| Medicaid Cuts Would Devastate Providers Serving ID/DD Populations | <p><img src="/Articles/PublishingImages/2025/Medicaid.jpg" class="ms-rtePosition-2" alt="Medicaid cuts" style="margin:5px;width:200px;height:200px;" />Medicaid cuts would be devastating to individuals with intellectual and developmental disabilities (ID/DD) and those who care for them. Virtually all 55,000 individuals with disabilities residing in the nation’s 5,300 intermediate care facilities (ICF) are on Medicaid.</p><p>ICFs provide active treatment and services for people with significant support needs. They offer 24-hour supervision, health care, therapies, activities, and training to maximize residents’ autonomy and independence. </p><p>Despite being the backbone of ID/DD care, Medicaid reimbursement rates often fall short of covering the actual cost of care, regardless of any future cuts. This underfunding has led to longer waitlists for home and community-based services programs, facility closures, and reduced access to timely, essential support that individuals desperately need.</p><p>The drop in ICFs, which has declined by more than 16 percent over the last 10 years, compounds the problem. Furthermore, newer facilities are not being built and certified at nearly the same pace as closures. This ultimately leads to fewer active Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities (ICFs/IID) and patients seeking care elsewhere or not at all.</p><p>Data show ICFs/IIDs are performing well. Centers for Medicare and Medicaid Services (CMS) survey ICFs/IIDs for regulatory compliance. Over 90 percent of surveys conducted in 2024 found zero condition-level deficiencies and demonstrated a commitment to quality care. </p><h3>Medicaid Doesn’t Cover Enough</h3><p>Medicaid does not fully cover the cost of care for individuals with intellectual and developmental disabilities. Access to quality long-term services and supports (LTSS) is at risk without adequate funding.</p><p>Provider taxes are one solution to expand services and support high-quality care. For more than 40 years, provider assessments (also called provider taxes) have helped states stabilize Medicaid funding and maintain care for vulnerable populations. There are 49 states and Washington, D.C., that rely on provider taxes to ensure that providers can continue serving Medicaid beneficiaries, and 32 of such states and D.C. apply these assessments for ICFs/IID.</p><p>Some federal budget proposals aim to lower the “Safe Harbor” limit on provider taxes from the current 6 percent, limiting states’ ability to use provider taxes. This would cut Medicaid funding without a replacement solution and reduce access to essential care for ID/DD populations while undermining efforts to recruit and retain much-needed stay in care facilities.</p><p>Medicaid is a lifeline for individuals with intellectual disabilities, especially those children and adults receiving 24-hour specialized care in ICFs/IIDs,” said Jamie L. Anthony, LSW, executive director, Developmental Options, a small non-profit organization located in Southeastern Idaho.</p><p>“ICFs provide essential access to health care, support services, and community resources, ensuring the individuals served receive necessary care and support to lead fulfilling lives and promote their independence and social inclusion,” Anthony said. “Without Medicaid, many would face significant barriers to essential services, limiting their opportunities for growth and well-being.”</p><h3>Forced to Reduce Services</h3><p>“The ICF industry has been plagued with funding challenges for over a decade, doing more with less, resulting in a significant decline in facilities nationwide,” Anthony said. “ICF providers rely upon Medicaid dollars for operation, allowing the industry to continue to survive for those individuals who benefit from the high-quality, individualized care plans and services.”</p><p>Anthony added, “Without Medicaid, or with significant cuts to Medicaid, they could face closure or be forced to reduce services. This would leave individuals with intellectual and developmental disabilities without access to critical care, potentially leading to institutionalization, neglect, or a lack of proper support in the community. Families may struggle to find alternative care options, and the overall quality of care could diminish.”</p><p>“We have reached a point where there are no further expense areas to reduce without significantly impacting essential services or operations, said Anthony. “Every line item has been carefully evaluated, and additional cuts would compromise the program’s core functions, quality of service, or overall sustainability. At this stage, the budget is already operating at minimal levels, and any additional reductions would harm the provider's ability to meet its goals.”</p><h3>Hiring Challenges Are Persistent</h3><p>Debbie Jenkins, advocacy director, Ohio Health Care Association, said that for a long time, ICF members have struggled to attract and retain the direct support professionals (DSPs), nurses, and other staff needed to care for their residents.</p><p>“For several years, they had to turn away people needing services because they couldn’t find enough staff to care for them,” Jenkins said.</p><p>In July 2023, the Ohio legislature passed HB 33, which invested significantly in ICF services to help increase wages. “This investment has stabilized most of our ICF providers' workforces,” Jenkins said. She said that during the past year and a half, her members told her that they have been able to adequately staff their current residents and take on a few new residents.</p><p>“However, challenges remain for serving people with significant needs requiring higher staffing ratios,” Jenkins said. “If Medicaid reimbursement for services is cut, any progress made in Ohio in the past year and a half would be lost. Providers would not be able to continue supporting their current wages, much less keep up with any future inflation.”</p><p>Additionally, Ohio has a pending provision in its budget bill that would eliminate the expansion population if the FMAP is reduced from the current 90 percent. </p><p>“Our rates do not cover these employees' full health insurance costs,” Jenkins said. Many DSPs are on Medicaid through the expansion population eligibility. If that goes away, we anticipate some DSPs will leave ICFs to find employment that includes health insurance benefits. These cuts would devastate the ICF workforce and leave many residents without care.”</p><h3>Wages a Key Determinant for Care</h3><p>Developmental Options has been actively working to raise wages for direct support staff to close the gap on open positions and attract reliable, dedicated caregivers. </p><p>“These efforts are critical to ensuring individuals receive the high-quality care they need,” Anthony said. “However, the uncertainty surrounding Medicaid funding has slowed this progress. Without stable and predictable funding, making the necessary wage adjustments and retaining staff is difficult, ultimately hindering the ability to fill positions and maintain consistent care for those who rely on these services.”