Technological innovations in health care are advancing at an incredible speed, and providers are being showered with marketing for a broad spectrum of technology solutions. At the same time, policymakers are seeking to establish policies that encourage adoption of technology to improve care while also protecting individuals from physical, psychological, or financial harm associated with such technologies. Provider investments in technology vary based upon market, organizational, and regulatory compliance factors. This article highlights the landscape of technology use in nursing facilities and what providers and policymakers are considering in investment and policy decisions.
Technologies Used in Nursing Homes
Health technologies used in nursing homes today are most effective if they can share information between providers, patients, payers, medical devices, and government agencies in an interoperable and secure manner. Ideally, many of these exchanges are automated. This usually means the provider needs access to broadband services. Additionally, sharing of information most efficiently requires the provider’s software platform, usually the electronic health record (EHR), to conform to the Office of the National Coordinator for Health Information Technology (ONC) certification standards, or to share information through a health information exchange (HIE) by complying with the Trusted Exchange Framework and Common Agreement (TEFCA).
Clinical technologies with growing use in nursing homes include telehealth platforms, sensor technology, wearable health technology, service delivery robots, and social robots. AI applications are being used in conjunction with these technologies to provide support and improve efficiencies with clinical decision-making, scheduling, quality improvement, and other activities. Interoperable technologies can also improve efficiencies during transitions of care with prior authorizations, claims processing, medical review, appeals, electronic quality measures (eQMs), public health surveillance, and medical research.
Technology Adoption in Nursing Homes
There are wide variations in digital capabilities across post-acute and long term care nursing home providers. This is the direct result of historical federal prioritization of hospital inpatient and primary care interoperability support through the implementation of the Health Information Technology for Economic and Clinical Health (HITECH) Act and in subsequent coordinated care, bundled care, and other integrated care value-based payment models advanced by the Centers for Medicare & Medicaid Services (CMS). Since nursing home providers were not specifically identified in the HITECH Act, the federal administrative support necessary to facilitate seamless, secure, interoperable electronic exchange of patient information has been quite limited.
In December 2023, the Office of the Assistant Secretary for Planning and Evaluation within the U.S. Department of Health and Human Services published a report stating that most nursing homes have EHR systems at rates similar to hospitals. However, a May 2024 ONC report indicated that only 17 percent of hospitals are able to routinely send interoperable health information to nursing home providers, and only 8 percent of hospitals were able to routinely receive such information from these providers. The recent efforts by the ONC in launching the TEFCA program to enable nationwide health information exchange could provide opportunities for nursing home providers with nonstandard health IT to exchange information through an HIE. The major nursing home EHR vendors support TEFCA HIE data-exchange capabilities for providers interested in participating.
However, while the technologies are advancing, and most of the digital infrastructure may be in place for providers, there are also several market and organizational factors that affect the extent of, or capacity for, health information technology (HIT) adoption, or digital maturity, in nursing homes. A research study1 published in October 2025 found that financial health factors were strongly associated with high HIT adoption. For example, nursing homes with the highest average operating income per resident day had the highest digital maturity, while those with the lowest income had the least use of HIT. Providers with more beds and higher census rates and that were affiliated with a nursing home chain also had higher HIT adoption rates. Notably, the percentage of Medicare patients, staffing levels, and for-profit or not-for-profit status were not linked to the rate of HIT adoption in nursing homes.
Market competition appears to have a curvilinear impact on the degree of nursing home digital maturity, as providers in moderately concentrated counties where several providers are competing for admissions appear to be leveraging their technology adoption for a competitive edge. Social capital factors, such as the nursing home’s distance to the closest hospital or the county Medicare Advantage penetration, did not appear to influence nursing home HIT adoption rates.
Federal Technology Regulatory Compliance Considerations
Provider investment in the adoption or expansion of interoperable HIT capabilities also requires consideration of current regulatory compliance factors, as well as those under consideration by policymakers. These factors should be incorporated into questions to ask technology vendors about their compliance with current requirements and their plans toward meeting new requirements under consideration. Additionally, provider investment strategies should also consider the new technology-related compliance policies and procedures and staff training that will need to be developed and implemented at the facility.
For example, providers using HIT must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy rule that established national standards to protect individuals’ medical records and other individually identifiable health information. Additionally, the 21st Century Cures Act of 2016 authorized the ONC to establish and enforce information-blocking regulations that ensure patients have easy electronic access to their available electronic health information at no cost, including via apps of their choice.
Policymakers are also exploring multiple health technology topics that may impact nursing homes in the future. In 2025, there have been multiple congressional hearings related to HIT, including discussion of cybersecurity concerns, the use of AI in clinical decision support and with Medicare Advantage prior authorization, public health, wearable health technologies, and telehealth. Regulatory activity surrounding HIT potentially impacting nursing homes was also heavy in 2025 across multiple agencies, including the following:
- Department of Health and Human Services Office for Civil Rights: Proposal to expand HIPAA cybersecurity rule.
- Drug Enforcement Administration: Proposal to restrict tele-prescribing access for veterans.
- Centers for Medicare & Medicaid Services: Requests for information regarding burden reduction, eQMs, and a potential interoperability quality measure, as well as a request for comment on a skilled nursing facility HIT readiness survey for potential quality-improvement organization HIT capabilities support.
- Assistant Secretary for Technology Policy: Request for information on the HIT ecosystem.
- Food and Drug Administration: Request for comment on the use of “real world” interoperable health data in clinical trials.
- National Library of Medicine: Request for information regarding technology funding priorities in clinical trials.
- National Institutes of Health: Request for information regarding AI strategy.
Summing It All Up
For providers that are considering an expansion of their HIT capabilities, there are myriad options and opportunities but no one-size-fits-all solutions, and many options involve significant investment. Providers will need to prioritize those investments based upon their unique situation, including their current digital maturity, available resources, care solutions needed to improve quality, and confidence that the new technology being adopted will improve customer and employee satisfaction, protect the organization from regulatory or legal issues associated with the technology, and provide a favorable return on investment.
The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) recognizes the impact of public policy decisions related to HIT on providers and the unique challenges faced by providers with limited resources, broadband access, and in-house technology expertise. AHCA/NCAL continues to advocate for federal support to help narrow the digital divide.
Reference
1. McHugh JP, Cardoso H, Bui N, Alexander GL. Market and Organizational Characteristics Associated with Nursing Home Health Information Technology Maturity. J Gerontol Nurs. 2025 Oct;51(10):10-16. doi: 10.3928/00989134-20250916-01. Epub 2025 Oct 1. PMID: 4103239
Daniel Ciolek is associate vice president of therapy advocacy for the American Health Care Association.