
<p></p>
<p>Nutrition-related observations that should trigger follow-up include:<br></p>
<ul><li>Refusing favorite foods.</li><li>Fatigue and falling asleep mid-meal.</li><li>Coughing, throat clearing, or pocketing food.</li><li>Chewing difficulty, denture problems, or mouth pain.</li><li>Mood changes, withdrawal, or loss of interest in meals.</li><li>Constipation or abdominal discomfort affecting appetite.</li></ul>
<p>Weight-loss prevention becomes significantly more effective when teams view observation as part of clinical surveillance, not just “getting trays passed.”</p>
<h3>Care Plans Must Have Action Triggers</h3>
<p>Many care plans include supplements, snacks, and encouragement, yet residents still lose weight because the plan lacks triggers that define when to escalate. Without clear escalation thresholds, decline continues quietly until the next weight check creates urgency.</p>
<p>High-performing facilities embed triggers to prompt the team to act before weight loss becomes severe. A reliable system includes:<br></p>
<ul><li>Intake thresholds that require nurse notification.</li><li>Defined interventions for refusal patterns.</li><li>Automatic interdisciplinary review for sustained decline.</li><li>Consistent follow-up and documentation of outcomes.</li></ul>
<p>When triggers are standardized, early response becomes routine rather than reactive.</p>
<div><center><table cellspacing="0" class="ms-rteTable-9" style="width:69%;"><tbody><tr class="ms-rteTableHeaderRow-9"><th class="ms-rteTableHeaderEvenCol-9" rowspan="1" colspan="1" style="width:710px;"><h4 class="ms-rteElement-H4B">
<span class="ms-rteFontSize-2 ms-rteThemeForeColor-1-0"><span class="ms-rteFontSize-2"></span>CNA Meal Support Script (Simple, Consistent, Effective)</span></h4></th></tr><tr class="ms-rteTableOddRow-9"><td class="ms-rteTableEvenCol-9" style="width:710px;"><p>Use this during meal rounds and documentation:<br></p><ol><li>“Are you having pain, nausea, or trouble chewing today?”</li><li>“Do you want me to open your items and set you up?”</li><li>“Do you prefer bites first, or drinks first?”</li><li>“I’m noticing you’re eating less than usual…what feels different today?”</li><li>“I’m going to report this to the nurse so we can help you.”</li></ol><p>
<strong>Key documentation cue:</strong><br>Instead of poor appetite, document
<em>why</em>: “Resident ate 25 percent due to fatigue and fell asleep after 10 minutes; reported to nurse.”</p></td></tr></tbody></table>
</center></div>
<h3>Supplements Are a Tool—Not a Plan</h3></span> </div><p style="text-align:left;">Supplements are often appropriate, but they work only when integrated into the workflow. Leaders should audit supplement processes the same way they would audit medications:<br></p><ul style="text-align:left;"><li>Is the supplement consistently delivered?</li><li>Is it offered at the right time for the resident?</li><li>Does the resident prefer the flavor/temperature?</li><li>Is intake measured or estimated?</li><li>Is the supplement replacing the meal instead of supporting it?</li></ul><p style="text-align:left;">A supplement order without consistent delivery and meaningful tracking becomes an expensive checkbox, not an intervention.</p><h3 style="text-align:left;">The Leadership Shift: Fix the System, Not the Symptom</h3><p style="text-align:left;">The most effective question is not, “What can we add?” It is “What system is failing?”</p><p style="text-align:left;">When facilities strengthen CNA workflow, dining systems, observation practices, and care plan triggers, weight loss declines and resident outcomes improve across the board. </p><p style="text-align:left;">After all, nutrition impacts everything: mobility, skin integrity, mood, participation, infection risk, and overall quality of life.</p><p style="text-align:left;">
<span><span><img src="/Articles/PublishingImages/2026/Veronica-Ceaser-26.png" alt="veronica Ceaser" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" /></span></span>Weight-loss prevention is not a dietary department's responsibility. </p><p style="text-align:left;">It is a facility system.<br></p><p style="text-align:left;">
<em>Veronica Ceaser, MBA, MSN, LNHA, RN, GERO-BC is a long term care consultant and the founder of GEM Healthcare Consulting.</em></p><p style="text-align:left;">
<em><br></em></p><p style="text-align:left;">
<span class="ms-rteFontSize-1" style="font-family:aptos, sans-serif;color:#212121;">Provider<span class="Apple-converted-space ms-rteFontSize-1"> </span><em>magazine includes information from a variety of sources, such as contributing experts. The views expressed by external contributors do not necessarily reflect the views of<span class="Apple-converted-space ms-rteFontSize-1"> </span></em>Provider<em> magazine and AHCA/NCAL.<span class="Apple-converted-space ms-rteFontSize-1"> </span></em></span><span class="ms-rteFontSize-1" style="font-family:aptos, sans-serif;color:#96607d;"><em><span style="text-decoration:underline;"><a href="/About/Pages/Submit-Article.aspx" title="https://www.providermagazine.com/About/Pages/Submit-Article.aspx" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="color:#96607d;margin-top:0px;margin-bottom:0px;">Learn how to submit an article.</a></span></em></span><br></p></center> | 2026-03-12T04:00:00Z | <img alt="" src="/Articles/PublishingImages/2026/no_eat.png" style="BORDER:0px solid;" /> | Diet;Caregiving | Weight loss is rarely about one missed tray. It usually reflects breakdowns in workflow, observation, communication, and follow-through. If the interventions exist only on paper, resident decline will continue. |
