Modernizing Physician Leadership

Chief medical officers are expected to have not only deep clinical skills but also strategic insight, business competency, and team leadership experience.

Steve Manning 9/4/2026

Management

leadership

In December 2019, Elizabeth Burns, MD, accepted the role of chief medical officer (CMO) at Avamere Living, a role her boss, Avamere founder and former CEO Rick Miller, could not yet describe. “We know we need a chief medical officer,” he told her. “We’re just not exactly sure what we need, but we know we need one.”

Within months, the COVID-19 pandemic settled the issue for the entire sector. “COVID became a pivotal moment that fundamentally reshaped physician leadership in post-acute and long term care,” Burns reflected. “It demonstrated that physicians are essential, not only during times of crisis, but also in shaping strategy, driving innovation, improving quality, and preparing organizations for the future.” For decades, federal regulation has required a medical director in every skilled nursing facility. As residents’ needs grow more complex, providers are modernizing their physician leadership models and ensuring that the medical director’s role at the facility level is effectively supported by the C-suite.

More Complexity, More Responsibility

Long term care professionals know all too well what’s driving these changes. With more older adults living at home longer, resident acuity continues to steadily climb. “Providers are increasingly asked to serve residents with greater clinical and behavioral needs while demonstrating measurable outcomes and reliably managing transitions to and from hospitals,” Mark Prifogle, chair of the American College of Health Care Administrators, told Provider earlier this year.

As facility operators adapt, their medical directors have taken on more and more responsibility. “The medical director role is a role that’s been defined by federal regulation for decades, and it is very specific from a regulatory standpoint,” observed Richard Feifer, MD, MPH, FACP, a PALTmed director at large who served as chief medical officer and executive vice president at Genesis HealthCare. “The day-to-day reliance on the medical director, the engagement, the involvement—that’s what’s been increasing over the last number of years.”

Elizabeth Burns Burns, who was named chief medical officer at American Health Care Association/National Center for Assisted Living in 2025, described a role that expanded far past its statutory remit. “The medical director role has evolved well beyond regulatory oversight and clinical compliance,” she said. “Today’s medical directors are increasingly expected to lead quality improvement, champion evidence-based care, foster interdisciplinary collaboration, leverage data and technology, and help organizations succeed in an increasingly complex health care environment.”

Masonicare, a Connecticut provider whose services span independent living through hospice, shows just how much responsibility the modern medical director shoulders. As CEO JP Venoit told Provider, Masonicare has three medical directors: one for its behavioral health hospital, one for hospice and home care, and a third who oversees everything else—nursing homes, assisted living, and independent living.

“Our residents now have more choice,” he explained. “People who would have been in a nursing home ten or twelve years ago, they’re in assisted living, residential living, or their home. We’ve taken the approach that our medical directors help us keep them in the setting they call home longer and safer.”

From the Bedside to the Boardroom

There’s no single threshold at which a provider needs a CMO. Feifer pointed to scale: “For organizations that operate multiple facilities and have more overarching needs for medical oversight and medical leadership, that’s where the CMO comes in,” he said.

Titles vary, as well, as some organizations opt for a chief clinical officer label or simply elevate their medical director to a senior management role. Masonicare’s three medical directors, for instance, work alongside the C-suite.

No matter the title, the role requires a bird’s-eye view. A CMO (or equivalent) fields clinical issues across the entire organization rather than at a single facility, tying those issues to broader strategic concerns.

Rich Feifer “The CMO role is one that often involves the wearing of two hats simultaneously,” Feifer explained. “There’s the medical leadership hat that’s focused on quality of care and medical care and appropriate staffing. And then there’s the business hat, helping the enterprise succeed. The enterprise needs to be successful to fulfill its mission, and it needs to do so in a medically responsible way.”

“I liken it to being a bridge between the bedside and the boardroom,” said Shealynn Buck, MD, CMO at Lockton Companies, where she helps organizations design clinical strategies that improve outcomes, quality, and value. “As you think about both clinical and financial outcomes, having that expertise that can bridge those pieces, that’s really important.” She argued that whether an organization needs a CMO is less about size than about complexity.

She also described the CMO as an ambassador to the health care ecosystem itself. “Whenever there is the need for ensuring clinical integrity, clinical leadership, and representing that in the health care market, a CMO can be really valuable for that,” she said.

What Providers Look For

As providers expand their physician leadership models, they’re looking for a few key competencies in potential CMOs. Perhaps most important is the ability to synthesize that bird’s-eye view of the health care industry with the granular concerns of a company or even a facility.

“CMOs sit at an intersection point between patient care and the business,” Buck explained. “Having some business acumen but also understanding technology and how technology is impacting health care is really important.” She stressed the need for a “dot-connector mindset” that makes it possible to see where an individual community’s needs fit within the larger system, and how that system can be used to meet those needs.

JP Venoit For Feifer, the ideal CMO candidate is someone with a high level of leadership experience. “One of the most important qualities is someone who has led organizations and has been responsible for the overall performance, medical and otherwise, of large teams,” he said. “This is not something that necessarily comes naturally to an individual physician who’s been providing direct patient care all of their career. This is a different skill set that takes training and mentorship to develop.”

Then there’s fluency in the myriad tongues one must speak to lead a health care business—another trait that distinguishes CMOs from medical directors. “The CMO needs to speak the language of the frontline doctor; that’s a medical language,” Feifer explained. “Then the CMO needs to speak the language of the chief financial officer; that’s a financial language. Then they need to speak the language of the head of business development; that’s a sales language. For a CMO to be highly successful, they need to be fluent in all of those languages and more.”

Buck identified one competency that may seem counterintuitive. “As clinicians, as physicians, we’re often trained to be the decision-maker,” she said. “But as complex as health care is, not one person has all the answers. As a physician leader and CMO, it’s important to have a network of folks that you’re not afraid to ask questions of and have some of your blind spots tested.”

A Seat at the Table

A CMO can support the medical team only if the organization supports the CMO. Feifer’s advice in that regard is simple: “Ensure that they have a seat at the table and are invited to offer their unique perspective on all matters pertaining to the enterprise,” he said. “They should never be pigeonholed or just restricted to the one corner of the organization that is medical care, but they should be a full-fledged leader that comes at every issue with a unique lens.”

For Burns, a successful physician leadership model is a holistic one, with the high-level and facility-level roles working in tandem toward the same objectives. “Rather than thinking of the medical director and CMO as separate roles, I view them as part of a continuum of physician leadership,” she said. “The medical director remains the clinical leader closest to resident care, while the CMO extends that clinical perspective across the organization, translating frontline insights into enterprise-wide strategy.”

leadership Feifer echoed her perspective, arguing that an enterprise physician leader’s first responsibility is “ensuring that every facility has a strong medical director performing at the top of their abilities.” From there, the job is to foster a culture of “continuous performance improvement,” one where the clinical team is working collaboratively to deliver the highest quality of care. Done right, this approach naturally turns the care team into a training ground for future physician leaders, whether at the facility or enterprise level.

Reflecting on the evolving role of physician leadership, Burns cited a line credited to quality-improvement scholar Paul Batalden: “Every system is perfectly designed to get the results it gets.”

“If we want different outcomes for residents, families, and providers, we must intentionally redesign the way physician leadership is integrated into our organizations,” Burns concluded. “That means modernizing both the medical director role and the chief medical officer role so physician leaders have the influence and support within the leadership team to improve quality, access, and innovation in person-centered care across the continuum.”

Steve Manning is a journalist based in New York City.

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Bright Clearings Ahead in Caring for People with Dementia

https://www.providermagazine.com/Issues/2026/Fall/Pages/Bright-Clearings-Ahead-in-Caring-for-People-with-Dementia.aspx