</p><h3>Technology a Possible Solution</h3><p>Anthony said that better use of technology, such as artificial intelligence, could help to solve some of the funding and hiring gaps.</p><p>“It is important for our company and the industry to look for ways in which technology and AI can help us achieve more with fewer resources, allowing us to meet the regulations’ intent while maintaining high-quality programs,” Anthony said. “For example, finding software solutions that automate routine workflows reduce the time staff spends documenting while capturing critical data and allow agencies to make data-driven decisions can help improve compliance without adding staff.”</p><p><span><img src="/PublishingImages/Headshots/PaulBergeron.jpg" alt="Paul Bergeron" class="ms-rtePosition-2" style="margin:5px;width:140px;height:140px;" /></span>“However, a hurdle regarding software solutions is that many systems only focus on a single function (billing or scheduling, for example) and don't truly integrate tools and solutions that align with the ICF/IID regulations or program structure,” said Anthony.</p><p><em>Paul Bergeron is a freelance writer based in Herndon, VA.</em><br></p> | 2025-04-22T04:00:00Z | <img alt="" height="740" src="/Articles/PublishingImages/2025/Medicaid.jpg" width="740" style="BORDER:0px solid;" /> | Policy | Despite being the backbone of ID/DD care, Medicaid reimbursement rates often fall short of covering the actual cost of care, regardless of any future cuts. This underfunding has led to longer waitlists for home and community-based services programs, facility closures, and reduced access to timely, essential support that individuals desperately need. |
| 5 Fundraising Must-Do’s for Your Non-Profit Facility in Today’s Economy | <p><img src="/Articles/PublishingImages/740%20x%20740/fundraising.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:200px;height:200px;" />Times are changing, and if you’re a leader in a non-profit senior living facility, you’ve probably felt the pinch. Costs are climbing, donors have more choices than ever and keeping up can feel like a full-time job. In today’s dynamic economy, fundraising really is a full-time job.<br><br>That’s why more and more non-profit facilities are bringing on full-time professional fundraisers called development officers. Whether your facility is going full-time or if you as a leader have taken on the role yourself, here are five tried-and-true fundraising strategies that you should be adopting now to help keep the lights on and the care top-notch for your seniors.<br></p><h3>1. Make Donors Feel Like Family</h3><p>Nobody likes to feel like just another name on a mailing list. People give when they feel connected, so treat your donors like family. Here’s how:<br></p><ul><li>Send heartfelt thank-you notes, not just receipts. It’s what I call the long-lost art of the handwritten note. And it goes a long way. </li><li>Host casual get-togethers, like coffee with the director, so donors can see firsthand the impact of their support. Don’t ask for money at these gatherings, just dote on your supporters.</li><li>Make note of and acknowledge donor birthdays, their spouse, and/or kids’ birthdays, anniversaries, and other significant events. There are innovative CRMs that will track that for you.</li></ul><p>A little warmth and personal touch will often turn one-time donors into lifelong champions of your mission.</p><h3>2. Knock on Every Grant Door You Can Find</h3><p>With government grants disappearing or shrinking, it’s time to do the hard digging. You just have to know where to look. Here’s how to make sure you don’t leave money on the table:<br></p><ul><li>Partner with businesses for sponsorships—many companies love to give back to their communities. And large corporations are often required to support local non-profits.</li><li>Look into cause-marketing campaigns where a percentage of sales from a business benefits your facility.</li><li>Encourage matching gift programs so donors can double their impact with help from their employers.</li><li>And keep applying for local, state, and federal grants that support senior services. There may be less of them, but they’re still out there.</li></ul><p>Grants and corporate partnerships can help ease financial stress and open up new opportunities for your facility.</p><h3>3. Get Tech-Savvy with Fundraising</h3><p>If your fundraising efforts are still stuck in the past, it’s time for an upgrade. Online giving is bigger than ever, and it’s easier than you think.<br></p><ul><li>Host virtual or hybrid events to reach more people while cutting costs.</li><li>Start a crowdfunding campaign—people love to give when they see others chipping in too.</li><li>Use donor management software to track giving trends and personalize outreach.</li><li>Accept non-traditional donations like cryptocurrency and stocks to appeal to younger donors.</li></ul><p>By embracing technology, you’ll make giving easier, more accessible, and you’ll come off looking “in the know” with younger generations of donors.</p><h3>4. Get the Community Involved</h3><p>Your town is full of people who want to help—you just have to give them a reason to show up. Here’s how to rally the troops:<br></p><ul><li>Consider a membership program where supporters get exclusive perks for a yearly donation.</li><li>Offer hands-on volunteer opportunities so people can see the impact of their efforts up close.</li><li>Work with churches, civic groups, and local businesses to co-host fundraising events.</li><li>Tap into your biggest fans and turn them into ambassadors who spread the word and bring in new donors.</li><li>And give back! Support other causes in your community. Don’t just be a taker—be a giver. You will attract new supporters that way.</li></ul><p>When the community feels invested, they’ll go the extra mile to support your mission.</p><h3>5. Make Giving Easy and Automatic</h3><p>People love to give, but they also love convenience. Setting up automatic giving options makes it easy for donors to support you without having to think about it each month. Here’s how:<br></p><ul><li>Launch a “Friends of [Your Facility]” monthly giving club.</li><li>Partner with local stores and restaurants for round-up donation programs.</li><li>Encourage payroll deductions through workplace giving programs.</li><li>Sign up for passive fundraising programs like AmazonSmile and credit card donation programs.</li></ul><p>By making giving effortless, you’ll create a steady stream of income to keep things running smoothly.</p><p>Running a non-profit senior living facility isn’t for the faint of heart, but with the right fundraising strategies, we can weather any unconventional turns in the economy storm. Focus on relationships, seek out every grant opportunity, embrace digital giving, engage your community, and make donating easy. When you put in the effort, your donors will too—ensuring your seniors continue to receive the care and dignity they deserve.<br><br><em><img src="/Articles/PublishingImages/2025/Robert-Hahn.jpg" alt="Robert Hahn" class="ms-rtePosition-1" style="margin:5px;width:135px;" />Robert Hahn is the chief advancement officer for Birmingham Green Senior Living Facility in Manassas, Virginia. His role encompasses community engagement, mission/brand awareness, marketing, and development. Prior to serving at Birmingham, Hahn’s professional concentration was on developing non-profits that focused on rural hunger in America and poverty in Central America.</em><br></p> | 2025-04-17T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/fundraising.jpg" style="BORDER:0px solid;" /> | Management | Costs are climbing, donors have more choices than ever and keeping up can feel like a full-time job. That’s why more and more non-profit facilities are bringing on full-time professional fundraisers called development officers. |