| Celebrating NCAL's 25 Years of Innovation, Collaboration, and Excellence | <p><img src="/Issues/2026/Spring/PublishingImages/NCALanny.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:200px;" />It is often joked that if you’ve visited one assisted living community, you’ve seen one assisted living community. Assisted living varies from state to state and even from community to community—and that’s one of the many reasons it is so popular among residents and their families. That diversity and flexibility, while a strength, also means there is no single operating model or regulatory framework that applies everywhere. As a result, assisted living community leaders across the country benefit from strong support, practical resources, targeted education and training, and a trusted national voice to advance their work and impact. <br></p><p>In 1995, the American Health Care Association (AHCA) saw this opportunity and responded with the establishment of the National Center for Assisted Living (NCAL), which has grown stronger as a beacon for assisted living providers. </p><p>Pat Giorgio, president and CEO of Iowa-based Evergreen Estates, said, “Working with the American Health Care Association was our best partnership to bring united voices to represent providers and consumers and be an advocate in Washington, D.C. AHCA was clearly the strongest voice for nursing homes, and to align assisted living with them made perfect sense.”</p><p>Sarah Silva, vice president of operational services at Generations and current NCAL chair, stressed that the resources and best practices provided by NCAL over the years contribute to the organization’s legacy of enhancing senior care quality. “As an operator and provider,” she said, “NCAL has absolutely helped enhance the quality in our communities.”</p><h3>From a Seedling to a Tree</h3><p>Like the care sector it represents, NCAL evolved over time. In the 1980s, AHCA created a residential care committee to represent the growing membership in this area. Many of these members were or later became assisted living communities.</p><table cellspacing="0" class="ms-rteTable-0" style="width:100%;height:300px;"><tbody><tr class="ms-rteTableEvenRow-0" style="text-align:center;"><td class="ms-rteTableEvenCol-0" style="width:50%;height:100px;"><img src="/Issues/2026/Spring/PublishingImages/Spr26_Anny1.jpg" alt="" style="margin:5px;width:351px;" /><div style="text-align:center;"></div></td><td class="ms-rteTableOddCol-0" colspan="1" style="width:50%;height:100px;text-align:center;"><span><img src="/Issues/2026/Spring/PublishingImages/Spr26_Anny4.jpg" alt="Pat Giorgio" class="ms-rtePosition-4" style="margin:5px;width:365px;" /></span></td></tr><tr class="ms-rteTableOddRow-0" style="text-align:center;"><td class="ms-rteTableEvenCol-0" style="width:50%;"><span class="ms-rteFontSize-1 ms-rteThemeForeColor-2-0"><strong>LaShuan Bethea at the 2025 NCAL Day</strong></span></td><td class="ms-rteTableOddCol-0" colspan="1" style="width:50%;"><span class="ms-rteFontSize-1 ms-rteThemeForeColor-2-0"><strong>Past NCAL Chair Pat Giorgio<br><br></strong></span></td></tr></tbody></table><p>Between 1995, when it was created, and 1997, NCAL shifted from an initial concept within AHCA into a more defined and active presence, culminating in the organization assuming responsibility for supporting and engaging assisted living members under the NCAL name.</p><p>Then, in 2001, NCAL became a full-fledged association, recognized as the assisted living arm of AHCA. The organization’s first bylaws were approved, and Jan Thayer was elected the first chair of the NCAL board of directors. </p><p>Jan Thayer, the namesake of NCAL’s Jan Thayer Pioneer Award, was the owner and operator of Riverside Lodge in Grand Island, Neb. She was a renowned leader within not only NCAL, but within the Nebraska affiliate and the entire assisted living profession. Her professional motto was “to deliver the same care that you would provide for your own mother.” Each year, NCAL presents the Jan Thayer Pioneer Award to an individual who has moved the senior care profession forward and demonstrates dedication, leadership, and contributions to the profession—just like Thayer.