Bright Clearings Ahead in Caring for People with Dementia

<img src="/Issues/2026/Fall/PublishingImages/Dementia2_Fall26.jpg" alt="dementia" style="margin:5px;width:575px;height:403px;" />Dementia remains a progressive disease for which there is no cure, but the landscape of care of people with dementia has changed significantly. While there are still some rough roads and dark clouds, there are also spots of sunlight, bright clearings, and colorful scenery.“Culture change has transformed dementia care from a task-focused model to one centered on person-centered care planning and quality of life,” said Gretchen Pace, CDP, CADDCT, CMDCP, director of memory care and activity support at Aperion Care.There have been many advancements in dementia care in recent years, and while there are still challenges and barriers to overcome, the focus of this care is increasingly on individuals: what matters most to them, what they are capable of and what they can no longer do, and prioritizing nonpharmacological interventions to promote safety, comfort, and quality of life.<h3>Key Paradigm Shift </h3><img src="/Issues/2026/Fall/PublishingImages/Dementia_DeLonCanterbury.jpg" alt="DeLeon Canterbury" class="ms-rtePosition-2" style="margin:5px;" />As knowledge about dementia has grown, it has become increasingly apparent that the disease impacts everyone differently. As DeLon Canterbury, PharmD, BCGP, the Deprescribing Pharmacist® and founder of GeriatRx, Inc., said, “If you’ve seen one person with dementia, you’ve seen one person with dementia.”Michelle Wallace, BSN RN, MEDSURG-BC, GERO-BC, and director of clinical services at Vetter Senior Living, agreed and noted, “There’s been a shift from a disease focus to prioritizing the resident’s goals and their abilities—that is, preserving what function they still have and what they are still able to do. It’s about creating meaningful moments for residents and allowing their families to be part of it, as well.” She explained, “If you have someone who was a cook on a ranch, for example, they can still remember parts of cooking even as their cognitive function declines. We can recreate the cooking experience for them, let them do the parts they still can, and support them where they need help.”There also is a growing focus on sensory engagement. Wallace said, “We use a great deal of music and memory equipment, utilizing earphones and personalized music lists for residents. This really helps prevent a lot of out-of-character behavioral responses, and it has helped reduce the use of psychotropic medications.” Pace explained, “Sensory and multisensory approaches are increasingly incorporated with things like sensory rooms or areas, aromatherapy, fidget and tactile tools, and nature-based experiences. Such interventions help regulate emotions and provide meaningful stimulation.”<h3>Freedom, Independence, and Measured Risks </h3>Charles de Vilmorin, senior vice president of resident engagement at LifeLoop, observed that “a fundamental change in dementia care is happening worldwide, with a growing focus on freedom, autonomy, and enablement.” This means supporting people to live as fully as possible in environments that preserve choice and freedom of movement while thoughtfully managing risk. <img src="/Issues/2026/Fall/PublishingImages/Dementia_de-Vilmorin.jpg" alt="Charles de Vilmorin" class="ms-rtePosition-2" style="margin:5px;" />The Hogeweyk®, a care neighborhood in the Netherlands, exemplifies this approach. Its twenty-seven small homes and its streets, open green spaces, grocery store, pub, theater, and many clubs create an everyday neighborhood setting rather than an institutional one. “The idea is to balance freedom and safety—to create a supportive environment where people living with dementia can make choices, move freely within the community, and continue participating in everyday life,” de Vilmorin said.Another focus receiving greater attention in the care of people with dementia is meaningful engagement and social connection. “The evidence is increasingly clear that social isolation and loneliness are serious health risks,” de Vilmorin explained. “Meaningful, personalized engagement and genuine human connection should be treated as essential components of care, not optional amenities.” <h3>Montessori Makes Inroads </h3>Montessori principles adapted for dementia care continue to grow, said Pace, because they focus on preserved abilities, meaningful roles, choice and independence, and success rather than failure. The Montessori Dementia Program was designed by geriatric medicine specialists and Montessori educators. Residents are encouraged to contribute, lead activities, and participate in purposeful daily tasks. “I have seen some amazing benefits with this,” Pace said, adding, “By focusing on skills residents have, we can empower those individuals to perform tasks independently again and foster that sense of purpose and self-worth.”The Montessori-inspired lifestyle training and credentialing program at the Center for Applied Research in Dementia is a system-level intervention for senior living communities to create environments that support people living with physical and cognitive disabilities. The center’s innovation officer, Evan Shelton, PhD, said, “We sometimes say that a Montessori community is a community that is led, to the extent possible, by the residents, so we start with remaining strengths rather than deficits. Then we build routines and opportunities for residents around those strengths and preferences.” That might mean a prepared environment with clear visual cues, such as signage to let residents know what’s allowed and what’s not allowed or to help them know when something will be happening, such as mealtimes or activities.Shelton noted, “A prepared environment is just one way of promoting independence, and it does so without involvement from any staff. We also think differently about activities. So rather than thinking about activities as a program of entertainment, much like a resort or a service model—a cruise ship, for example—we focus on activity with purpose.”Montessori communities often include resident-led committees. A welcoming committee, for example, might include several residents who decide how to welcome a new resident. Shelton said this gives current residents a purposeful way to support someone through a stressful life transition.Finally, he said, “we talk about twelve principles for how to engage with a resident who’s living with dementia.” <img src="/Issues/2026/Fall/PublishingImages/Dementia_Pace.jpg" alt="Gretchen Pace" class="ms-rtePosition-2" style="margin:5px;" />These are practical things that staff can practice every day, such as breaking down a task into steps and slowing down to match the resident’s pace. Each principle is meant to shift the dynamic from one person’s giving care and another’s receiving it to two active participants in the process. Residents are treated with respect and equality rather than having their day directed for them.One additional aspect of the Montessori-inspired lifestyle that is unique, said Shelton, involves learning. “It’s a bit of a misconception that persons living with dementia are no longer able to learn,” he said. “Learning happens with repetition, and that’s a remaining strength for people with dementia. We can use that remaining ability to help persons with dementia learn routines and procedures that make everyday life easier and enable them to stay more independent.”<h3>Age-Friendly Care and Dementia Go Hand in Hand </h3>The Age-Friendly Health System model and 4Ms framework (what matters, mentation, mobility, and medication) align perfectly with dementia care because it keeps the focus on the whole person. Pace explained, “‘What matters’ ensures we honor the individual’s preferences and life story. ‘Mentation’ supports cognitive health and emotional well-being. ‘Mobility’ helps maintain independence, function, and quality of life. ‘Medication’ encourages careful use of medications to avoid side effects that can worsen cognition or increase fall risk. Together, the 4Ms provide a person-centered approach that promotes dignity, safety, and meaningful living for people with dementia.”Pace further observed, “For a long time in dementia care, we had debates about the locked doors, and we realized that that wasn’t a good approach. But there were uncertainties about how to balance what matters to residents and what they want while keeping them safe. When you focus on the person first, safety just kind of automatically follows.” But she stressed, “We have security in place for a reason, and when secure units are necessary, it’s important to make them homey and inviting.”<h3>The Evolution of Memory Care </h3>According to the National Center for Assisted Living, 44 percent of assisted living residents have some form of cognitive impairment, so it is not surprising that memory care is the fastest-growing component of senior care. <img src="/Issues/2026/Fall/PublishingImages/Dementia_quote1.jpg" alt="‘Meaningful, personalized engagement and genuine human connection should be treated as essential components of care, not optiona" class="ms-rtePosition-1" style="margin:5px;width:200px;height:358px;" />Sarah Howd, MD, associate professor of medicine and geriatrics at the University of Rochester (UR) and medical director of Senior Living Practice at UR Medicine Geriatrics Group, said, “Memory care falls under the assisted living umbrella, but what we’re really seeing is that memory care is becoming an almost distinct level of care somewhere between assisted living and nursing homes.” She added, “The main legislation for assisted living in the past five years has targeted memory care and dementia units, so I think there is a focus on protecting this vulnerable population.”She noted that there are “more and more states that require specific staff training to work in memory care units to increase the level of care and the ability for people to age in place longer.” This shift to a greater emphasis on memory care is essential to fill a gap. While many assisted living residents with cognitive impairment are able to live independently, they need more support as the disease advances and as they become frailer over time. Increasingly, memory care programs are prioritizing this support to enable residents to stay in their homes or preferred settings longer.Pace concluded, “Memory care has evolved from a primarily task-focused and safety-driven model to a more person-centered approach that emphasizes quality of life, dignity, and meaningful engagement. Today, we recognize that safety is important, but so is autonomy. The goal is to balance protection with choice by understanding each person’s abilities, preferences, and values. Through individualized care planning and measured risk-taking, we can support residents in maintaining as much independence and purpose as possible while still ensuring their well-being.”<h3>Tech Talks . . . and Listens </h3>As in other areas of health care, technology is enhancing and streamlining the care provided to people with dementia. These tools are among recent innovations: <ul><li>Telehealth. While this technology isn’t new, it is becoming more widespread, particularly in expanding access to care and specialist services in rural areas. “We use it in our rural areas for working with behavioral health specialists. This not only provides individuals with access to services they wouldn’t otherwise be able to secure, but it also helps reduce some of the</li><li>Remote monitoring. Wearable devices and smart home systems that collect health data, such as mobility and medication management, are growing in use. These also can be used to create and maintain music playlists, enable family members to communicate and share photos and videos, offer memory support and other games, and provide reminders about medications and appointments. </li><li>Sensory-engagement technology. Innovations such as interactive light projections to encourage movement, socialization, and cognitive engagement, and stimulating scents designed to improve memory, are gaining popularity.</li></ul><img src="/Issues/2026/Fall/PublishingImages/Dementia_quote2.jpg" alt="‘Today, we recognize that safety is important, but so is autonomy. The goal is to balance protection with choice by understandin" class="ms-rtePosition-2" style="margin:5px;width:200px;height:371px;" />Of course, it’s impossible to talk about technology without addressing artificial intelligence. Evan Shelton said, “With the emergence of AI, I think there are a few promising areas and a few areas where we need to be cautious. The most promising uses of AI, in my view, are tools that help staff better understand residents—their histories, strengths, preferences, needs, routines, and relationships. AI could help suggest who a resident might connect with, what activities may be meaningful to them, or how to adapt an activity to match their abilities.” He also sees promise in using AI to help staff think through responsive behaviors. When residents exit-seek, call out, or resist care, staff don’t always know what to do beyond redirect them in the moment. A well-designed AI tool, Shelton said, could guide staff through a more thoughtful process—prompting them to consider what unmet need the behavior might be communicating—and then help them brainstorm ways to meet that need instead of simply trying to stop the behavior.Shelton said he is more skeptical about AI as companionship. “We are starting to see technologies designed to simulate social connection, and we need to be very careful there. People living with dementia need real relationships, not just the appearance of a relationship. There are also ethical concerns around confusion, consent, and whether the person understands what the technology is and is not. Technology should support human connection, not replace it.”<h3>Medication Matters </h3>While there are ongoing advancements and trials for dementia-related medications, there also is a growing focus on nonpharmacological interventions and meeting people where they are. This aligns with the goals of the long term care and senior living profession to deliver person-centered care by getting to know individuals and understanding their stories and what matters most to them. “It’s helpful to know that someone worked a night shift their entire life,” Howd offered, “so you understand why they’re not sleeping or why they’re up and walking around at night.” She stressed that families need to be involved. She recalled one family who said their father would settle down if they put a western movie on TV. “We’re doing a better job of addressing potential nonpharmacologic interventions instead of jumping to medications,” she said.Efforts to reduce antipsychotic use are significant, said Wallace. “When we add an antipsychotic medication for a resident with dementia, it increases the mortality risk, the risk of stroke, the risk of falls, and the risk of cognitive decline and aspiration pneumonia.” When knowledge of the resident is used to determine how to address the root causes of behaviors, solutions that benefit the resident and staff become apparent.<img src="/PublishingImages/Headshots/HollyHarmon.jpg" alt="Holly Harmon" class="ms-rtePosition-2" style="margin:5px;" />Holly Harmon, senior vice president of quality, regulatory, and clinical services at the American Health Care Association, has seen the impact nationwide. “Skilled nursing facilities have been leading the way for more than a decade, working with CMS [Centers for Medicare & Medicaid Services] and other stakeholders through the National Partnership to Improve Dementia Care in Nursing Homes to reduce the unnecessary use of antipsychotics, with remarkable results that improved the lives of tens of thousands of residents.” Between 2011 to 2024, federal data found that skilled nursing facilities reduced the off-label use of antipsychotic medications by nearly 40 percent. Increased awareness and ongoing collaboration with policymakers, as well as other medical professionals and families, remain key, Harmon added. “We support continued education about the proper use of psychotropic drugs across all parts of the health care continuum.” That’s because physicians and hospitals play a significant role in what medications residents may be prescribed prior to when they are admitted to a long term care facility. Even family members can sometimes urge their use when they are concerned about their loved one’s behavior and unaware of the side effects. “Shared decision-making is crucial,” Harmon emphasized, and long term care providers consistently strive to work with physicians and families to develop the appropriate care plan for each resident.In some cases, antipsychotic medications are necessary and beneficial to certain individuals; however, the long term care profession’s primary focus when it comes to care of people with dementia has been nonpharmacological interventions, enriching programming, and meaningful relationships with direct caregivers. “I continue to be amazed and inspired by our member providers who are constantly innovating how to provide better quality of care and quality of life for the people who live in our nation’s long term care communities,” Harmon said.<h3>Hope Remains</h3>The future of dementia care is bright. Pace noted, “One of the biggest lessons from dementia research in recent years is that quality of life can be improved even when we cannot cure the disease. Research has shown that person-centered care, meaningful engagement, social connection, personalized activities, and supportive environments can significantly reduce distress and enhance well-being. We’ve also learned that behavioral expressions are often a form of communication, and by understanding the person’s unmet needs, we can provide more compassionate and effective care.” Joanne Kaldy is a freelance writer and communications consultant based in New Orleans.

Care of people with dementia has evolved from a task-focused, safety-first model to a person-centered approach, supported by emerging technology and research.