| How Nursing Homes Can Revitalize Their Nursing School Partnerships | <p><img src="/Articles/PublishingImages/740%20x%20740/nurses.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:200px;height:200px;" />Spring is a time to clean, organize, and prepare for warmer days. Nursing homes can use this season of transition as an opportunity to refresh their partnerships, including those with schools of nursing. Whether a nursing home has an established partnership with a school of nursing or is looking for a new partner, nursing homes and schools of nursing can forge effective, stimulating partnerships with mutual benefits.</p><p>Schools of nursing can provide value to nursing homes that want to enhance the quality of care for residents and diversify their talent recruitment strategies. Positive, impactful clinical experiences for nursing students in nursing homes can expose a new generation of nurses to the benefits of working with older adults while also helping them strengthen their gerontological nursing skills. Nursing faculty can be an invaluable resource for nursing home leadership through the sharing of clinical processes, techniques, and evidence-based programs.</p><p>However, nursing homes have not always been satisfied with their school of nursing partners. Many nursing home leaders believe they don’t have the resources or time to invest in clinical education for nursing students, especially with ongoing staffing challenges. They may also find it stressful to work with clinical faculty who have no prior nursing home experience.</p><p>Effectively partnering with schools of nursing is an effort in creativity and requires work on both sides. But like all work that is worth doing—there are tremendous rewards for both partners.</p><h3>Partnerships in Pennsylvania</h3><p>Over the past four years, nursing homes from the <a href="https://www.patnhc.org/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Pennsylvania Teaching Nursing Home Collaborative</a> have identified promising practices for how to reinvigorate academic-practice partnerships between nursing homes and schools of nursing. The Collaborative’s lead nursing home partners in Pennsylvania, including Presbyterian SeniorCare The Willows, UPMC Canterbury Place, Centre Care, and Wesley Enhanced Living Main Line, have worked closely with their partner schools of nursing to strengthen their working relationships and improve experiences for residents, nursing home staff, nursing students, and faculty.</p><p>“Showing nursing students this specialty of care allows them to see the autonomy and critical thinking skills that the long-term care nurse possesses,” said Taylor McMahon, RN, director of nursing at Presbyterian SeniorCare The Willows. “This will help long-term care recruit the future workforce by giving them the opportunity to pursue a career that makes a difference by serving older adults.”</p><p>Nursing homes can use the following strategies validated by the Collaborative’s partners to revitalize their partnerships with schools of nursing. </p><h3>Assess What Has and Hasn’t Worked In the Past </h3><ul><li><strong>Take a step back.</strong> Reflect on what has and hasn’t worked well with current and/or previous partnerships. Be sure to involve direct caregivers and licensed nurses in this conversation. Determine if a previous partnership didn’t work because of the nursing home, the school of nursing, or both, and whether it can be salvaged.</li><li><strong>Establish goals.</strong> What would be most beneficial for the facility? Does the nursing home need to test a new way to engage local nursing students? How could nursing students most benefit the residents during their clinical time in the facility? </li></ul><h3>Update or Create New Partnership Structures </h3><ul><li><strong>Find a new partner.</strong> Nursing home leaders can connect with local schools of nursing at networking events, conferences, or by reaching out via email to the school’s dean, lead clinical coordinator, or faculty who focus on gerontological nursing. Nursing homes located in Pennsylvania can access resources from the <a href="https://www.patnhc.org/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Pennsylvania Teaching Nursing Home Collaborative</a> to find local nursing programs that are open to new partnerships. </li><li><strong>Build a team.</strong> Include people from multiple departments to help coordinate the partnership. Ideally, they will have both interest and time. Assign roles such as who will work with instructors to design clinical experiences that benefit both the nursing students and residents, and who will manage and teach students during their rotations. </li><li><strong>Establish standing meetings.</strong> During the first meeting, nursing home leaders can clearly communicate their goals for the partnership while also hearing from the school of nursing about their goals for students’ clinical experiences. These meetings are an opportunity to create a plan that meets both partners’ needs. Plan for debrief meetings with the nursing home team after students’ clinical experiences to ensure concerns are addressed quickly.</li><li><strong>Orient faculty.</strong> Before students’ clinical rotations begin, invite nursing faculty to tour the nursing home so that instructors can get to know layout of the facility, confirm the goals for the clinical rotation, and pre-determine any needs the students might have such as parking or public transit routes.</li></ul><h3>Embrace Co-Design for Clinical Rotations</h3><ul><li><strong>All teach, all learn.</strong> Create an environment where everyone can teach and learn from each other. Invite faculty to share new methods of care delivery they are seeing in other settings. Encourage nursing home team members to highlight their care delivery methods that students and faculty may not encounter in any other clinical setting. </li><li><strong>Create a common language.