</p><h3>Moving with the Evolution</h3><p>Having an organization to help assisted living communities evolve and adjust as the demographics and needs of residents changed has been exceedingly useful. Giorgio explained, “Back in the early 1990s, it was very evident that we were a social and not a medical model. However, as time went by, we had to respond to market demands and trends.” NCAL, she said, helped providers respond to customers and meet their needs. <br></p><p><span></span></p><table cellspacing="0" class="ms-rteTable-0" style="width:100%;height:300px;"><tbody><tr class="ms-rteTableOddRow-0" style="text-align:center;"><td class="ms-rteTableEvenCol-0" rowspan="1" style="width:50%;"><span><img src="/Issues/2026/Spring/PublishingImages/Spr26_Anny5.jpg" alt="Past NCAL Chairs" class="ms-rtePosition-4" style="margin:5px;width:235px;height:226px;" /></span></td><td class="ms-rteTableOddCol-0" colspan="1" rowspan="1" style="width:50%;"><img src="/Issues/2026/Spring/PublishingImages/Spr26_Anny2.jpg" alt="" style="margin:5px;width:342px;" /><br></td></tr><tr class="ms-rteTableEvenRow-0" style="text-align:center;"><td class="ms-rteTableEvenCol-0" rowspan="1" style="width:50%;"><strong class="ms-rteFontSize-1 ms-rteThemeForeColor-2-0">Past NCAL Chairs Nicolette Reilly, Howie Groff, <br>and Van Moore</strong></td><td class="ms-rteTableOddCol-0" colspan="1" rowspan="1" style="width:50%;"><strong class="ms-rteFontSize-1 ms-rteThemeForeColor-2-0">Kathy Fiery, NCAL New Jersey Affiliate</strong></td></tr></tbody></table><p>To support providers in this work over the years, NCAL has developed a wide range of education and training resources as the profession evolves. Among the many are customer relations resources, instruction on managing falls, and clinical resources focused on quality improvement and dementia care. The organization also offers resources on data, why it matters in assisted living, and how to start collecting it. Providers can also utilize the association’s education platform, ahcancalED, to access numerous assisted living trainings.</p><p></p><p>NCAL is especially helpful for smaller providers, Giorgio suggested, as they often don’t have the time or ability to create their own resources. She offered, “Assisted living has been very innovative and embraced changes in technology and consumer needs, and NCAL has been a key part of this.”</p><h3>Evolving Models of Care</h3><p>Giorgio added that NCAL also helped create a bridge between nursing homes and assisted living as assisted living communities began to take on more medically complex residents and offer medical services.<br></p><p>Silva agreed, noting, “We still try to be a social model that meets medical needs as we’re able, but individual states have different interpretations of what that means. NCAL has done a great job of keeping up with individual state regulations and providing resources to our state associations.”</p><p><span></span></p><table cellspacing="0" class="ms-rteTable-0" style="width:100%;height:300px;"><tbody><tr class="ms-rteTableEvenRow-0" style="text-align:center;"><td class="ms-rteTableEvenCol-0" rowspan="1" style="width:50%;"><img src="/Issues/2026/Spring/PublishingImages/Spr26_Anny7.jpg" alt="" style="margin:5px;width:302px;height:272px;" /><br></td><td class="ms-rteTableOddCol-0" colspan="1" rowspan="1" style="width:50%;"><img src="/Issues/2026/Spring/PublishingImages/Spr26_Anny9.jpg" alt="" style="margin:5px;width:237px;height:270px;" /><span></span></td></tr><tr class="ms-rteTableOddRow-0"><td class="ms-rteTableEvenCol-0" rowspan="1" style="width:50%;text-align:center;"><span class="ms-rteFontSize-1 ms-rteThemeForeColor-2-0"><strong></strong><strong>Former NCAL Staff David Kyllo, Martece Yates, <br>and Shelley Wagar</strong></span></td><td class="ms-rteTableOddCol-0" colspan="1" rowspan="1" style="width:50%;text-align:center;"><span class="ms-rteFontSize-1 ms-rteThemeForeColor-2-0"><strong>Past NCAL Chairs Robert Van Dyk (left) <br>and Chris Mason</strong></span></td></tr></tbody></table><p></p><p>NCAL always has its finger on the pulse of trends and developments, she said, with an eye on what practices and initiatives work well as the assisted living model evolves. “This is a lot to stay on top of, and it takes a national association like NCAL to do it,” Silva said. </p><p>Howard Groff, president of Minnesota-based Tealwood Senior Living, said, “[Former NCAL board chair] Chris Mason used to say that assisted living is a social model with a medical conscience. Over time, we’ve become more of a medical model with a social conscience. The medical service escalation has really ramped up over the years, and NCAL has supported that evolution.”</p><p>To support members in their efforts to monitor and track state regulations, NCAL created the Regulatory Resource Center, which includes the NCAL State Regulatory Review and resources on affordable assisted living, a state bill tracker, state assisted living survey data, and associated state regulations. All these resources are intended to easily help members stay informed on changing state regulations and take action on important issues affecting the profession. </p><p>Gerald Hamilton, owner and operator of BeeHive Homes, said, “NCAL has adapted well to our profession as it’s evolved. We’ve been responding well to the changing needs of our residents, and NCAL has done a great job of supporting us and pivoting with us—providing both advocacy and resources.”