2026-09-04T04:00:00Z

Caregiving;Dementia

‭(Hidden)‬ Stories of Care

News Currents

Inspiring Excellence and Improving Lives in Long Term Care	https://www.providermagazine.com/Issues/2026/Fall/Pages/Inspiring Excellence and Improving Lives in Long Term Care.aspx	Inspiring Excellence and Improving Lives in Long Term Care	<p>Long term care providers across the nation are dedicated to enhancing the quality of life for residents through the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) National Quality Award Program. Grounded in the Baldrige Criteria for Performance Excellence, this esteemed program drives improvement in leadership, strategic planning, workforce, customer service, operations, and knowledge management. Participants advance through three levels of recognition—Bronze, Silver, and Gold—each requiring a higher standard of performance excellence.</p><p>This summer, AHCA/NCAL announced the names of nearly 1,200 long term care organizations recognized with a 2026 National Quality Award—908 <span style="color:#cc6600;"><strong>Bronze</strong></span> awards in 50 states, 259 <span class="ms-rteThemeForeColor-3-2"><strong>Silver</strong></span> awards in 44 states, and an elite two <span style="color:#ffcc00;"><strong>Gold</strong></span> awards.</p>	This summer, AHCA/NCAL announced the names of nearly 1,200 long term care organizations recognized with a 2026 National Quality Award—908 Bronze awards in 50 states, 259 Silver awards in 44 states, and an elite two Gold awards.	2026-09-04T04:00:00Z	<img alt="" src="/Articles/PublishingImages/740%20x%20740/QualityAward_logos.jpg" style="BORDER:0px solid;" />	Quality Awards	National AHCA/NCAL Quality Awards
Exhibitor Categories	https://www.providermagazine.com/Issues/2026/Fall/Pages/Exhibitor-Categories.aspx	Exhibitor Categories	<p style="text-align:center;"><img src="/Issues/2026/Fall/PublishingImages/categories1.jpg" alt="expo hall" style="margin:5px;width:500px;height:334px;" /> </p><p><br></p><p>Looking for solutions to today’s biggest challenges? The Delivering Solutions 26 Expo Hall brings together the industry’s leading companies to help providers improve care, streamline operations, and prepare for what’s next.</p><p>Use the exhibitor categories below to plan your visit around what matters most to your organization. Exhibiting companies offer workforce and operations solutions for technology, resident care, and beyond. This year, be sure to explore the growing number of exhibitors featuring AI-powered solutions, and see firsthand how artificial intelligence is reshaping the future of long term care.</p><p><br></p><table cellspacing="0" width="100%" class="ms-rteTable-0"><tbody><tr class="ms-rteTableEvenRow-0"><td class="ms-rteTableEvenCol-0" style="width:50%;">Accreditation/Credentialing/Association<br>AHCA Member Services<br>AI: Admissions & Discharge<br>AI: Clinical Support & Risk Prediction<br>AI: Financial Performance<br>AI: Quality, Compliance & Survey Readiness<br>AI: Resident Experience & Family Communication<br>AI: Staffing, Workforce & Employee Engagement<br>Aids to Daily Living<br>Analytics/Business Intelligence<br>Architecture & Interior Design<br>Behavioral Health<br>Capital Equipment/Furnishings<br>Communication Systems & Services<br>Compliance Resources<br>Computer/Data Management<br>Consulting: Clinical Quality & Resident Care<br>Consulting: Facility Planning & Development<br>Consulting: Financial Management & Reimbursement<br>Consulting: Operational Efficiency & Management<br>Consulting: Regulatory Compliance & Survey Readiness<br>Customer Engagement/CRM/Marketing <br>Debt & Equity Capital Provider<br>Dementia Care<br>Diabetic Supplies<br>Dietary Services/Nutrition<br>Disaster Planning Services<br>Education/Training<br>Electronic Medical/Health Records<br>Emergency/Nurse Call<br>Environmental Supplies & Services<br>Facility Maintenance/Property Management<br>Fall Prevention/Detection/Wander Management<br>Financial/Business Office Services<br>Flooring<br>Group Purchasing<br>Health Care Acquisitions<br>Heating & Cooling<br>Hospice<br>Housekeeping/Laundry<br>Human Resources Systems<br><span><span><span>In-Home Care<br>Incontinence/Skin Care<br>Infection Control/Disease Management<br>Insurance/Risk Management<br>Internet/Television Services</span></span></span><br></td><td class="ms-rteTableOddCol-0" style="width:50%;"><span><span>Laboratory/Diagnostic Services<br>Legal Services<br>Life Assisting Technology/Devices</span><br>Managed Care<br>Medical Director/Physician Services Groups<br>Medical Supplies & Equipment<br>Mental Health Services<br>Mobile Diagnostics<br>Oral Health<br>Other<br>Payroll Services<br>Pharmacy Services/Pharmaceutical/Medication<br> Management<br><br><img src="/Issues/2026/Fall/PublishingImages/categories2.jpg" alt="" style="margin:5px;width:300px;height:200px;" /><br><br>Physiatry Service<br>Professional Management Services<br>Psychology Services<br>Publications<br>Quality Management<br>Recruitment/Staffing<br>Referral Services<br>Rehabilitation Therapy Services<br>Renal Care<br>Resident/Care Plan Systems<br>Respiratory Care<br>Revenue Cycle Management<br>Security/Monitoring<br>Senior Services<br>Telehealth/Telemedicine<br>Transportation/Vehicles<br>Uniforms<br>Utility Management Services<br>Wellness<br>Wound Care</span></td></tr></tbody></table><p><br><br></p>	Exhibiting companies offer workforce and operations solutions for technology, resident care, and beyond.	2026-09-08T04:00:00Z	<img alt="" src="/Issues/2026/Fall/PublishingImages/expohall.jpg" style="BORDER:0px solid;" />		Convention
Behind the Program 2026	https://www.providermagazine.com/Issues/2026/Fall/Pages/Behind-the-Program-2026.aspx	Behind the Program 2026	<p>AHCA/NCAL applauds the hard work of the 2026 National Quality Award Examiners, Judges, and Board for their time and dedication to improving long term care through the Quality Award journey.</p><p><br></p><p style="text-align:center;"><img src="/Issues/2026/Fall/PublishingImages/qaward_silver.jpg" alt="" style="margin:5px;width:150px;height:150px;" /> <img src="/Issues/2026/Fall/PublishingImages/qaward_gold.jpg" alt="" style="margin:5px;width:150px;height:150px;" /></p><p style="text-align:center;"><br></p><table cellspacing="0" width="100%" class="ms-rteTable-0"><tbody><tr class="ms-rteTableEvenRow-0"><td class="ms-rteTableEvenCol-0" style="width:33.3333%;"><br></td><td class="ms-rteTableOddCol-0" style="width:33.3333%;"><br></td><td class="ms-rteTableEvenCol-0" style="width:33.3333%;"><br></td></tr></tbody></table><p><strong>Thank You to Our Sponsors</strong><br>The National Quality Award Program is proudly sponsored by AHCA/NCAL Associate Business Members: </p><p><br><img src="/Issues/2026/Fall/PublishingImages/Sponsors-2026.jpg" alt="" style="margin:5px;" /></p>	AHCA/NCAL applauds the hard work of the 2026 National Quality Award Examiners, Judges, and Board for their time and dedication to improving long term care through the Quality Award journey.	2026-09-04T04:00:00Z	<img alt="" src="/Articles/PublishingImages/740%20x%20740/GoldSilver.jpg" style="BORDER:0px solid;" />	Quality Awards	Convention
A Day of Learning, Leadership, and Inspiration at NCAL Day 2026	https://www.providermagazine.com/Issues/2026/Fall/Pages/A-Day-of-Learning,-Leadership,-and-Inspiration-at-NCAL-Day-2026.aspx	A Day of Learning, Leadership, and Inspiration at NCAL Day 2026	<p><img src="/Issues/2026/Fall/PublishingImages/AL_Fall26.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:310px;height:310px;" />If you’re looking to maximize your experience at Delivering Solutions 26, make plans now to attend the 20th annual <a href="https://ds26.eventscribe.net/index.asp" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="Register for NCAL Day" target="_blank">NCAL Day</a> on Sunday, October 11. Designed specifically for assisted living professionals, this full-day program delivers practical education, inspiring stories, and valuable networking opportunities—all while allowing attendees to earn additional continuing education (CE) credits.</p><p>From leadership development and workforce culture to clinical excellence and innovative care strategies, NCAL Day offers something for every member of the assisted living team.</p><h3>A Full Day of Education and Professional Growth</h3><p>NCAL Day features a robust educational lineup focused on the trends, challenges, and opportunities shaping assisted living today. Administrators and nurses who attend can earn six CE hours, making the event an excellent opportunity to both invest in professional development and gain continuing education credits to meet licensing requirements.</p><h3>Finding ‘Your Fearless Edge’</h3><p>The day begins with an inspiring keynote from Chris Vasami, founder of Vasami Training and Method.</p><p>In his address, “Your Fearless Edge: Unlocking Your Personal Greatness,” Vasami will share a powerful personal journey that transformed his perspective on leadership and resilience. A former Division I baseball player who was drafted by the Colorado Rockies, Vasami spent more than twenty years coaching before facing life-changing health challenges, including a cancer diagnosis and hypothyroidism.</p><p>Through those experiences, he discovered that resilience is not something people are born with; it’s something they develop. His keynote will challenge attendees to examine how mindset, purpose, and intentional habits can help them overcome obstacles and achieve personal and professional greatness.</p><h3>Celebrating 25 Years of NCAL and the Legacy of Jan Thayer</h3><p><span></span></p><h3><span><img src="/Issues/2026/Fall/PublishingImages/AL2_Fall26.jpg" alt="Assisted Living" class="ms-rtePosition-2" style="margin:5px;width:300px;" /></span></h3>One of the highlights of NCAL Day will be a special luncheon session recognizing a major milestone: the National Center for Assisted Living’s 25th anniversary.<p></p><p>“A Legacy of Leadership: Celebrating Jan Thayer and 25 Years of NCAL” honors one of assisted living’s most influential pioneers. Through an engaging panel discussion featuring colleagues, friends, and industry leaders who worked alongside Thayer, attendees will gain unique insight into the origin and evolution of the assisted living profession.</p><p>The conversation will explore the challenges, innovations, and defining moments that helped shape the field while highlighting how Thayer’s vision and leadership continue to influence assisted living communities today. It’s a meaningful opportunity to reflect on how far the profession has come and where it’s headed.</p><h3><span></span>Practical Solutions for Today’s Challenges</h3><p>NCAL Day’s educational sessions are designed to help attendees address real-world challenges and improve outcomes within their communities. Topics include:<br></p><ul><li>Beyond Four Walls: Wellness Coordination and Connected Care</li><li>Elevating and Empowering Clinical Leaders</li><li>Redefining Senior Living Rehab for Revenue & Retention</li><li>Observations to Insights: Leveraging Real-World Data to Create a Personalized Care Experience</li><li>Reduce Rehospitalization Through Early Recognition</li><li>Driving Better Outcomes in AL: Integrating Population Health and Value-Based Care Strategies</li></ul><p>These sessions offer practical strategies and innovative approaches that attendees can take back to their organizations and implement immediately.<br></p><h3>Building Stronger Teams Through Connection</h3><p>The day concludes with a thought-provoking keynote presentation from Cara Silletto, a nationally recognized expert on workforce culture and employee retention.</p><p>In “Set Judgment Aside: Build Teams that Truly Connect,” Silletto examines how judgment and assumptions create divisions within teams, leading to lower morale, reduced collaboration, and higher turnover. Drawing on her experience working with senior care organizations, she provides practical tools for creating stronger workplace relationships and a more connected culture.</p><p>Whether you’re leading a department, managing a community, or serving on the front lines of care, this session offers valuable insights for building trust and strengthening team performance.</p><h3><img src="/SiteCollectionImages/logos/ncal_large_color.jpg" class="ms-rtePosition-2" alt="NCAL" style="margin:5px;width:175px;height:117px;" />Don’t Miss NCAL Day 2026</h3><p><img src="/PublishingImages/Headshots/Pam%20Truscott_2022.jpg" alt="Pam Truscott" class="ms-rtePosition-2" style="margin:5px;width:150px;height:210px;" />NCAL Day is the perfect opportunity to deepen your knowledge, connect with peers, celebrate the profession’s rich history, and gain inspiration for the future.</p><p>Join us on October 11, 2026, for a day dedicated to advancing assisted living through education, leadership, and meaningful connection. You don’t want to miss it! </p><p><em>Pam Truscott is director of quality for the National Center for Assisted Living (NCAL).</em></p>	Attend NCAL Day to deepen your knowledge, connect with peers, celebrate the profession’s history, and get inspired.	2026-09-04T04:00:00Z	<img alt="" src="/Issues/2026/Fall/PublishingImages/AL_Fall26.jpg" style="BORDER:0px solid;" />	Assisted Living	Spotlight on Assisted Living