</strong> Nursing homes can implement the <a href="https://www.ihi.org/networks/initiatives/age-friendly-health-systems" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Age-Friendly Health Systems 4Ms framework</a> to 1) enhance the quality of their person-centered care approaches, and 2) use the 4Ms as a “common language” to ease communication with faculty and teach nursing students essential gerontological nursing skills. </li><li><strong>Leverage “What Matters.”</strong> Residents enjoy spending time with students, in particular with the 4Ms “What Matters” activities where residents can share their personal stories and students can improve their interpersonal communication skills. </li><li><strong>Highlight the uniqueness.</strong> Nursing home staff can show students that nursing homes are a unique opportunity for nurses to work in an environment that is not only clinical but also residents’ homes, where collaborating across departments is critical to ensuring residents are healthy, safe, and happy.</li></ul><p>“We don’t expect this to be a quick fix for our staffing issues, but rather we are planting the seeds for the future,” said Kim Ratliff, RN, director of nursing at Wesley Enhanced Living Main Line.</p><p><img src="/Articles/PublishingImages/2025/Sophie-Campbell.jpg" alt="Sophie Campbell" class="ms-rtePosition-2" style="margin:5px;width:130px;height:160px;" />As nursing schools begin to prepare for the next academic year, spring is the perfect time for nursing homes to rethink and renew their partnerships. The <a href="https://www.patnhc.org/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Pennsylvania Teaching Nursing Home Collaborative</a> provides free resources that have been created for and by nursing homes and schools of nursing committed to improving their academic-practice partnerships. <br><br><em>Sophie Campbell, MSN, RN, CRRN, RAC-CT, CNDLTC, is the executive director of the Pennsylvania Association of Directors of Nursing Administration (PADONA). </em><br></p> | 2025-04-08T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/nurses.jpg" style="BORDER:0px solid;" /> | Management | Nursing homes can use this season of transition as an opportunity to refresh their partnerships, including those with schools of nursing. |
| Ask This Critical Question Before Retrofitting a Building | <p><img src="/Articles/PublishingImages/2025/senior_room.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:200px;" />One of the most important questions to ask before starting a facility retrofit project often goes unanswered: “How are people actually using the building?”</p><p>It is easy to make assumptions. Residents spend the majority of their time in their rooms or apartments, the dining hall, and social areas. Visitors follow residents and staff work on dedicated floors or wings. But what if these assertions were only partially true?</p><p>What if data tells you when residents are most likely to want to socialize or are more susceptible to falls. Similarly, you may learn that the first stop for visitors is in one-on-one meetings with medical staff or the business office manager. Further, staff are often pulled in to help residents all over the community, instead of a dedicated floor, to fill ongoing staffing gaps. Those insights can shape the resident, staff, and visitor experience and influence retrofits.</p><p>Yet when it comes time for the building or community to undergo a retrofit, these assumptions are carried out in the planning and construction because real data on actual behaviors is not used.<br></p><h3>The Impact of Relying on Assumptions During Retrofits </h3><p>While the building and amenities get an appealing facelift, a retrofit based on assumptions miss an opportunity to optimize the human experience within the building.</p><p>Here are a few examples of what happens. Dedicated visiting areas feature expensive new furniture that goes unused. The latest tech tools and digital apps looked great and easy to use during the demo, but months later your staff still faces a steep learning curve. Meanwhile, residents find it difficult to adapt to the changes, impacting their quality of life. These issues can be avoided by having a better understanding of how the building is used before the retrofit starts.</p><p>With 42 percent of senior care communities in the U.S. being at least 25 years old, there is a pressing need to upgrade and modernize facilities. This is becoming increasingly critical as demographics shift. By the year 2030, there will be more adults over 60 than there are under that age.</p><h3>Getting Real-Time Insights Without Compromising Privacy</h3><p>Without real insights into how residents, staff and visitors use the buildings, retrofit investments won’t pay off. But how do you get that information?</p><p>You can monitor behavior but that is time consuming, invasive, and lends itself to personal bias. Or you can look at research, but it is often an additional cost and is based on empirical data as opposed to intel specific to your community. Another option is to ask people to participate in a survey, but that, too, is time consuming and opinion based.</p><p>Lately, one way that senior care communities are resolving this issue is by capturing real data on how humans interact in buildings using newer technologies that ensure privacy.</p><p>For example, using thermal heat-sensing technology provides insight into human movements in a space without knowing the individuals that are present. The thermal technology depicts humans as small circles that are moving or stationary. This technology can come in the form of a sensor that goes on the wall, blending into the retrofit design.</p><p>What senior care administrators can infer from the sensor data are insights such as the best location for a visiting area, or when residents are most likely to engage in social activities based on their behaviors as opposed to a scheduled time. From a health perspective, being notified of changes in a resident’s movement allows staff to respond faster to emergencies. These urgent notifications, often a text, reduce technology learning curves because the complex computing is done behind the scenes.</p><h3>The Benefits of Building Insight: Safety, Compliance, and Revenue</h3><p>Having insight into how humans use a building before investing in a retrofit creates an opportunity to boost safety, ensure compliance, and improve the continuum of resident care.</p><p>It can also deliver better returns on the retrofit investment, according to administrators at Ranagård Community, which is using privacy-friendly heat-based sensors in over 700 apartments.</p><p>The sensors work with nurse call systems and immediately alert staff to incidents such as wandering, falls, or an increase in trips to the bathroom. This makes better use of staff time that was previously spent doing scheduled resident check-ins. They also have a digital record of activities, care, and responses in the event of an inquiry.