</p><h3>A Structure to Support the Future</h3><p>Aligned with the development of NCAL’s bylaws, a formal governance structure was also established. At its center is a stand-alone board of directors composed of representatives from states across the federation. As a federation of state‑affiliated associations, NCAL recognized the need for a leadership development program that would equip leaders in each affiliated state to broaden their leadership capacity and engage more deeply in advocacy, quality initiatives, and strategic priorities—an effort embodied in the NCAL State Leader Program. Reflecting the diversity of the states NCAL represents, NCAL’s governance structure was intentionally designed to cultivate and support the next generation of leaders, ensuring a strong and sustainable leadership pipeline for the future.</p><h3>Guiding Principles</h3><p>Groff recalled, “In the beginning, we started talking about what kind of guardrails we needed to put in place for a sector that varied widely from state to state, but we agreed that we didn’t want to become overscrutinized or overregulated.” </p><p>He said they also had to tread lightly so as not to blur the lines with the skilled nursing sector or step on its toes. With NCAL’s help, he said, “it was interesting watching the transition of skilled nursing–assisted living relationships to complementary and realizing that many providers operated both assisted living communities and nursing homes, often on the same campus or even in attached buildings.”</p><p>In 2014, NCAL developed Guiding Principles as an information resource to generally describe what assisted living is and ways the assisted living profession is striving to continue developing and improving services. It included defining assisted living, licensure and certification, and building/physical plant, and was refreshed in 2024. </p><p><span><img src="/Issues/2026/Spring/PublishingImages/Spr26_Anny10.png" class="ms-rtePosition-2" alt="" style="margin:5px;width:350px;height:245px;" /></span>“These guiding principles were one of NCAL’s most significant accomplishments. They show what the organization is all about, and they go hand in hand with quality,” said Groff. NCAL and assisted living communities are bound by much, but nothing more so than quality, he noted, adding, “We always want to make sure we are following solid practices in nursing care and have the right number of staff for the services we provide.”</p><p>Hamilton added, “NCAL and AHCA have helped identify ways we can improve our leadership in our communities; and the better the job we do of leading our staff, the more we are able to retain good people. This has had a positive impact on turnover, which, in turn, enables better care and care transitions.”</p><h3>Uniting the Profession</h3><p>NCAL was very successful at bringing people together to solve problems, share ideas and best practices, and advocate for their residents. Groff said, “NCAL did an incredible job of putting together national committees that provide knowledge-based information to people who need it but don’t have the time to pursue it on their own because they are too busy doing their jobs.” </p><p>NCAL also established specific committees to support assisted living members, but none of these things could be accomplished without great leadership. Groff shared that Steve Chies, a former AHCA chair, “always said that whoever we elect as chairperson of NCAL is going to stand on the shoulders of the person in front of them. And we’ve had many great leaders.” He added, “They have all been committed to their profession and having buildings where people are cared for the way they would want for their own family or themselves.”</p><p>The interactions and connections NCAL have enabled are powerful and memorable. Hamilton said, “I’ve enjoyed many great collaborations with a number of people I’ve worked with as colleague, mentor, and friend.” </p><p>He also fondly remembered speaking as NCAL chair at the national AHCA/NCAL convention. “Having that opportunity to represent NCAL and speak alongside our nursing home colleagues is an experience that stands out in my mind,” he added. </p><h3>The Harmony of the Collective Voice</h3><p>Even though assisted living is overseen by states, providers still need to be able to advocate for their residents and communities at the national level. NCAL provides the support and resources to make NCAL members’ voices heard. </p><table cellspacing="0" width="100%" class="ms-rteTable-0"><tbody><tr class="ms-rteTableEvenRow-0" style="text-align:center;"><td class="ms-rteTableEvenCol-0" style="width:50%;"><img src="/Issues/2026/Spring/PublishingImages/Spr26_Anny6.jpg" alt="" style="margin:5px;" /></td><td class="ms-rteTableOddCol-0" style="width:50%;"><img src="/Issues/2026/Spring/PublishingImages/GeraldHamilton.jpg" alt="" style="margin:5px;" /></td></tr><tr class="ms-rteTableOddRow-0"><td class="ms-rteTableEvenCol-0" style="text-align:center;"><span><strong class="ms-rteFontSize-1 ms-rteThemeForeColor-2-0">2026 NCAL Chair Sarah Silva</strong></span></td><td class="ms-rteTableOddCol-0" style="text-align:center;"><span><span class="ms-rteFontSize-1 ms-rteThemeForeColor-2-0"><strong>Past NCAL Chair Gerald Hamilton</strong></span></span></td></tr></tbody></table><p><br></p><p>Giorgio said, “We need our legislators to understand the impact of budget cuts and changes to health care on our older adults, including those in assisted living.”