Operationalizing OIG Insight to Stay Ahead of Regulatory Risk	https://www.providermagazine.com/Issues/2026/Fall/Pages/Operationalizing-OIG-Insight-to-Stay-Ahead-of-Regulatory-Risk.aspx	Operationalizing OIG Insight to Stay Ahead of Regulatory Risk	<p><img src="/Issues/2026/Fall/PublishingImages/cgiving2_Fall26.jpg" alt="doctor checklist" class="ms-rtePosition-2" style="margin:5px;width:459px;" />Survey focus rarely shifts without warning; the signals are already in the system. Office of Inspector General (OIG) reports often identify patterns of concern months or even years before the issues become survey priorities, enforcement initiatives, or widespread citation trends. For long term and post-acute care leaders, the opportunity lies in going beyond simply reading these reports. They can translate them into operational surveillance by analyzing staff behaviors and setting priorities in quality assurance and performance improvement (QAPI).</p><p>Facilities that treat OIG findings as retrospective miss the advantage. Facilities that operationalize them gain valuable predictive insight.</p><h3>From Oversight to Early-Warning System</h3><p>OIG reports are targeted examinations of risk, payment vulnerability, and quality concerns across Medicare and Medicaid programs. Viewed through a leadership lens, they serve as an early-warning system for future regulatory scrutiny. Rather than become defensive or ask whether a finding applies directly to their organization, leaders should ask what system failure may be revealed.</p><p>Most OIG focus areas fall into three broad categories:<br></p><ul><li>clinical risks affecting resident outcomes</li><li>documentation and coding concerns involving Minimum Data Set (MDS) accuracy, reimbursement, and medical necessity</li><li>program integrity issues related to billing, services, and care delivery</li></ul><p>These three areas align with leadership responsibilities in quality, compliance, and clinical oversight. They can help identify vulnerabilities before they become survey deficiencies.</p><h3>Translating Findings into Facility-Level Action</h3><p>Start by identifying the underlying failure point. For example, a report on inappropriate antipsychotic medication use may appear at first to be a medication management issue. A deeper review often reveals broader concerns, such as inconsistent interdisciplinary review, limited use of nonpharmacological interventions, inadequate physician oversight, insufficient staff training, or documentation gaps. Looking beyond the outcome helps leaders focus on root causes rather than symptoms.</p><p>Second, map the concern to the systems responsible for preventing, detecting, or correcting the problem. Examples are admission and assessment processes, care-planning workflows, interdisciplinary communication, physician engagement, pharmacy oversight, staff education, and certified nursing assistant (CNA) observation and reporting. Examining how information moves through these systems can reveal breakdowns long before a surveyor or auditor identifies a deficiency.</p><p>Third, connect the issue to relevant survey domains. Many OIG findings align directly with areas that surveyors evaluate routinely, such as quality of care, unnecessary medications, infection prevention and control, resident rights, and quality of life. Understanding these connections helps leaders recognize how a single operational weakness can affect multiple aspects of compliance and resident outcomes.</p><p>Finally, incorporate the risk into QAPI activities. OIG findings should inform risk assessments, performance monitoring, and performance improvement projects (PIPs). Used effectively, they become practical tools for continuous improvement.</p><h3>Embedding Intelligence into Daily Operations</h3><p><img src="/Issues/2026/Fall/PublishingImages/cgiving_Fall26.jpg" class="ms-rtePosition-2" alt="caregiving" style="margin:5px;width:250px;height:250px;" />The most effective facilities integrate annual OIG reviews into existing leadership and QAPI processes. For example, a simple monthly or quarterly review can be highly effective. Assign a leader, such as the director of nursing services or compliance nurse, to review a recent OIG report or work plan item. Ask this leader to summarize it during a leadership or QAPI meeting, identify one or two facility-specific vulnerabilities, and assign measurable follow-up actions.</p><p>Operational integration can occur across multiple settings:<br></p><ul><li>Use OIG trends to support PIP selection and prioritize high-risk areas.</li><li>Review relevant findings with the medical director and interdisciplinary team.</li><li>Incorporate OIG themes into staff education and competency programs.</li><li>Update audit tools and leadership rounding processes to monitor identified risks.</li><li>Track key metrics and report results through the QAPI committee.</li></ul><p>When frontline staff understand how daily practices connect to broader regulatory concerns, compliance becomes part of routine operations rather than part of a rush to prepare for survey.</p><h3>Operationalizing a Focus Area</h3><p>An OIG finding related to infection-control deficiencies can prompt a review of the systems, processes, and behaviors that influence infection-prevention performance. The response should include root cause analysis and monitoring of infection rates, hand hygiene, isolation compliance, and other indicators to evaluate improvement efforts. </p><p>Shared ownership of infection prevention across disciplines helps create sustained practice change and strengthens both outcomes and consistency.</p><h3>Common Pitfalls</h3><p>Organizations often limit OIG reports to compliance discussions when they should be viewed as operational risk indicators. A compliance officer or leadership team may review the reports, but the findings are never translated into audits, process reviews, staff education, or performance-improvement activities. As a result, valuable insight remains disconnected from day-to-day operations. A more effective approach is to assign findings to specific departments and incorporate them into quality-improvement plans, audits, and staff education initiatives.</p><p>Another common mistake is failing to connect findings to frontline care. Reports frequently highlight issues that originate in daily resident interactions, assessment practices, documentation, communication, or care delivery processes. To make meaningful change possible, nurses, CNAs, therapists, and other team members must understand how the findings relate to their responsibilities. Organizations can strengthen implementation efforts by sharing relevant findings with frontline staff and using case examples, competency training, and team discussions to illustrate their impact on resident care and daily practice.</p><p>Leaders must not overlook interdisciplinary accountability. Many OIG concerns focus on prescribing practices, therapy utilization, care coordination, physician engagement, pharmacy oversight, or discharge planning. Addressing these risks requires collaborating across departments rather than relying on nursing alone to implement corrective actions. Success is more likely when representatives from all affected disciplines participate in risk assessments, action planning, and ongoing monitoring activities.</p><p>Finally, organizations sometimes wait for survey trends or citations to confirm a risk before taking action. By that point, regulators have often been signaling concern for months or years through OIG reports, work plan items, and other oversight activities. Facilities that proactively evaluate these signals are better positioned to identify vulnerabilities, strengthen systems, and reduce the likelihood of future deficiencies. Rather than wait for deficiencies to emerge, organizations should routinely review OIG publications and work plan updates and assess whether identified risks need to be addressed in their own operations.</p><h3>Key Takeaway</h3><p><img src="/Articles/PublishingImages/2025/Lauren-Stenson.jpg" alt="Lauren Stenson" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" />OIG reports are more than simply audits of past performance. They offer insight into emerging areas of regulatory focus. Start by reviewing a recent OIG work plan item during a leadership or QAPI meeting, assessing whether the risk is an issue in your organization, and then conducting a focused audit or process review. When OIG findings are translated into daily practice, organizations can identify vulnerabilities earlier, strengthen resident safety, and improve operational readiness. </p><p><em>Lauren Stenson, DNP, RN, CNDLTC, QCP, DNS-CT, is curriculum development specialist at the American Association of Post-Acute Care Nursing (AAPACN).</em></p><p><em><br></em></p><p><em><img src="/Issues/2026/Spring/PublishingImages/AAPACN.jpg" class="ms-rtePosition-2" alt="AAPACN" style="margin:5px;width:215px;height:61px;" /><span class="ms-rteFontSize-1">The American Association of Post-Acute Care Nursing (AAPACN®) champions innovation and transformation across the post-acute care continuum by enabling providers to deliver unparalleled care. Representing more than 18,000 post-acute care nurses and leaders in over 6,100 facilities nationwide, AAPACN provides industry-leading education, certification, and evidence-based resources that elevate quality of care and drive operational excellence.</span> <span class="ms-rteFontSize-1">Learn more at AAPACN.org.</span></em></p>	Providers that treat Office of Inspector General findings as retrospective miss out on valuable predictive insights.	2026-09-04T04:00:00Z	<img alt="" src="/Issues/2026/Fall/PublishingImages/cgiving_Fall26.jpg" style="BORDER:0px solid;" />	Caregiving;Policy	Focus on Caregiving
Why Authenticity Is Winning on Social Media	https://www.providermagazine.com/Issues/2026/Fall/Pages/Why-Authenticity-Is-Winning-on-Social-Media.aspx	Why Authenticity Is Winning on Social Media	<p><img src="/Issues/2026/Fall/PublishingImages/Tech2_Fall26.jpg" alt="senior on phone" class="ms-rtePosition-2" style="margin:5px;width:450px;height:300px;" />Every day, the world is bombarded with the newest and greatest AI technology. Add to that the growing roster of AI agents—ChatGPT, Gemini, Copilot, Claude, Perplexity—and the list of new AI tools grows. We can employ AI for almost any task, and the pace shows no signs of slowing. Thousands of AI platforms and tools now exist. Tech company Ascendix reported in 2025 that there are approximately 90,000 AI companies worldwide.</p><p>Social media is no different. Facebook has Meta AI, X has Grok, TikTok has Symphony. Whether they are creating graphics or brainstorming ideas, marketing and social media professionals are producing content faster than ever before thanks to AI.</p><p>While AI is certainly changing the landscape, one shift stands out: people now value authenticity more than ever. </p><h3>Human Connection</h3><p>One message keeps surfacing: audiences are craving more human connection, not less.</p><p>As AI use increases, people are placing greater value on authenticity, relationships, and real experiences. Entrepreneur Gary Vaynerchuk described this transition as a return to the analog world, and he predicts an explosion in live events and in-person gatherings.</p><p>In other words, the more digital the world becomes, the more people seek human connection.</p><p>Long term care facilities and assisted living communities are well positioned to harness this shift. Every day, these facilities provide the human connection people are striving for. Whether through intimate interactions between residents and staff or community-wide events, long term care offers much more than care; it creates connections.</p><p>That is a story worth telling.</p><h3>Telling Our Story</h3><p>Social media offers a way to show families that their loved ones are receiving the care and love they deserve—and that those loved ones are living life to the fullest. There is so much life happening within these facilities, and social media helps highlight it.</p><p>A compelling example comes from Gainesville Health Care Clinic in Missouri. The facility created a TikTok page that has earned over two million likes, thanks to such videos as “Racing with the Times” and “Whack-a-staff.” In an interview with local news, one resident, upon hearing those numbers, said, “Somebody out there really loves me.”</p><span><h3>The Goalposts Have Moved</h3><p>Marketers are well acquainted with social media algorithms, and they rank content based on a variety of signals. They are different on each platform and change often, and staying current requires constant attention. As social media shifts toward authenticity and transparency, the goalposts have moved along with it.<br>Here are a few things many algorithms are now calculating. (See table below.) </p></span><br><table cellspacing="0" width="100%" class="ms-rteTable-2"><tbody><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2" style="width:50%;"><strong class="ms-rteForeColor-6">Rewarded</strong></td><td class="ms-rteTableOddCol-2" style="width:50%;"><span class="ms-rteForeColor-6"><strong>Penalized</strong></span></td></tr><tr class="ms-rteTableOddRow-2"><td class="ms-rteTableEvenCol-2"><span class="ms-rteForeColor-6"><strong>Engagement. </strong>Social media success used to be measured by impressions or views. Now, the algorithm favors content that generates audience engagement: likes, comments, shares, and similar interactions.</span></td><td class="ms-rteTableOddCol-2"><span class="ms-rteForeColor-6"><strong>AI-generated content.</strong> Platforms are increasingly rewarding posts that feel authentic and spark meaningful engagement. LinkedIn, in particular, has been actively moving away from AI-generated content.</span></td></tr><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2"><span class="ms-rteForeColor-6"><strong>Video.</strong> Video continues to perform well on social media, and watch times are increasing.</span></td><td class="ms-rteTableOddCol-2"><span class="ms-rteForeColor-6"><strong>Links. </strong>Social media companies want users to stay on their platforms. Including a link in a post actively encourages users to leave, and the algorithm penalizes that. This presents a challenge, especially when sharing important information.</span></td></tr></tbody></table><h3>Helpful Tips</h3><p>A few practical tips for using AI in social media are worth highlighting:<br></p><ul><li><strong>AI policy. </strong>Every organization should have a clear AI policy in place.</li><li><strong>Prompts.</strong> When using AI, provide an accurate and detailed description of the desired outcome. Give specific instructions, and don’t settle for the first output.</li><li><strong>V</strong><strong>erify.</strong> Nothing AI generates should be used without verification. AI has been known to produce plagiarized content, so due diligence is essential — every output should be checked carefully.</li></ul><p>As AI continues to evolve, social media will evolve alongside it. New tools will emerge, algorithms will shift, and platforms will launch new features.</p><p>But one thing is unlikely to change: people want to connect with people.</p><p><img src="/Issues/2026/Spring/PublishingImages/NathanWooden.jpg" alt="Nathan Wooden" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" />For long term care and assisted living providers, that is good news. Every day, these communities create moments of joy, friendship, purpose, and belonging. Social media offers an opportunity to share those moments with families, prospective residents, policymakers, and the public.</p><p>AI can be a valuable tool when it helps teams work smarter. But it shouldn’t overshadow what makes these stories powerful in the first place: the people behind them.</p><p><em>Nathan Wooden is social media manager at AHCA/NCAL.</em><br></p>	As AI reshapes social media, long term care providers have an edge: the authentic human connection audiences are increasingly craving.	2026-09-08T04:00:00Z	<img alt="" src="/Issues/2026/Fall/PublishingImages/Tech_Fall26.jpg" style="BORDER:0px solid;" />	Technology	Technology in Health Care