</p><p><span><img src="/Articles/PublishingImages/2024/Honghao-Deng.jpg" alt="Honghao Deng" class="ms-rtePosition-2" style="margin:5px;width:124px;height:171px;" /></span>The community estimates they save $1,875,000 per year by reducing 0.5 falls per year based on an average cost of $5,000 cost per fall, which requires two nurses to accompany a resident to the hospital. With safer buildings, they believe they can increase occupancy by 250 beds, resulting in an additional $2,160,000 per year.</p><p>Each community must determine their own return on investment on retrofits. Yet as the need for senior care rises and residents demand modern buildings, the retrofit process should always start with a clear understanding of how the building is being used.<br><br><em>Honghao Deng is CEO and co-founder of </em><a href="https://www.butlr.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><em>Butlr</em></a><em>.</em><br></p> | 2025-03-25T04:00:00Z | <img alt="" src="/Articles/PublishingImages/2025/senior_room.jpg" style="BORDER:0px solid;" /> | Design;Architecture | Each community must determine their own return on investment on retrofits. Yet as the need for senior care rises and residents demand modern buildings, the retrofit process should always start with a clear understanding of how the building is being used. |
| Navigating Therapy Provider Transitions | <p><img src="/Articles/PublishingImages/2025/doc_paperwork.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:200px;height:200px;" />Having worked in long term care in a variety of roles, this professional has seen firsthand the challenges that arise when an organization decides to change its therapy provider. </p><p>My experience includes delivering direct care for both contract and in-house therapy services as an occupational therapist, then serving as a single site therapy manager, to an executive rehab leader overseeing multiple therapy programs through acquisitions, divestitures, and provider transitions, and now as a compliance manager guiding organizations in strengthening their compliance programs.</p><p>This range of experiences has allowed me to see the successes and pitfalls that can occur, from deciding that a new therapy provider is necessary to ensuring a relationship stays strong, and everything in between.</p><p>Whether transitioning from a contract therapy provider to in-house services, selecting a new contract partner, or navigating operational and regulatory complexities, organizations must carefully balance continuity of care, financial stability, and compliance. Rushed transitions can lead to gaps in service delivery, contract disputes, and reimbursement challenges.</p><p>The good news? A well-planned transition can ensure that the new provider is not only a replacement, but a true partner aligned with the organization’s culture, values, and clinical standards. The following steps offer a roadmap to navigate this process thoughtfully, minimizing disruption, and maximizing success.</p><h3>Step 1: Assessing the Need for a New Provider</h3><p>Organizations typically consider changing their therapy provider for several key reasons. Performance concerns like inconsistent service delivery or compliance issues may prompt leadership to explore alternative options. Additionally, financial considerations often play a role as organizations seek opportunities for cost efficiencies without compromising quality. In some cases, the motivation stems from a desire for enhanced service offerings or a more aligned partnership that supports the organization's long-term strategic goals.</p><p>When evaluating a potential transition, it is essential for leadership to conduct a thorough assessment of the existing provider's strengths and weaknesses. Identifying gaps enables leadership to make informed decisions and positions the organization to choose a new therapy provider that aligns with its specific goals.</p><h3>Step 2: Collaborating with a Selection Committee</h3><p>Once the decision is made to transition to a new therapy provider, it is essential to establish a multidisciplinary committee to guide and oversee the entire selection process. This committee should comprise key stakeholders from various departments within the organization to ensure that all perspectives are considered. At a minimum, the committee should include the compliance officer, nursing home administrator, director of nursing, head of clinical operations, chief financial officer, and a representative from information technology. Consider including a resident representative to ensure that the voices of those directly impacted by therapy services are heard.</p><p>The transition committee will work together to establish objective criteria that define the ideal therapy provider for the organization. This criterion should be used to create a scorecard against which an organization can weigh each provider. With these standards in place, the next step is to issue a request for proposal (RFP). The RFP should clearly outline the organization’s expectations, goals, and timeline, providing potential providers with a clear understanding of what is required for consideration.</p><h3>Step 3: Performing Due Diligence</h3><p>The committee should use the ratings gathered in the RFP to create a short list of the top providers they want to investigate further. Final candidates should be invited onsite for interviews and/or presentations. This interview is an opportunity to ask detailed questions about the providers' services, culture and how they plan to meet the organization's specific needs.</p><p>An organization must conduct reference checks, appropriate credentialing, and background checks as required by state, federal regulation, or the Office of Inspector General (OIG).  For example, sanction screenings such as OIG's List of Excluded Individuals and Entities, the federal System for Award Management and the State Medicaid Provider Exclusion and Suspension List should be conducted. Review the providers’ compliance policy, ask for evidence of regulatory and compliance training and inquire about their claims denial rate. Even if a provider looks good on paper, it is critical to see if their practices reflect their values before making a final decision.</p><h3>Step 4: Facilitating Contract Negotiations</h3><p>Once the top therapy provider is selected, both parties are ready to formalize their business relationship. A contract policy provides a structure for those tasked with negotiation. To start, this should include fundamental provisions like indemnification, liability, compensation, and billing among other items. Additionally, the organization should ensure that the contract includes a clause requiring the provider to adhere to the organization’s code of conduct and compliance program.</p><p>A definition of deliverables involving key performance indicators, adequate and competent staffing, and resident satisfaction goals should also be included.