</p><p></p><p>This is why thousands of assisted living providers have attended AHCA/NCAL’s annual Congressional Briefing over the past 25 years. Meeting with elected officials at the federal level is important, and through attendance at this event, assisted living providers access valuable resources and education—and meet with their representatives on Capitol Hill to advocate the profession’s priorities. </p><h3>Here’s to the Future</h3><p>NCAL may be celebrating its 25th anniversary, but the organization is just getting started. Silva said, “NCAL has shown that it can turn challenges into opportunities, and it will continue to do so moving forward.” <br></p><p>This includes, she said, studying demographics and anticipating the expectations of assisted living residents who are seeking services now and in the future. It also means helping these communities stay a step ahead and meeting the demands of older adults who want to remain active and engaged and have meaningful experiences, as well have their care needs fulfilled.</p><p>“We have the largest generation of seniors in history coming, and we have to be prepared for them. This is our greatest opportunity, and we are pleased to be working with NCAL on this,” said Silva. </p><p>Groff observed, “Increasingly, we need to be meeting elders where they are and determine how to anticipate and provide services older adults in this care setting will need tomorrow and in the future. We also need to help providers use AI and other technology.”</p><p>Hamilton added, “It will be more important to us as providers to get more involved with population health efforts and new networks and payer arrangements.” This presents opportunities for NCAL and its members.</p><h3>A Lasting Legacy</h3><p>“If you look at assisted living 25 years ago compared to today, we would not be where we are as an industry—not as advanced or sophisticated or tech savvy—without NCAL. This association has forever changed the footprint of what assisted living is and will be in this country,” said Silva. </p><table cellspacing="0" class="ms-rteTable-0" style="width:100%;height:300px;"><tbody><tr class="ms-rteTableEvenRow-0" style="text-align:center;"><td class="ms-rteTableEvenCol-0" rowspan="1" style="width:50%;"><img src="/Issues/2026/Spring/PublishingImages/Spr26_Anny3.jpg" alt="" style="margin:5px;width:251px;" /><span></span></td><td class="ms-rteTableOddCol-0" colspan="1" rowspan="1" style="width:50%;"><img src="/Issues/2026/Spring/PublishingImages/Spr26_Anny8.jpg" alt="" style="margin:5px;width:240px;" /></td></tr><tr class="ms-rteTableFooterRow-0" style="text-align:center;"><td class="ms-rteTableFooterEvenCol-0" rowspan="1" style="width:50%;"><span class="ms-rteFontSize-1 ms-rteThemeForeColor-2-0"><strong>NCAL’s Newsletter, <em>FOCUS</em></strong></span></td><td class="ms-rteTableFooterOddCol-0" colspan="1" rowspan="1" style="width:50%;"><span class="ms-rteFontSize-1"><span></span></span><span><span class="ms-rteFontSize-1"><strong><span class="ms-rteThemeForeColor-2-0">General Colin Powell with Former NCAL </span><br class="ms-rteThemeForeColor-2-0"><span class="ms-rteThemeForeColor-2-0">Staff Member Martece Yates</span><br><br></strong></span></span></td></tr></tbody></table><p>“The most important thing an association can do,” Giorgio said, “is listen to what their members tell them and what their lived experiences are, then represent that on a national level. NCAL has done that well and consistently since the start. It’s a sign of leadership if you can stay true to your message and respectfully listen to the other voices that are out there, then seek common ground. NCAL is a leader.”</p><p></p><p>NCAL and its leaders have always been visionaries, and that stands out. “NCAL has always focused not just on the present,” Hamilton said, “but on what [assisted living] providers see or would like to see in the next five, ten, or even twenty-five years. This is the launching pad for ideas, programs, and initiatives to be proactive in overcoming challenges and embracing opportunities.”</p><p>NCAL has been a steadfast presence alongside providers as they navigate the changes, challenges, and evolution of assisted living. </p><p>“The journey matters,” said Groff, “and NCAL has traveled with us, providing tools, resources, education, and advocacy that make a difference.”</p><p>Happy 25th anniversary, NCAL! </p><table cellspacing="0" class="ms-rteTable-1" style="width:100%;"><tbody><tr class="ms-rteTableEvenRow-1"><td class="ms-rteTableEvenCol-1" colspan="2" style="width:88px;text-align:center;"><span class="ms-rteFontSize-4"><strong class="ms-rteForeColor-6 ms-rteFontSize-4">NCAL Timeline</strong> </span></td></tr><tr class="ms-rteTableOddRow-1"><td class="ms-rteTableEvenCol-1" style="width:75px;"><strong>198</strong><strong>1</strong></td><td class="ms-rteTableOddCol-1" style="width:703px;">The first assisted living community opens in Oregon. </td></tr><tr class="ms-rteTableEvenRow-1"><td class="ms-rteTableEvenCol-1" style="width:75px;height:56px;"><strong>1995</strong></td><td class="ms-rteTableOddCol-1" style="width:703px;height:56px;">The National Center for Assisted Living (NCAL) is created. <a href="https://www.ahcancal.org/Education-Events/Pages/NALW.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">National Assisted Living Week<sup>®</sup></a> is established and celebrated every year beginning on Grandparent’s Day in September.