AI Is Transforming Rehabilitation in Long Term Care	https://www.providermagazine.com/Issues/2026/Fall/Pages/AI-Is-Transforming-Rehabilitation-in-Long-Term-Care.aspx	AI Is Transforming Rehabilitation in Long Term Care	<p><img src="/Issues/2026/Fall/PublishingImages/Rehab2_Fall26.jpg" alt="senior rehab with AI" class="ms-rtePosition-1" style="margin:5px;width:375px;height:250px;" />Artificial intelligence (AI) is quickly becoming a practical tool in nursing homes and assisted living communities. For physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs), AI is supporting more personalized, efficient, and proactive rehabilitation by automating documentation, analyzing movement and speech, identifying residents at risk for functional decline, and adapting treatment in real time.</p><p>Rather than replacing clinicians, AI is helping them make better-informed decisions while reducing administrative burden and creating more time for direct resident care. Although AI applications are still emerging, research supporting their use continues to increase, making now the right time for providers to begin preparing.</p><h3>Start with Your Mission, Not the Technology</h3><p>Successful AI implementation begins by identifying the problem to solve, not by selecting the newest technology. Organizations should first determine whether they want to reduce documentation time, improve therapy outcomes, detect functional decline earlier, reduce falls or hospitalizations, or increase resident engagement. Different priorities require different AI solutions.</p><p>Providers also need an adequate digital foundation, including interoperable electronic health records, reliable connectivity, cybersecurity protections, quality data, and staff training. Collaboration among therapists, nurses, physicians, administrators, IT staff, and compliance professionals is equally important. Pilot projects with measurable outcomes—such as documentation time, clinician satisfaction, resident outcomes, and return on investment—allow organizations to evaluate new technologies before broader deployment.</p><p>Beginning with organizational goals instead of technology helps ensure AI strengthens resident care rather than becomes another disconnected software platform.</p><h3>AI Is More Than Chatbots</h3><p>While generative AI tools such as ChatGPT receive the most attention, rehabilitation is benefiting from a much broader range of technologies. Today's rehabilitation teams are beginning to use an array of tools:<br></p><ul><li>ambient AI documentation</li><li>wearable sensors</li><li>computer vision and motion analysis</li><li>predictive analytics</li><li>virtual reality</li><li>conversational coaching tools</li><li>speech recognition</li><li>clinical decision support</li><li>remote monitoring</li><li>robotics and smart assistive devices</li></ul><p>Together, these technologies are transforming assessment, treatment, monitoring, documentation, and care planning. Therapists remain responsible for every evaluation and clinical decision; AI simply provides better information and more-efficient tools.</p><h3>AI Is Reducing Documentation Burden</h3><p><img src="/Issues/2026/Fall/PublishingImages/Rehab_Fall26.jpg" alt="rehab" class="ms-rtePosition-2" style="margin:5px;width:285px;height:285px;" />One of AI's most immediate benefits is reduced documentation time. Ambient AI systems can generate clinical notes during evaluations and treatment sessions, allowing therapists to review and approve documentation rather than create it from scratch. Early studies suggest these tools reduce after-hours charting, lessen administrative burden, improve documentation quality, and allow clinicians to spend more face-to-face time with residents.</p><h3>How AI Is Expanding Rehabilitation</h3><p>Researchers are finding discipline-specific applications for AI while also demonstrating benefits that span rehabilitation practice.<br></p><ul><li><strong>Physical therapy:</strong> Computer vision systems analyze gait, posture, balance, and joint movement, while wearable sensors monitor exercise performance and provide real-time feedback. AI-powered coaching tools can encourage residents to complete prescribed exercise programs between therapy sessions.</li><li><strong>Occupational therapy: </strong>AI helps therapists evaluate functional performance by analyzing activities of daily living using wearable devices and environmental sensors. These tools may detect subtle functional changes earlier and support more individualized treatment planning.</li><li><strong>Speech-language pathology: </strong>Machine learning is being used to analyze speech characteristics, monitor communication disorders over time, and support therapy through automated scoring, adaptive exercises, and personalized treatment materials.</li></ul><p>Across all three disciplines, AI serves as a clinical support tool, not as a replacement for therapist expertise or judgment.</p><h3>Virtual Reality Is Becoming Smarter</h3><p>Virtual reality is emerging as one of the most promising AI-supported rehabilitation technologies. Residents recovering from stroke or orthopedic injuries or who have Parkinson's disease or cognitive impairment can practice walking, balance, communication, daily activities, and cognitive exercises in immersive environments that automatically adjust difficulty based on performance. Beyond formal therapy, virtual reality is also being used for reminiscence therapy, virtual travel, pain management, fall-prevention training, cognitive stimulation, and social engagement programs that enhance quality of life.</p><h3>AI Beyond the Therapy Department</h3><p>AI is also improving rehabilitation by monitoring residents outside therapy sessions. Wearable devices, smart beds, remote monitoring systems, and predictive analytics continuously track mobility, sleep, vital signs, and activity patterns. Combined with electronic health record data, these technologies can identify residents at increased risk of falls, skin breakdown, hospitalization, cognitive decline, or functional deterioration, allowing rehabilitation teams to intervene earlier. AI is also supporting care planning, medication management, telehealth, clinical decision support, and administrative automation, strengthening collaboration across the interdisciplinary care team.</p><h3>Keeping People at the Center</h3><p>As AI adoption accelerates, providers should remember that technology exists to support their mission, not define it. Successful implementation requires strong governance, transparency, cybersecurity, privacy protections, staff education, and ongoing evaluation. Organizations should understand how AI recommendations are generated, monitor systems for bias and accuracy, and ensure resident information remains protected.</p><p>Most importantly, clinicians remain accountable for every clinical decision. AI can summarize information, recognize patterns, and generate recommendations, but licensed professionals must always interpret those insights within the context of each resident's goals, preferences, and needs. The most successful organizations will use AI as another clinical tool that enhances compassionate, person-centered care rather than replaces it.</p><h3>Looking Ahead</h3><p><img src="/PublishingImages/Headshots/DanCiolek_2024.jpg" alt="Dan Ciolek" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" />Artificial intelligence is rapidly becoming another tool in the rehabilitation toolbox. Whether generating documentation, measuring gait, analyzing speech, personalizing virtual reality therapy, or identifying residents at risk before problems develop, AI is helping rehabilitation professionals work more efficiently and intervene earlier.</p><p>The future of rehabilitation isn't about choosing between technology and people. It's about using technology wisely to reduce administrative burden, strengthen clinical decision-making, and give therapists more time to help residents achieve greater independence, function, and quality of life.</p><p>For nursing homes and assisted living communities, that may be AI's greatest promise: not to replace human care, but to give caregivers the information they need—and more time—to better provide it.</p><p><em>Daniel Ciolek is associate vice president of therapy advocacy for the American Health Care Association.</em></p>	AI is a useful tool in the rehabilitation toolbox, allowing therapists to work more efficiently and intervene earlier.	2026-09-08T04:00:00Z	<img alt="senior rehab" src="/Issues/2026/Fall/PublishingImages/Rehab_Fall26.jpg" style="BORDER:0px solid;" />	Artificial Intelligence	Technology in Health Care
Celebrating 30 Years of Quality Excellence	https://www.providermagazine.com/Issues/2026/Fall/Pages/Celebrating-30-Years-of-Quality-Excellence.aspx	Celebrating 30 Years of Quality Excellence	<p><img src="/Issues/2026/Summer/PublishingImages/QA_30years.jpg" alt="30 Years of Excellence" class="ms-rtePosition-2" style="margin:5px;" />Thirty years ago, the AHCA/NCAL National Quality Award Program was established and set out with an ambitious goal: not simply to recognize excellence in long term and post-acute care, but to help providers build it. Since its launch in 1996, the program has evolved into the profession’s most respected and widely used quality-improvement program.</p><p>Today, the program’s impact is measured by more than just the Bronze, Silver, and Gold awards presented each year. Decades of performance data show that Silver and Gold Quality Award recipients consistently achieve better outcomes than their peers, including higher Five-Star ratings, lower staff turnover, and better outcomes in quality performance measures.</p><p><br></p><p style="text-align:left;"><img src="/Issues/2026/Fall/PublishingImages/BTN_Fall26.jpg" alt="Quality Excellence" style="margin:5px;width:400px;height:276px;" /><br></p>	Thirty years ago, the AHCA/NCAL National Quality Award Program was established and set out with an ambitious goal.	2026-09-04T04:00:00Z	<img alt="" height="594" src="/Issues/2026/Summer/PublishingImages/QA_30years.jpg" width="740" style="BORDER:0px solid;" />	By the Numbers	By the Numbers