</p><p>Consider bundling value-added services, such as participation in key meetings and periodic training for staff and residents, alongside the main target. These services may not be billable but enhance the quality of the care delivered. Lastly, the organization should ensure that legal counsel reviews the contract before execution.</p><h3>Step 5: Developing a Transition Plan</h3><p>Once an organization is ready to bring in a new therapy provider, it’s essential to create a timeline that pinpoints clear milestones for each transition phase.</p><p>A communication campaign should be developed to ensure consistency of messages and promote transparency to residents, families, and staff, fostering confidence that continuity of care will be maintained.</p><p>Another key part of the timeline is staff training and integration to make sure that a new provider’s team is familiar with the organization’s culture and operational workflows. <br></p><p>Technology integration also contributes to the transition plan, ensuring interoperability, data security and adequate equipment and infrastructure.  A compliance checklist should also be created to ensure the organization remains survey- and audit-ready.</p><h3>Step 6: Implementing and Monitoring</h3><p>Once contracts are signed and a transition plan is in motion, the transition committee must stay engaged. For the transition to be truly effective, the existing staff and the new therapy team can collaborate for a seamless changeover.</p><p>Another key step in implementation is reviewing the policies of both the organization and the therapy provider to ensure alignment with the organization's values and standards. <br>On the monitoring side, organizations should ensure they are audit-ready, schedule mock surveys to verify compliance with federal and state regulations, track providers' performance against agreed-upon terms, and create a channel for residents and families to provide feedback as the team continues to shift.</p><h3>Step 7: Overseeing the Post-Transition</h3><p>Finally, over the course of three to six months, the transition team should stay involved to ensure that the new therapy provider meets expectations.</p><p>The team’s role in this stage is substantial and will require a similar representation of individuals within the organization who can tackle areas including:<br></p><ul><li>Regulatory compliance.</li><li>Monitoring performance.</li><li>Reviewing key performance indicators. </li><li>Collecting and analyzing resident and family feedback.</li></ul><h3>Keeping a Strong Partnership</h3><p>Transitioning therapy providers is a large undertaking that can significantly impact the residents and staff of an organization. To respect the investment of time from the search committee and honor the mission of providing top quality care to residents, the organization should take care to maintain the partnership with a therapy provider and find ways to strengthen it proactively.</p><p><img src="/Articles/PublishingImages/2025/Angele-Tran.jpg" alt="Angele Tran" class="ms-rtePosition-1" style="margin:5px;" />Strengthening these relationships can take multiple forms but should include open communication that allows challenges to be addressed and practices to be improved upon. The partnership between the organization and therapy provider should be built on a shared commitment to delivering exceptional care while upholding the organization’s mission and values.<br><br><em>Angele Tran, OTR/L, CHC, CAPS, is a compliance manager at Friends Services Alliance in Blue Bell, Penn. She is a licensed occupational therapist in Pennsylvania.</em><br></p> | 2025-03-04T05:00:00Z | <img alt="" src="/Articles/PublishingImages/2025/doc_paperwork.jpg" style="BORDER:0px solid;" /> | Management | Whether transitioning from a contract therapy provider to in-house services, selecting a new contract partner, or navigating operational and regulatory complexities, organizations must carefully balance continuity of care, financial stability, and compliance. |
| Finding Solutions for the Booming Long Term Care Population | <p><img src="/Issues/2025/Spring/PublishingImages/Silver-Tsunami.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:200px;height:200px;" />Every day 10,000 baby boomers turn 65, according to U.S. Census data. The baby boomer generation began turning 65 in 2011 and will continue to add 10,000 each day through 2030. <br></p><p>The number of older adults will more than double over the next several decades to top 88 million people and represent over 20 percent of the population by 2050, according to a 2019 report from AARP. This silver tsunami of aging individuals will have a ripple effect through U.S. society, impacting industries across the nation. One of the most affected sectors will be the long term care profession.  <br></p><p>This rapid increase in older adults will create challenges and opportunities for the long term care profession over the next few decades. In addition to having more older individuals, people are living longer—between 2022 and 2040, the number of people who are 85 or older will more than double, according to the “Aging in the United States” report to Congress in May 2024. </p><h3>Demand for Senior Care Facilities</h3><p>The long term care profession has been aware of this coming demographic shift for years and will need to provide solutions in several main areas. First and foremost is availability. Demand strongly outpaces supply and will continue to widen as the baby boomers age. <br></p><p>This demand is a business opportunity for those operating senior living, assisted living, and skilled nursing facilities. In addition to expanding and modernizing facilities, new locations will need to be built and staffed. This has led to innovation in construction methods to meet the rising need for space. <br></p><p>Tino Popescu, vice president of clinical services at Maplewood Senior Living, said some states, such as Texas, California, and Florida, may each need more than 250 new nursing homes by 2030 to maintain current population-to-nursing-home ratios.<br></p><p><img src="/Issues/2025/Spring/PublishingImages/Tino-Popscu.jpg" alt="Tino Popescu" class="ms-rtePosition-2" style="margin:5px;" />“However, staffing shortages, rising labor costs, and high construction expenses constrain growth,” Popescu said. “New development remains slow, and acquisitions are focused on smaller, distressed assets. Federal policy shifts—particularly in Medicaid reimbursement—will be critical in shaping investment strategies.”<br></p><p>“The industry has been trying to solve this by creating less expensive construction,” Zach Bowyer, MAI, MRICS, executive managing director, Cushman & Wakefield, said. “For example, hotel conversions can reduce real estate costs.”<br></p><p>Developers sense the need to move quickly and efficiently in building structures to serve this population, according to BKV Group’s Senior Housing Practice Leader, Grant Warner.<br></p><p>“Some are shifting toward prototype construction that saves time and money,” said Warner. “Some are also focusing on much-deserved areas such as suburbs, exurbs, rural communities, and urban areas.” Others are developing pre-fabricated housing solutions to save time and money.