</td></tr><tr class="ms-rteTableOddRow-1"><td class="ms-rteTableEvenCol-1" style="width:75px;"><strong>1998</strong></td><td class="ms-rteTableOddCol-1" style="width:703px;">NCAL publishes the first edition of the <a href="https://www.ahcancal.org/Assisted-Living/Policy/Pages/state-regulations.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">State-by-State Regulatory Review. </a><br></td></tr><tr class="ms-rteTableEvenRow-1"><td class="ms-rteTableEvenCol-1" style="width:75px;"><span><strong>1998</strong></span></td><td class="ms-rteTableOddCol-1" style="width:703px;">NCAL begins the <a href="https://www.ahcancal.org/Assisted-Living/About-NCAL/Pages/NCAL-State-Leader-Program.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">NCAL State Leader Program.</a></td></tr><tr class="ms-rteTableOddRow-1"><td class="ms-rteTableEvenCol-1" style="width:75px;"><strong></strong><span><strong>2001</strong></span></td><td class="ms-rteTableOddCol-1" style="width:703px;">NCAL’s first bylaws are approved; recognized as the assisted living arm of AHCA’s membership. Jan Thayer is elected as first chair of the NCAL Board of Directors.</td></tr><tr class="ms-rteTableEvenRow-1"><td class="ms-rteTableEvenCol-1" style="width:75px;"><strong>2006</strong></td><td class="ms-rteTableOddCol-1" style="width:703px;">The first annual NCAL Day is held as part of the AHCA/NCAL Annual Convention & Expo.</td></tr><tr class="ms-rteTableOddRow-1"><td class="ms-rteTableEvenCol-1" style="width:75px;"><strong>2010</strong></td><td class="ms-rteTableOddCol-1" style="width:703px;">NCAL begins the <a href="https://www.ahcancal.org/Assisted-Living/Awards-Programs/Pages/Awards.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">NCAL Awards Program.</a> </td></tr><tr class="ms-rteTableEvenRow-1"><td class="ms-rteTableEvenCol-1" style="width:75px;"><strong>2012</strong></td><td class="ms-rteTableOddCol-1" style="width:703px;">Assisted living is recognized as an official component of the <a href="https://www.ahcancal.org/Quality/National-Quality-Award-Program/Pages/default.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">AHCA/NCAL National Quality Award Program.</a></td></tr><tr class="ms-rteTableOddRow-1"><td class="ms-rteTableEvenCol-1" style="width:75px;"><strong>2014</strong></td><td class="ms-rteTableOddCol-1" style="width:703px;">NCAL develops Guiding Principles for Assisted Living. </td></tr><tr class="ms-rteTableEvenRow-1"><td class="ms-rteTableEvenCol-1" rowspan="1" style="width:75px;"><strong>2015</strong></td><td class="ms-rteTableOddCol-1" rowspan="1" style="width:703px;">Assisted living is integrated into <a href="https://www.ahcancal.org/Data-and-Research/LTC-Trend-Tracker/Pages/default.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">LTC (Long Term Care) Trend Tracker</a>. </td></tr><tr class="ms-rteTableOddRow-1"><td class="ms-rteTableEvenCol-1" rowspan="1" style="width:75px;"><strong>2018</strong></td><td class="ms-rteTableOddCol-1" rowspan="1" style="width:703px;">Maine Veterans Home – Machias in Machias, Maine, and Sunrise of Gurnee, a Sunrise Senior Living community in Gurnee, Ill., become the first freestanding assisted living communities ever to attain the Gold Quality Award. </td></tr><tr class="ms-rteTableEvenRow-1"><td class="ms-rteTableEvenCol-1" rowspan="1" style="width:75px;"><strong>2022</strong></td><td class="ms-rteTableOddCol-1" rowspan="1" style="width:703px;">NCAL establishes the <a href="https://www.ahcancal.org/Assisted-Living/Policy/Pages/default.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Assisted Living Regulatory Resource Center.</a></td></tr><tr class="ms-rteTableOddRow-1"><td class="ms-rteTableEvenCol-1" rowspan="1" style="width:75px;"><strong>2024</strong></td><td class="ms-rteTableOddCol-1" rowspan="1" style="width:703px;">NCAL launches the <a href="https://www.ltcdatacooperative.org/?_gl=1%2a9w29hp%2a_gcl_au%2aMTAwOTMxMzY2OS4xNzczMDcwNjI4" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Long-Term Care Data Cooperative</a> for assisted living.</td></tr><tr class="ms-rteTableFooterRow-1"><td class="ms-rteTableFooterEvenCol-1" rowspan="1" colspan="2" style="text-align:center;"><span class="ms-rteFontSize-1"><em></em><em>This is an abbreviated list of milestones. A more comprehensive timeline will be on display at Delivering Solutions 26, October 11-14 in Boston, Mass.</em></span></td></tr></tbody></table><p><em></em></p><p><em></em></p><p><em><br></em></p><p><em>Joanne Kaldy is a freelance writer and communications consultant based in New Orleans.</em><br></p> | 2026-03-06T05:00:00Z | <img alt="" src="/Issues/2026/Spring/PublishingImages/NCALanny.jpg" style="BORDER:0px solid;" /> | Assisted Living | In 1995, AHCA saw this opportunity and responded with the establishment of the National Center for Assisted Living, which has grown stronger as a beacon for assisted living providers. |