30 Years of Pursuing Excellence	https://www.providermagazine.com/Issues/2026/Fall/Pages/30-Years-of-Pursuing-Excellence.aspx	30 Years of Pursuing Excellence	<span></span><p style="text-align:center;"><img src="/Issues/2026/Fall/PublishingImages/QA_header.jpg" alt="" style="margin:5px;width:925px;height:225px;" /><br></p><p>Thirty years ago, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) National Quality Award Program was established and set out with an ambitious goal: not simply to recognize excellence in long term and post-acute care, but to help providers build it.</p><p>Since its launch in 1996, more than 8,000 skilled nursing centers and assisted living communities have embarked on the Quality Award journey. What began as an innovative application of the Baldrige Excellence Framework has evolved into the profession’s most respected and widely used quality-improvement program—a nationwide program that has shaped organizations, developed leaders, and improved care for older adults and individuals with disabilities.</p><p>Today, the program’s impact is measured by more than just the Bronze, Silver, and Gold awards presented each year. Decades of performance data show that Silver and Gold Quality Award recipients consistently achieve better outcomes than their peers, such as higher Five-Star ratings, lower staff turnover, and better outcomes in quality-performance measures.</p><h3>More Than an Award</h3><p>Long before the first award applications were submitted, Baldrige expert Mark Blazey was helping design what the program would become. Blazey—who helped develop the program’s original scoring calibration guidelines, trained examiners for more than a decade, and served as a judge and member of the Quality Award Board—said the program’s greatest innovation was its focus on development rather than recognition alone.</p><p>“Baldrige recognized organizations that had already achieved excellence,” Blazey said. “The AHCA/NCAL program was designed to develop excellence.”</p><p>That philosophy became the foundation of the program’s three progressive levels: Bronze, Silver, and Gold (formerly Step I, Step II, and Step III, respectively). This allowed providers to build organizational maturity one step at a time. Blazey believes this structure is the reason the program has endured for three decades.</p><p>“The organizational profile required at Bronze may sound simple,” he said, “but it forces organizations to think through why they are in business, what they want to achieve, what is critical for success, and what the customers want. Those conversations become the first step toward long-term improvement.”</p><p>Throughout his involvement, Blazey focused on ensuring the evaluation process remained rigorous, fair, and consistent. He developed the scoring calibration guide, still used today, to increase examiner consistency and worked to align program policies with the Baldrige framework. He considers the AHCA/NCAL National Quality Award Program to be one of the most effective Baldrige-based initiatives in the world.</p><p>“What impressed me most wasn’t just the applicants,” Blazey said in retrospect. “The program itself continuously improved. The staff used the same quality principles internally that they asked providers to use. That’s why the program has lasted.”</p><p style="text-align:center;"><span><img src="/Issues/2026/Fall/PublishingImages/QATimeline-(2).jpg" alt="QA timeline" class="ms-rteImage-4" style="margin:5px;width:600px;height:330px;" /></span><br></p><h3>Not a Finish Line</h3><p>For providers, the Quality Award Program quickly becomes much more than an application.</p><p>Allan Engelauf, chief executive officer of Vista Pacifica Enterprises, began his organization’s journey in 2014 after seeing another California provider achieve Gold and being motivated to become a top organization in the state. Over the next several years, his independently owned, two-building organization progressed through Bronze and Silver and ultimately earned the Gold Award in 2019 on its first attempt.</p><p>“We were a good organization when we started, but the journey to Gold changed our standards,” Engelauf said. “It made us look in the mirror at areas where we were weak and really made us raise the bar for ourselves. It changed how we thought about systems and how we continuously improve.”</p><p>For Engelauf, earning Gold wasn’t the finish line; it was an invitation to give back.</p><p>“Right after we won the Gold in 2019, I started as a Gold examiner in 2020,” he said. “I felt like after spending six years learning the criteria, I didn’t want that knowledge to stop with us. Serving as an examiner allows me to help other organizations grow the same way we did.”</p><p>For Engelauf, giving back was the natural next step. After spending years learning from examiners and applying their feedback, becoming an examiner himself allowed him to complete the circle—helping other providers navigate the same journey that transformed his own organization.</p><p>Thirty years after the program’s launch, Engelauf’s story represents one of the program’s greatest legacies: providers who complete the journey return to help guide the next generation of applicants, ensuring the culture of continuous improvement remains for years to come.</p><h3>Building Better Systems</h3><p>That same theme resonates with Tawnya Dennis, administrator of Lofland Park Center in Seaford, Delaware. The center earned the Gold Award in 2024, and Dennis now serves as both an examiner and a member of the Quality Award Board.</p><p>She first learned about the program at a state association educational seminar and immediately recognized its potential. Beginning with a Bronze Award, which Lofland Park earned in 2016, Dennis steadily guided her organization through the program while simultaneously serving as an examiner. Along the way, she credits the framework with preparing her organization for significant federal regulatory changes.</p><p>“When the QAPI [quality assurance and performance improvement] regulations became more robust, we already had those systems in place because of the Quality Award Program,” Dennis said. “We understood it wasn’t about having another meeting—it was about building systems that drive success.”</p><p>Perhaps even more valuable than the recognition itself, Dennis said, is the detailed examiner feedback organizations receive after each application. After an unsuccessful Gold application, her team carefully studied the feedback report, strengthened key systems, and ultimately earned Gold the following year.</p><p>“The feedback report is invaluable,” she said. “It tells you exactly where you need to improve. If you’re willing to listen and make the changes, it becomes your road map.”</p><p>For Dennis and her team at Lofland Park, that sentiment continues long after receiving the Gold recognition.</p><p>“The journey never really stops,” she said. “You achieve Gold, but continuous improvement doesn’t end there. The Quality Award Program becomes the way you operate.”</p><h3>30 Years and Still Improving</h3><p>If anyone has witnessed the evolution of the National Quality Award Program, it’s Cathy Bergland.</p><p><img src="/Issues/2026/Fall/PublishingImages/QA_CathyBergland.jpg" alt="Cathy Bergland" class="ms-rtePosition-1" style="margin:5px;" />After serving as an examiner, trainer, judge, consultant, and now Quality Award Board Chair, Bergland has spent more than a decade helping shape the program and watching hundreds of organizations progress from Bronze to Silver, and an elite few to Gold. For Bergland, the program’s longevity isn’t accidental. It has thrived because it was designed to help providers continuously strengthen their organizations.</p><p>“What I love most is the developmental nature of the program,” Bergland said. “It doesn’t ask organizations to become exceptional overnight. It helps them build that capability one step at a time.”</p><p>Bergland said some of the most inspiring organizations are those that return to the program after already achieving Gold, not because they need another award, but because they remain committed to becoming better. </p><p>“The strongest organizations continue to evaluate themselves, challenge themselves, and reengage with the framework because they know improvement never stops,” Bergland said. “I don’t really think of it as an application. It’s a management document. When it becomes the way you lead your organization—not just a paper you write—it is a framework to improve care and services every single day.”</p><p>But Bergland believes the real reason for the program’s success is the people behind it. Thousands of volunteer examiners, judges, mentors, and board members have dedicated countless hours over the past thirty years to helping providers improve. That commitment remains the program’s greatest strength.</p><p><img src="/Issues/2026/Summer/PublishingImages/Cristina-Walls.jpg" alt="Cristina Walls" class="ms-rtePosition-2" style="margin:5px;" />“Where would this program be without this army of volunteers?” she said. “As board chair, I can’t help but say a huge thank-you to all those volunteers.” </p><p>Because, in the end, the National Quality Award Program has never been about just earning an award; it’s about people helping people deliver better care.</p><p><em>Cristina Walls is senior manager, public affairs at the American Health Care Association/National Center for Assisted Living.</em></p>	Thirty years ago, AHCA/NCAL National Quality Award Program was established and set out with an ambitious goal: not simply to recognize excellence in long term and post-acute care, but to help providers build it.	2026-09-04T04:00:00Z	<img alt="" src="/Issues/2026/Summer/PublishingImages/QA_30years.jpg" style="BORDER:0px solid;" />	Quality Awards	Special Feature
Aligning Pharmacy Partnership with the Reality of Senior Living	https://www.providermagazine.com/Issues/2026/Fall/Pages/Aligning-Pharmacy-Partnership-with-the-Reality-of-Senior-Living.aspx	Aligning Pharmacy Partnership with the Reality of Senior Living	<p><strong class="ms-rteForeColor-8">ADVERTORIAL</strong></p><p>Senior living operators are navigating a more complex care environment than ever before. Residents are entering communities with higher acuity, more chronic conditions, and more complicated medication regimens. At the same time, communities are managing persistent staffing pressure, rising operating costs, and increasing expectations from residents and families.</p><p><img src="/Issues/2026/Fall/Pages/Aligning-Pharmacy-Partnership-with-the-Reality-of-Senior-Living.aspx" class="ms-rtePosition-2" alt="" style="margin:5px;width:0px;" /><img src="/Issues/2026/Fall/PublishingImages/Clark_PharMerica.jpg" alt="Scott Clark" class="ms-rtePosition-2" style="margin:5px;" />In that environment, pharmacy providers can no longer be viewed only as medication suppliers. For operators, the right pharmacy partner should help make care delivery more reliable, more consistent, and easier to manage across the day-to-day realities of community operations. It should reduce friction for staff, support safer medication use, help control avoidable costs, and bring clinical and operational expertise that strengthens the care team.</p><p>According to Scott Clark, chief clinical officer at PharMerica, a true pharmacy partner must bring to the table in a genuinely collaborative effort clinical expertise and proactive oversight. This collaborative role is becoming increasingly important as senior living communities work to balance three connected pressures: higher resident acuity, constrained staffing resources, and rising costs.</p><h3>Higher Acuity Requires Stronger Clinical Oversight</h3><p>Residents managing multiple chronic conditions often rely on multiple medications, which can increase the risk of drug interactions, duplicative therapy, side effects, falls, confusion, and avoidable hospitalizations. Clark points out that because a resident’s clinical profile constantly evolves, the individualized care plan must evolve, as well.</p><p>For operators, this means pharmacy support should go beyond dispensing. Communities should expect a pharmacy partner to bring proactive medication review, geriatric expertise, and close collaboration with prescribers and care teams. The goal is not simply to manage a list of medications but to help ensure each resident’s therapy remains safe, appropriate, and aligned with evolving care needs.</p><p>Clark explains, “Regular medication reviews are one of the most impactful things we can do. They allow us to identify opportunities such as needed dose adjustments and discontinuation of medications if they are no longer needed. This equates to better disease control and improved quality of life for residents.”</p><p>This is where specialized pharmacy expertise matters. Older adults respond differently to medication, and their conditions can interact in ways that require careful clinical oversight. Clark stresses that by combining specialized geriatric training with the work of an interdisciplinary care team, consultant pharmacists help ensure that therapy remains safe and deeply aligned with the resident’s overall goals of care. A partner with this experience can help communities identify clinical risks earlier, support regulatory compliance, and give care teams more confidence that medication therapy is being managed with the right level of clinical rigor.</p><h3>Pharmacy Providers Should Help Ease the Burden on Staff</h3><p>Higher acuity would be challenging enough in a fully staffed environment. But many senior living communities are still operating with lean teams, competing priorities, and caregivers who are asked to manage more complexity with limited time. That makes operational support from a pharmacy partner just as important as clinical support.</p><p>Operators should expect pharmacy workflows that reduce manual work, simplify routine tasks, and help staff spend less time chasing down medication-related issues. Reliable medication delivery, clear communication, refill support, integration with community systems, and responsive local service all contribute to a more predictable day-to-day experience.</p><p><img src="/Issues/2026/Fall/PublishingImages/Pharmerica_KelseyHaan_r.jpg" alt="Kelsey Haan" class="ms-rtePosition-2" style="margin:5px;width:147px;" />One example is cycle fill, which helps communities begin each medication cycle with the exact medications they need. Kelsey Haan, director of account management at PharMerica Senior Living, notes that this process gets caregivers started on the right track at the beginning of each cycle, eliminating last-minute follow-ups. She explains that by actively chasing down pending authorizations before they delay treatment, the pharmacy team proactively removes administrative tasks from stretched nursing staff.</p><p>A pharmacy partner can also support staff through on-site or in-community resources. Mobile technicians, clinical consultants, and nurse-led education can help with medication pass efficiency, cart audits, compliance support, and staff training.</p><p>Education is another critical part of staff support. As regulations, resident needs, and medication standards evolve, communities benefit from pharmacy partners that help translate clinical and regulatory changes into practical guidance for care teams. PharMerica’s <a href="http://www.pharmerica.com/illuminate" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Illuminate">Illuminate</a> education platform and continuing education resources are examples of how a pharmacy provider can support staff development while helping communities stay current on best practices. Haan notes that investing in staff through these educational platforms is also a powerful tool for caregiver retention.</p><p>The larger point for operators is simple: pharmacy should not create more work for already stretched teams. It should help remove obstacles, improve consistency, and allow staff to stay focused on residents.