<br></p><p>Despite increased demand, growth in new senior housing options is at one of the lowest levels in recent history, according to Anne Hill, senior vice president of Bayview, PACE, which provides financing for senior living and long-term care facilities.<br></p><p>Like other commercial real estate segments, construction starts have slowed significantly nationwide due to the more expensive financing environment and elevated construction and labor costs.<br></p><p>Doug King, vice president emeritus, health care at Project Management Advisors, Inc., said he is confident that existing assisted living communities will be able to scale up, as renovating existing housing stock doesn’t require significant adaptation to become an effective assisted living community. <br></p><p>“The need for skilled nursing facilities is another, more complex matter,” King said. “These licensed rooms have technology and other health care features such as telemetry, medical gases, nurse calls, patient lifts, and provisions for patient safety, such as handrails, that are not found in the typical multifamily residential structure.”</p><h3>Affordability Remains a Primary Challenge</h3><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, according to Bowyer. “When you look at housing affordability in the middle markets, half the population can’t afford it,” he said.<br></p><p>“We need more solutions on the horizon for the middle market, which is made up of folks who will have a fixed income that doesn't align with some of the more luxurious options, such as teachers, firefighters, skilled trade workers,” according to Shannon Arnold, president, Kara Casa. <br></p><p>The number of unpaid caregivers (such as family and/or friends) will on average decrease over the next five years, resulting in the increased need for paid caregiving in an appropriate long term care setting such as assisted living, according to a 2024 article from the National Council on Aging (NCOA).<br></p><p>Over 15 million (or roughly one in three) older adults aged 65 and older are economically insecure, with incomes below 200 percent of the Federal Poverty Level said NCOA. Unfortunately, many seniors must spend down their assets in order to qualify for Medicaid to have their long term care covered. (Medicare does not cover long term care.) To qualify for Medicaid, most states require that you demonstrate that you require skilled nursing level care. Not everyone who needs long term care necessarily needs 24/7 support and may have their needs better met in a setting like assisted living. <br></p><p>One option is to make assisted living a more affordable option to meet the changing needs of a growing elderly population. Assisted living communities that are 100 percent Medicaid are often built in areas specifically to serve low-income residents. To offer affordable assisted living exclusively requires an entirely different business model and vigorously looking for loans and programs to stay viable. This includes HUD loans, low-income tax credits, and USDA multifamily housing direct loans. Public-private partnerships are needed to identify opportunities and facilitate grant programs or other financing options.<br></p><p><img src="/PublishingImages/Headshots/LBethea.jpg" alt="LaShuan Bethea" class="ms-rtePosition-1" style="margin:5px;width:186px;height:233px;" />Research shows that some seniors will need more affordable assisted living options, as fewer resources and fewer family caregivers will impact the need for and ability to access assisted living care. But the path to getting there faces obstacles.<br></p><p>“There are many challenges that need to be addressed in order for assisted living providers to be able to deliver more affordable care options,” said National Center for Assisted Living Executive Director LaShuan Bethea. “How long term care is currently financed, Medicaid underfunding, and essential public-private partnerships—these all need to be considered as we face an increasing senior population that will depend on the high-quality care offered in assisted living sooner than we realize.”  </p><h3>Managing Multiple Conditions</h3><p>One result of a longer lifespan is that those in the 80+ demographic are also experiencing more health issues. Popescu said it is estimated that 90 percent of adults over age 65 experience one or more chronic conditions requiring specific treatments and medical care.<br></p><p>This need to manage multiple conditions has led to an increase in innovations in technology. Technology use has exploded in the long term care profession in the past few decades and will be a critical part of caring for the silver tsunami. Innovations in monitoring and care practices have allowed skilled nursing residents to avoid hospital visits and continue to be managed in the facility. <br></p><p>Electronic health records, interoperability, telehealth, and cybersecurity developments have helped move paper records into the electronic age, allowing for greater collaboration and communication, particularly in moving between care locations and physicians. <br></p><p>Artificial intelligence is one of the most exciting areas of technology in long term care right now. Whether AI is helping to optimize the use of staff time, monitoring residents to reduce falls, providing companions or enrichment activities, AI is finding its way into the industry in a myriad of ways. <br></p><p>“We not only have a rapidly growing number of elders in this demographic group, but many are not aging in healthy ways,” Banta said. “There is tremendous growth in dementia and co-morbidities that will require a vast expansion of acute care resources and housing in this country.”<br></p><p><img src="/PublishingImages/Headshots/DavidGifford_2022.jpg" alt="David Gifford, MD" class="ms-rtePosition-1" style="margin:5px;" />Greater research and development in treatment methods for conditions such as dementia are experiencing greater uptake as well. An estimated 6.9 million Americans age 65 and older are living with Alzheimer’s dementia as of 2024, according to Popescu. This number could potentially grow to 13.8 million by 2060 without medical breakthroughs. Alzheimer’s remains the fifth-leading cause of death among Americans age 65 and older. <br></p><p>As a sector, “We have a good history of caring for residents with advanced dementia,” said David Gifford, chief medical officer at AHCA/NCAL. New, neurology-forward approaches to care have shown great promise in helping those with dementia manage these conditions better.<br></p><p><img src="/PublishingImages/Headshots/PaulBergeron.jpg" alt="Paul Bergeron" class="ms-rtePosition-2" style="margin:5px;width:185px;height:185px;" />While the silver tsunami brings challenges with higher numbers of seniors living longer and with more conditions, long term care as a profession is poised to tackle those challenges. New thinking, compassion, and technology—combined with investment, regulatory support, and a focus on workforce—will see the long term care segment growing well into the future. <br><br><em>Paul Bergeron is a freelance writer based in Herndon, VA.</em></p> | 2025-02-28T05:00:00Z | <img alt="Silver Tsunami" src="/Issues/2025/Spring/PublishingImages/Silver-Tsunami.jpg" style="BORDER:0px solid;" /> | Assisted Living;Caregiving | The first in an article series about the challenges and opportunities the silver tsunami will bring to long term care in the United States.