| The Leader Behind the Numbers: Chris Wright | <p><img src="/Issues/2026/Spring/PublishingImages/Spr26_ChrisWright.jpg" alt="Chris Wright" class="ms-rtePosition-2" style="margin:5px;width:340px;height:340px;" />Chris Wright has worn multiple hats in long term care, including certified public accountant (CPA), vice president, entrepreneur, board member, lifetime achievement award recipient, and son of a skilled nursing resident. But he sees his ultimate role as servant. Today, he is chair of the American Health Care Association (AHCA) board of governors, setting the national policy agenda for long term and post-acute care and serving care providers nationwide. </p><p>Wright credits certain basics for sustaining him: faith, family, and humility, to name a few. What makes him an authority is his ability to keep the lessons he’s learned front and center while leading others to reach new goals and results.</p><p>His desire to advocate for the long term care profession was inspired by those who expanded his appreciation early on. “My mother had a stroke in her seventies, and she was in a nursing home for eight years, and before she passed away, I learned a whole different perspective, being on the family side. I became very appreciative of the unsung heroes in the facility. </p><p>“That experience made me want to advocate even more for our residents, for my mom and the staff.”</p><h3>A Numerical Start</h3><p>Wright’s career started in numbers. After earning a bachelor’s degree in accounting from Lenoir-Rhyne University in Hickory, N.C., he went to work at a CPA firm. At 25, he landed his first role at a Southeast regional nursing home chain in North Carolina, working in the finance department. Eventually, he was promoted to the operations wing as vice president of budgeting and planning. </p><p>“I worked directly with the vice president of operations, and I would be the numbers guy,” Wright said. He gained firsthand knowledge of how nursing homes worked through his many trips to the chain’s more than fifty communities, assisting administrators while he performed profit and loss reviews, managed accounts payable, and oversaw the preparation of all the nursing home budgets. The organization also had ancillary companies, including those covering therapy, pharmacy, and medical supplies. </p><h3>The ‘Right’ Personality</h3><p>Here, Wright said, is when he fell in love with the profession. “You know, as a CPA, you’re not expected to have an outward personality, but I was told I did have that personality. It was then that I realized the importance of the work we were doing and that there were people behind the numbers. That led me into this very challenging but rewarding industry.”<br></p><p>Wright realized what he was getting into. “This is not a very glorified industry,” he said. “You have to be mission driven, and you have to want to serve and help people with their quality of life as they get older.”</p><p><a href="https://www.icarehn.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><img src="/Issues/2026/Spring/PublishingImages/iCare.jpg" class="ms-rtePosition-1" alt="iCare" style="margin:5px;" /></a>After serving in the “numbers guy” role for eight years, Wright moved on to do CPA consulting work for skilled nursing clients in the Denver area. His practice expanded to operational strategies, reimbursement, and, eventually, management and ownership. It was then that his company bid on facilities in Connecticut and purchased them out of receivership. Wright moved back to the East Coast to run the newly created iCare Management, now iCare Health Network, in Manchester, Conn.</p><p>Right away, Wright welcomed a turnaround challenge. “Our model at the beginning was to buy underperforming facilities,” he explained. “Of the twelve buildings we have today, nine were purchased out of receivership. We built those up to increase the value and quality of care. </p><p>“We own all the assets, management operations, and the real estate, which I think is a very good model. When you can manage all the challenges, that goes a long way in this environment.” </p><p>iCare Health Network delivers comprehensive short term rehabilitation and long term care services across its continuum of skilled nursing centers. While iCare serves a traditional nursing home population in many locations, it specializes in caring for individuals with complex medical, behavioral, and social challenges who are often underserved in traditional settings.<br></p><p>iCare centers offer extensive programming in behavioral health, substance use disorders, memory care, and justice-involved care. In Connecticut, each iCare center features at least one specialized clinical program. These range from advanced management of refractory heart failure and chronic pulmonary disease to on-site dialysis services and dedicated care pathways and programs for individuals living with HIV, Huntington’s disease, limb loss, and other complex conditions. The organization also provides specialized services for veterans and other high-acuity populations.<br></p><p>Many of the individuals iCare serves have experienced housing instability, substance use disorders, justice involvement, and other stigmatizing barriers to care. iCare’s unique model is part of Wright’s desire to be a problem solver.