</p><h3>Cost Containment Starts with Better Medication Management</h3><p>Operating cost pressure is another area where pharmacy can play a meaningful role. Operators should expect their pharmacy partner to help identify practical ways to make medication management more predictable, affordable, and efficient.</p><p>That support can take several forms. Over-the-counter formularies can help residents access commonly used products at lower, more predictable prices. Additionally, financial navigation programs—such as helping families enroll in the Medicare Prescription Payment Plan—can space out out-of-pocket costs while streamlining administrative work for community staff.</p><p>But one of the most important cost levers is medication optimization. When pharmacists work closely with providers and care teams to identify unnecessary, duplicative, or redundant medications, the result can be meaningful for both residents and communities. Fewer unnecessary medications reduce cost exposure, simplify administration, and decrease the risk of adverse events.</p><p>As Haan reflects, the ultimate goal is to ensure residents are receiving only the most appropriate, highly targeted therapies: “We’re not filling an average of twenty scripts per resident; we’re filling ten, and their well-being is improved.”</p><h3>What This Means for Operators</h3><p>For senior living operators, the “so what” is not that pharmacy support exists; it is whether that support comes together in a way that makes daily operations easier, safer, and more predictable. Many providers can offer medication delivery, clinical support, or education. The more meaningful question is whether those capabilities work together consistently when staffing is tight, resident needs change, and small medication issues become larger operational disruptions.</p><p>As Haan emphasizes, a dedicated partner must remain highly adaptable, constantly evolving to address new operational challenges as they arise. When proactive clinical oversight, responsive local support, and clear workflows work together, pharmacy becomes less of a burden to manage and more of an extension of the care environment. </p><p><br></p><p style="text-align:center;"><a href="https://pharmerica.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083"><img src="/Issues/2026/Fall/PublishingImages/PharMerica.jpg" alt="PharMerica" style="margin:5px;width:300px;height:45px;" /></a> </p>	Senior living operators are navigating a more complex care environment than ever before. Residents are entering communities with higher acuity, more chronic conditions, and more complicated medication regimens.	2026-09-04T04:00:00Z	<img alt="PharMerica" src="/Issues/2026/Fall/PublishingImages/PharMerica-740.jpg" style="BORDER:0px solid;" />	Caregiving	Special Feature
Modernizing Physician Leadership	https://www.providermagazine.com/Issues/2026/Fall/Pages/Modernizing-Physician-Leadership.aspx	Modernizing Physician Leadership	<p style="text-align:center;"><img src="/Issues/2026/Fall/PublishingImages/Leadership2_Fall26.jpg" alt="leadership" style="margin:5px;width:907px;height:272px;" /><br></p><p><br></p><p>In December 2019, Elizabeth Burns, MD, accepted the role of chief medical officer (CMO) at Avamere Living, a role her boss, Avamere founder and former CEO Rick Miller, could not yet describe. “We know we need a chief medical officer,” he told her. “We’re just not exactly sure what we need, but we know we need one.” </p><p>Within months, the COVID-19 pandemic settled the issue for the entire sector. “COVID became a pivotal moment that fundamentally reshaped physician leadership in post-acute and long term care,” Burns reflected. “It demonstrated that physicians are essential, not only during times of crisis, but also in shaping strategy, driving innovation, improving quality, and preparing organizations for the future.” For decades, federal regulation has required a medical director in every skilled nursing facility. As residents’ needs grow more complex, providers are modernizing their physician leadership models and ensuring that the medical director’s role at the facility level is effectively supported by the C-suite.</p><h3>More Complexity, More Responsibility</h3><p>Long term care professionals know all too well what’s driving these changes. With more older adults living at home longer, resident acuity continues to steadily climb. “Providers are increasingly asked to serve residents with greater clinical and behavioral needs while demonstrating measurable outcomes and reliably managing transitions to and from hospitals,” Mark Prifogle, chair of the American College of Health Care Administrators, told <em>Provider</em> earlier this year.</p><p>As facility operators adapt, their medical directors have taken on more and more responsibility. “The medical director role is a role that’s been defined by federal regulation for decades, and it is very specific from a regulatory standpoint,” observed Richard Feifer, MD, MPH, FACP, a PALTmed director at large who served as chief medical officer and executive vice president at Genesis HealthCare. “The day-to-day reliance on the medical director, the engagement, the involvement—that’s what’s been increasing over the last number of years.”</p><p><img src="/Issues/2026/Fall/PublishingImages/Leadership_LizBurns.jpg" alt="Elizabeth Burns" class="ms-rtePosition-1" style="margin:5px;" />Burns, who was named chief medical officer at American Health Care Association/National Center for Assisted Living in 2025, described a role that expanded far past its statutory remit. “The medical director role has evolved well beyond regulatory oversight and clinical compliance,” she said. “Today’s medical directors are increasingly expected to lead quality improvement, champion evidence-based care, foster interdisciplinary collaboration, leverage data and technology, and help organizations succeed in an increasingly complex health care environment.”</p><p>Masonicare, a Connecticut provider whose services span independent living through hospice, shows just how much responsibility the modern medical director shoulders. As CEO JP Venoit told <em>Provider</em>, Masonicare has three medical directors: one for its behavioral health hospital, one for hospice and home care, and a third who oversees everything else—nursing homes, assisted living, and independent living. </p><p>“Our residents now have more choice,” he explained. “People who would have been in a nursing home ten or twelve years ago, they’re in assisted living, residential living, or their home. We’ve taken the approach that our medical directors help us keep them in the setting they call home longer and safer.”</p><h3>From the Bedside to the Boardroom</h3><p>There’s no single threshold at which a provider needs a CMO. Feifer pointed to scale: “For organizations that operate multiple facilities and have more overarching needs for medical oversight and medical leadership, that’s where the CMO comes in,” he said. </p><p>Titles vary, as well, as some organizations opt for a chief clinical officer label or simply elevate their medical director to a senior management role. Masonicare’s three medical directors, for instance, work alongside the C-suite.</p><p>No matter the title, the role requires a bird’s-eye view. A CMO (or equivalent) fields clinical issues across the entire organization rather than at a single facility, tying those issues to broader strategic concerns. </p><p><img src="/Issues/2026/Fall/PublishingImages/Leadership_RichFeifer.jpg" alt="Rich Feifer" class="ms-rtePosition-1" style="margin:5px;" />“The CMO role is one that often involves the wearing of two hats simultaneously,” Feifer explained. “There’s the medical leadership hat that’s focused on quality of care and medical care and appropriate staffing. And then there’s the business hat, helping the enterprise succeed. The enterprise needs to be successful to fulfill its mission, and it needs to do so in a medically responsible way.”</p><p>“I liken it to being a bridge between the bedside and the boardroom,” said Shealynn Buck, MD, CMO at Lockton Companies, where she helps organizations design clinical strategies that improve outcomes, quality, and value. “As you think about both clinical and financial outcomes, having that expertise that can bridge those pieces, that’s really important.” She argued that whether an organization needs a CMO is less about size than about complexity.</p><p>She also described the CMO as an ambassador to the health care ecosystem itself. “Whenever there is the need for ensuring clinical integrity, clinical leadership, and representing that in the health care market, a CMO can be really valuable for that,” she said.</p><h3>What Providers Look For</h3><p>As providers expand their physician leadership models, they’re looking for a few key competencies in potential CMOs. Perhaps most important is the ability to synthesize that bird’s-eye view of the health care industry with the granular concerns of a company or even a facility.</p><p>“CMOs sit at an intersection point between patient care and the business,” Buck explained. “Having some business acumen but also understanding technology and how technology is impacting health care is really important.” She stressed the need for a “dot-connector mindset” that makes it possible to see where an individual community’s needs fit within the larger system, and how that system can be used to meet those needs.</p><p><span><img src="/Issues/2026/Fall/PublishingImages/Leadership_JPVenoit.jpg" alt="JP Venoit" class="ms-rtePosition-1" style="margin:5px;" /></span>For Feifer, the ideal CMO candidate is someone with a high level of leadership experience. “One of the most important qualities is someone who has led organizations and has been responsible for the overall performance, medical and otherwise, of large teams,” he said. “This is not something that necessarily comes naturally to an individual physician who’s been providing direct patient care all of their career. This is a different skill set that takes training and mentorship to develop.”</p><p>Then there’s fluency in the myriad tongues one must speak to lead a health care business—another trait that distinguishes CMOs from medical directors. “The CMO needs to speak the language of the frontline doctor; that’s a medical language,” Feifer explained. “Then the CMO needs to speak the language of the chief financial officer; that’s a financial language. Then they need to speak the language of the head of business development; that’s a sales language. For a CMO to be highly successful, they need to be fluent in all of those languages and more.”</p><p>Buck identified one competency that may seem counterintuitive. “As clinicians, as physicians, we’re often trained to be the decision-maker,” she said. “But as complex as health care is, not one person has all the answers. As a physician leader and CMO, it’s important to have a network of folks that you’re not afraid to ask questions of and have some of your blind spots tested.”</p><h3>A Seat at the Table</h3><p>A CMO can support the medical team only if the organization supports the CMO. Feifer’s advice in that regard is simple: “Ensure that they have a seat at the table and are invited to offer their unique perspective on all matters pertaining to the enterprise,” he said. “They should never be pigeonholed or just restricted to the one corner of the organization that is medical care, but they should be a full-fledged leader that comes at every issue with a unique lens.”</p><p>For Burns, a successful physician leadership model is a holistic one, with the high-level and facility-level roles working in tandem toward the same objectives. “Rather than thinking of the medical director and CMO as separate roles, I view them as part of a continuum of physician leadership,” she said. “The medical director remains the clinical leader closest to resident care, while the CMO extends that clinical perspective across the organization, translating frontline insights into enterprise-wide strategy.”</p><p><img src="/Issues/2026/Fall/PublishingImages/leadership_quote1.jpg" alt="leadership" class="ms-rtePosition-2" style="margin:5px;width:248px;height:235px;" />Feifer echoed her perspective, arguing that an enterprise physician leader’s first responsibility is “ensuring that every facility has a strong medical director performing at the top of their abilities.” From there, the job is to foster a culture of “continuous performance improvement,” one where the clinical team is working collaboratively to deliver the highest quality of care. Done right, this approach naturally turns the care team into a training ground for future physician leaders, whether at the facility or enterprise level.</p><p>Reflecting on the evolving role of physician leadership, Burns cited a line credited to quality-improvement scholar Paul Batalden: “Every system is perfectly designed to get the results it gets.”</p><p>“If we want different outcomes for residents, families, and providers, we must intentionally redesign the way physician leadership is integrated into our organizations,” Burns concluded. “That means modernizing both the medical director role and the chief medical officer role so physician leaders have the influence and support within the leadership team to improve quality, access, and innovation in person-centered care across the continuum.” <br><br><em>Steve Manning is a journalist based in New York City.</em></p>	Chief medical officers are expected to have not only deep clinical skills but also strategic insight, business competency, and team leadership experience.	2026-09-04T04:00:00Z	<img alt="leadership" src="/Issues/2026/Fall/PublishingImages/Leadership_Fall26.jpg" style="BORDER:0px solid;" />	Management	Cover Feature