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| Advancing Music Therapy Approaches in Dementia Care | <p><img src="/Articles/PublishingImages/2025/music-therapy.jpg" alt="Bridgetown Music showing “Music with Alexis” " class="ms-rtePosition-2" style="margin:5px;width:240px;height:240px;" />Music has long been recognized as a powerful tool in dementia care, offering comfort, connection, and cognitive stimulation for those experiencing memory loss. However, as expectations rise for more effective dementia care, the standard for music programs also increases. Today, there is a growing emphasis on approaches that deliver not just entertainment but true therapeutic impact, rooted in the formal field of music therapy.</p><p>"Music therapy is a clinical and evidence-based practice that uses music to accomplish individualized goals and objectives," explains Tara Jenkins, MT-BC, a board-certified music therapist and founder of <a href="https://www.harmonyindementia.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Harmony in Dementi</a>a. "Our work supports clients' social, emotional, cognitive, physical, communication, musical, and spiritual needs. Essentially, we use different aspects of music to achieve individualized goals both in and outside sessions."</p><p>But change is afoot within the dementia industry. While traditional music therapy provides a deeply personalized experience tailored to an individual's emotional and cognitive needs, new models are emerging that bring the benefits of music to entire communities, around the clock, creating shared moments of joy and interaction. The following examples offer a brief survey.</p><p>Jenkins focuses on the individualized approach, working closely with people living with dementia to use music as a means of communication, emotional expression, and cognitive engagement. Her one-on-one sessions are rooted in clinical training, using music to tap into personal memories and provide therapeutic benefits unique to each resident.</p><p>For many individuals, this approach helps unlock emotions, reduce anxiety, and improve mood in a way that traditional music activities often cannot. Mood management is particularly important in memory care since mood disorders can create depression and behavioral issues, which can often trigger the use of powerful medications—sometimes with ill effects.</p><p>“The familiarity of music from a person's young adult years is the vessel of comfort, and the music therapist is there as a guide to support dignity and intentional moments of joy,” adds board-certified musical therapist Kim Best, MT-BC, founder of <a href="https://kimbestmusictherapy.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Kim Best Music Therapy</a>. “Music therapy may look like magic, but it is the coming together of music, a person with dementia, and a music therapist—someone who not only cares deeply but is trained to carry music in a purposeful way to promote wellness.”</p><p>When requested, Best extends the conventional 1:1 model to small groups. But new tools bring new opportunities. </p><p>Perhaps the most current evolution of music therapy in dementia care is the video distribution of “dementia-friendly” music with therapeutic underpinnings. This removes the need for in-person music programs and opens the door for 24/7 access worldwide.</p><p>Alexis Baker, MT-BC, a board-certified music therapist and founder of <a href="https://www.bridgetownmt.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Bridgetown Music Therapy</a>, has taken the foundational principles of music therapy and expanded them into a structured group model. During the pandemic, personal visits were not permitted so she and her video producer husband, Tom, took her music therapy online for the first time.</p><p>Baker still practices both the 1:1 model and a group version to enlarge impact within a senior dementia care population. Her program, Music with Alexis, delivers “dementia-friendly” therapeutic music sessions via an online platform with hundreds of on-demand videos to choose from. Activity directors can shape their music program around the specific genres of music their residents prefer.</p><p>This group-based approach is particularly important in today’s senior living communities, where activity directors often struggle to meet the diverse needs of memory care residents. Many group music programs prioritize entertainment, selecting familiar songs for passive enjoyment. However, Music with Alexis offers a deeper level of engagement—drawing on music therapy techniques to encourage participation, stimulate cognition, and foster social connection.</p><p>Senior living professionals who have integrated the program into their programs report noticeable improvements in resident engagement and overall well-being. Erin Coran, manager of community life at Vincentian in Pittsburgh, Penn., shared, “The program has transformed the way we approach activities for our residents. The music brings joy to our community, and staff feel empowered by having such a reliable resource.”</p><p>By blending music therapy principles with a practical, community-friendly format, Baker and others like her have created a bridge between the highly individualized world of music therapy and the realities of group-based senior care. This innovative approach ensures that more residents can experience the emotional and cognitive benefits of music, reinforcing the idea that music is not just an activity. It’s a vital, accessible tool for enhancing the quality of life for those living with dementia.</p><p>As senior living communities continue to seek meaningful ways to support their residents, both individualized music therapy and structured group-based programs offer complementary solutions. Whether through one-on-one sessions that provide a deeply personal therapeutic experience or broader group engagement that fosters connection and joy, music remains one of the most effective and uplifting interventions in dementia care today.<br><br><em>Bill Pemberton, is a freelance writer focusing on senior health based in Dallas, Texas. </em><br><span id="ms-rterangepaste-end"></span></p> | 2025-02-25T05:00:00Z | <img alt="" src="/Articles/PublishingImages/2025/music-therapy.jpg" style="BORDER:0px solid;" /> | Caregiving;Dementia | As senior living communities continue to seek meaningful ways to support their residents, both individualized music therapy and structured group-based programs offer complementary solutions. |