</p><p>“From the beginning, iCare has chosen to lean into complexity and challenge rather than away from it,” said Wright. “Our care centers and programs are designed to serve individuals who are too often overlooked or underserved—those with challenging medical conditions, behavioral health needs, or complicated social circumstances—and to do so with clinical skill and in a stigma-free manner. That commitment to meeting underserved populations where they are is what distinguishes iCare within the post-acute landscape and is a point of pride.”</p><h3>A Dual Approach</h3><p>Wright credits iCare’s success to having a great team and bringing in people with fresh ideas to help run the day-to-day business. This allows the company to stick to its mission of caring for residents who may be difficult to place in other settings.<br></p><p>When it comes to balancing providers’ everyday realities with a long-term vision, Wright said a dual approach is required.</p><p>“You have to realize there are nonnegotiables that we must deal with. For example, if staffing is an issue, you’ve got to be very deliberate and manage it. You need to figure out a way to stabilize it and to pull it together. That is nonnegotiable.</p><p>“At the same time, even though people have a business to run, they also need to get involved and advocate, especially with the state associations. We know what the challenges are. It can be a hard thing to balance, but you have to stay involved and be deliberate and intentional on what you have to deal with,” he said.</p><h3>Transitioning Leadership</h3><p>Recently, Wright made his own leadership transition. In 2025, he stepped out of the position of CEO of iCare, brought on a new CEO, and took on a new role in the company as chairman.</p><p>“It gives me the opportunity to step back and focus on our growth,” he explained. “I look at what we do well and take from my experiences to focus on how we can continue our mission.” </p><h3>Stepping into AHCA </h3><p><span><img src="/Issues/2026/Spring/PublishingImages/AHCA.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:54px;" /></span>Wright embarked on another path when he joined the AHCA board of governors in 2018. At this juncture, advocacy became front and center. </p><p>“This was a pivotal point and life-changing for me. It was to move to the next step—taking my experiences of the last four decades and using them to advocate for residents and a staff at a national level.”</p><p>The next change came last year when he was elected chair of the AHCA board. In this new role, Wright said, remembering his own beginnings has factored into his mindset. </p><p>“I look at it as a servant position. I’m not here to exert control. It’s about serving our members, and I’m focused on unifying a lot of priorities that we need to advocate for.” </p><h3>Goals as AHCA Chair</h3><p>As chair, Wright sees support of state affiliates and continued collaboration with the Centers for Medicare & Medicaid Services as central to keeping progress moving. Advocating for changes to the <a href="/Articles/Pages/The-(Over)-Reliance-on-the-CMS-Five-Star-Quality-Rating-System.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Five-Star Quality Rating System</a> tops his priorities list as part of the association’s push to rationalize the oversight system. <br></p><p>“The Five-Star system is too confusing to consumers, and it changes all the time,” he said. “We’re all for transparency and accountability, but give us a system that truly rates facilities consistently, fairly, and in a timely fashion.”</p><p>Another priority has to do with reimbursement. While Wright highlights the sector’s victory last year in avoiding Medicaid cuts in the One Big Beautiful Bill Act, he pointed out the challenges individual states will have in figuring out how to manage the larger changes to the program due to the bill. With the federal share likely to shrink, Wright said, American Health Care Association/National Center for Assisted Living state affiliates will play a key role in navigating potential Medicaid cuts in their states to protect nursing homes as Congress intended. <br></p><p>Wright also pointed to improvements needed in Medicare Advantage plans, a key part of the AHCA Better Way agenda. For older and sicker populations, the program is challenging, with frequent delays or denials in post-acute care and prior-authorization requests.</p><p>“It’s frustrating, and my parents were on the program],” he said. “We want Medicare Advantage to do the right thing for the beneficiaries and deliver on its promise.”</p><h3>Keeping the Path and People in Mind </h3><p>With a full agenda ahead of him, Wright recalled his journey to this point. “I am very humbled, and I know how I got to where I am,” he said. “It wasn’t given to me on a silver platter. I paid for my own college education, for instance. I wasn’t handed a company and told, ‘Here, take it from here.’”<br></p><p>The numbers guy has come full circle, taking it from here. <br><br><em>Amy Mendoza is a freelance writer and editor specializing in long term care, health policy, and health care operations.</em></p> | 2026-03-06T05:00:00Z | <img alt="Chris Wright" src="/Issues/2026/Spring/PublishingImages/Spr26_ChrisWright.jpg" style="BORDER:0px solid;" /> | Caregiving;Management | “I look at it as a servant position. I’m not here to exert control. It’s about serving our members, and I’m focused on unifying a lot of priorities that we need to advocate for.” |