People On The Move

Vice President of Sales and Marketing	https://www.providermagazine.com/Lists/People On The Move/DispForm.aspx?ID=156	Vice President of Sales and Marketing	<img alt="Terri Mundy" src="/PublishingImages/People%20on%20the%20Move/POTM%202026/Fall/potm_Mundy.jpg" style="BORDER:0px solid;" />	Terri Mundy	Americare Senior Living
Regional Director of Operations	https://www.providermagazine.com/Lists/People On The Move/DispForm.aspx?ID=157	Regional Director of Operations	<img alt="Eric Windham" src="/PublishingImages/People%20on%20the%20Move/POTM%202026/Fall/potm_Windham.jpg" style="BORDER:0px solid;" />	Eric Windham	Americare Senior Living
President & CEO	https://www.providermagazine.com/Lists/People On The Move/DispForm.aspx?ID=158	President & CEO	<img alt="Dr. Cyrus Batheja" src="/PublishingImages/People%20on%20the%20Move/POTM%202026/Fall/potm_Batheja.jpg" style="BORDER:0px solid;" />	Dr. Cyrus Batheja, RN	Ecumen
NYSHCA/NYSCAL	https://www.providermagazine.com/Lists/People On The Move/DispForm.aspx?ID=159	NYSHCA/NYSCAL	<img alt="" src="/PublishingImages/People%20on%20the%20Move/POTM%202026/Fall/potm_Wagoner.jpg" style="BORDER:0px solid;" />	Joshua Wagoner	Waterview Hills Rehabilitation & Nursing Center and Salem Hills Rehabilitation & Healthcar
Program Director	https://www.providermagazine.com/Lists/People On The Move/DispForm.aspx?ID=160	Program Director	<img alt="Ashley McLean" src="/PublishingImages/People%20on%20the%20Move/POTM%202026/Fall/potm_McLean.jpg" style="BORDER:0px solid;" />	Ashley McLean	CareOne at Sharon

30 Years of Pursuing Excellence	https://www.providermagazine.com/Issues/2026/Fall/Pages/30-Years-of-Pursuing-Excellence.aspx	30 Years of Pursuing Excellence	<span></span><p style="text-align:center;"><img src="/Issues/2026/Fall/PublishingImages/QA_header.jpg" alt="" style="margin:5px;width:925px;height:225px;" /><br></p><p>Thirty years ago, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) National Quality Award Program was established and set out with an ambitious goal: not simply to recognize excellence in long term and post-acute care, but to help providers build it.</p><p>Since its launch in 1996, more than 8,000 skilled nursing centers and assisted living communities have embarked on the Quality Award journey. What began as an innovative application of the Baldrige Excellence Framework has evolved into the profession’s most respected and widely used quality-improvement program—a nationwide program that has shaped organizations, developed leaders, and improved care for older adults and individuals with disabilities.</p><p>Today, the program’s impact is measured by more than just the Bronze, Silver, and Gold awards presented each year. Decades of performance data show that Silver and Gold Quality Award recipients consistently achieve better outcomes than their peers, such as higher Five-Star ratings, lower staff turnover, and better outcomes in quality-performance measures.</p><h3>More Than an Award</h3><p>Long before the first award applications were submitted, Baldrige expert Mark Blazey was helping design what the program would become. Blazey—who helped develop the program’s original scoring calibration guidelines, trained examiners for more than a decade, and served as a judge and member of the Quality Award Board—said the program’s greatest innovation was its focus on development rather than recognition alone.</p><p>“Baldrige recognized organizations that had already achieved excellence,” Blazey said. “The AHCA/NCAL program was designed to develop excellence.”</p><p>That philosophy became the foundation of the program’s three progressive levels: Bronze, Silver, and Gold (formerly Step I, Step II, and Step III, respectively). This allowed providers to build organizational maturity one step at a time. Blazey believes this structure is the reason the program has endured for three decades.</p><p>“The organizational profile required at Bronze may sound simple,” he said, “but it forces organizations to think through why they are in business, what they want to achieve, what is critical for success, and what the customers want. Those conversations become the first step toward long-term improvement.”</p><p>Throughout his involvement, Blazey focused on ensuring the evaluation process remained rigorous, fair, and consistent. He developed the scoring calibration guide, still used today, to increase examiner consistency and worked to align program policies with the Baldrige framework. He considers the AHCA/NCAL National Quality Award Program to be one of the most effective Baldrige-based initiatives in the world.</p><p>“What impressed me most wasn’t just the applicants,” Blazey said in retrospect. “The program itself continuously improved. The staff used the same quality principles internally that they asked providers to use. That’s why the program has lasted.”</p><p style="text-align:center;"><span><img src="/Issues/2026/Fall/PublishingImages/QATimeline-(2).jpg" alt="QA timeline" class="ms-rteImage-4" style="margin:5px;width:600px;height:330px;" /></span><br></p><h3>Not a Finish Line</h3><p>For providers, the Quality Award Program quickly becomes much more than an application.</p><p>Allan Engelauf, chief executive officer of Vista Pacifica Enterprises, began his organization’s journey in 2014 after seeing another California provider achieve Gold and being motivated to become a top organization in the state. Over the next several years, his independently owned, two-building organization progressed through Bronze and Silver and ultimately earned the Gold Award in 2019 on its first attempt.</p><p>“We were a good organization when we started, but the journey to Gold changed our standards,” Engelauf said. “It made us look in the mirror at areas where we were weak and really made us raise the bar for ourselves. It changed how we thought about systems and how we continuously improve.”</p><p>For Engelauf, earning Gold wasn’t the finish line; it was an invitation to give back.</p><p>“Right after we won the Gold in 2019, I started as a Gold examiner in 2020,” he said. “I felt like after spending six years learning the criteria, I didn’t want that knowledge to stop with us. Serving as an examiner allows me to help other organizations grow the same way we did.”</p><p>For Engelauf, giving back was the natural next step. After spending years learning from examiners and applying their feedback, becoming an examiner himself allowed him to complete the circle—helping other providers navigate the same journey that transformed his own organization.</p><p>Thirty years after the program’s launch, Engelauf’s story represents one of the program’s greatest legacies: providers who complete the journey return to help guide the next generation of applicants, ensuring the culture of continuous improvement remains for years to come.</p><h3>Building Better Systems</h3><p>That same theme resonates with Tawnya Dennis, administrator of Lofland Park Center in Seaford, Delaware. The center earned the Gold Award in 2024, and Dennis now serves as both an examiner and a member of the Quality Award Board.</p><p>She first learned about the program at a state association educational seminar and immediately recognized its potential. Beginning with a Bronze Award, which Lofland Park earned in 2016, Dennis steadily guided her organization through the program while simultaneously serving as an examiner. Along the way, she credits the framework with preparing her organization for significant federal regulatory changes.</p><p>“When the QAPI [quality assurance and performance improvement] regulations became more robust, we already had those systems in place because of the Quality Award Program,” Dennis said. “We understood it wasn’t about having another meeting—it was about building systems that drive success.”</p><p>Perhaps even more valuable than the recognition itself, Dennis said, is the detailed examiner feedback organizations receive after each application. After an unsuccessful Gold application, her team carefully studied the feedback report, strengthened key systems, and ultimately earned Gold the following year.</p><p>“The feedback report is invaluable,” she said. “It tells you exactly where you need to improve. If you’re willing to listen and make the changes, it becomes your road map.”</p><p>For Dennis and her team at Lofland Park, that sentiment continues long after receiving the Gold recognition.</p><p>“The journey never really stops,” she said. “You achieve Gold, but continuous improvement doesn’t end there. The Quality Award Program becomes the way you operate.”</p><h3>30 Years and Still Improving</h3><p>If anyone has witnessed the evolution of the National Quality Award Program, it’s Cathy Bergland.</p><p><img src="/Issues/2026/Fall/PublishingImages/QA_CathyBergland.jpg" alt="Cathy Bergland" class="ms-rtePosition-1" style="margin:5px;" />After serving as an examiner, trainer, judge, consultant, and now Quality Award Board Chair, Bergland has spent more than a decade helping shape the program and watching hundreds of organizations progress from Bronze to Silver, and an elite few to Gold. For Bergland, the program’s longevity isn’t accidental. It has thrived because it was designed to help providers continuously strengthen their organizations.</p><p>“What I love most is the developmental nature of the program,” Bergland said. “It doesn’t ask organizations to become exceptional overnight. It helps them build that capability one step at a time.”</p><p>Bergland said some of the most inspiring organizations are those that return to the program after already achieving Gold, not because they need another award, but because they remain committed to becoming better. </p><p>“The strongest organizations continue to evaluate themselves, challenge themselves, and reengage with the framework because they know improvement never stops,” Bergland said. “I don’t really think of it as an application. It’s a management document. When it becomes the way you lead your organization—not just a paper you write—it is a framework to improve care and services every single day.”</p><p>But Bergland believes the real reason for the program’s success is the people behind it. Thousands of volunteer examiners, judges, mentors, and board members have dedicated countless hours over the past thirty years to helping providers improve. That commitment remains the program’s greatest strength.</p><p><img src="/Issues/2026/Summer/PublishingImages/Cristina-Walls.jpg" alt="Cristina Walls" class="ms-rtePosition-2" style="margin:5px;" />“Where would this program be without this army of volunteers?” she said. “As board chair, I can’t help but say a huge thank-you to all those volunteers.” </p><p>Because, in the end, the National Quality Award Program has never been about just earning an award; it’s about people helping people deliver better care.</p><p><em>Cristina Walls is senior manager, public affairs at the American Health Care Association/National Center for Assisted Living.</em></p>	Thirty years ago, AHCA/NCAL National Quality Award Program was established and set out with an ambitious goal: not simply to recognize excellence in long term and post-acute care, but to help providers build it.	2026-09-04T04:00:00Z	<img alt="" src="/Issues/2026/Summer/PublishingImages/QA_30years.jpg" style="BORDER:0px solid;" />	Quality Awards	Special Feature	Cristina Walls	53	3
Aligning Pharmacy Partnership with the Reality of Senior Living	https://www.providermagazine.com/Issues/2026/Fall/Pages/Aligning-Pharmacy-Partnership-with-the-Reality-of-Senior-Living.aspx	Aligning Pharmacy Partnership with the Reality of Senior Living	<p><strong class="ms-rteForeColor-8">ADVERTORIAL</strong></p><p>Senior living operators are navigating a more complex care environment than ever before. Residents are entering communities with higher acuity, more chronic conditions, and more complicated medication regimens. At the same time, communities are managing persistent staffing pressure, rising operating costs, and increasing expectations from residents and families.</p><p><img src="/Issues/2026/Fall/Pages/Aligning-Pharmacy-Partnership-with-the-Reality-of-Senior-Living.aspx" class="ms-rtePosition-2" alt="" style="margin:5px;width:0px;" /><img src="/Issues/2026/Fall/PublishingImages/Clark_PharMerica.jpg" alt="Scott Clark" class="ms-rtePosition-2" style="margin:5px;" />In that environment, pharmacy providers can no longer be viewed only as medication suppliers. For operators, the right pharmacy partner should help make care delivery more reliable, more consistent, and easier to manage across the day-to-day realities of community operations. It should reduce friction for staff, support safer medication use, help control avoidable costs, and bring clinical and operational expertise that strengthens the care team.</p><p>According to Scott Clark, chief clinical officer at PharMerica, a true pharmacy partner must bring to the table in a genuinely collaborative effort clinical expertise and proactive oversight. This collaborative role is becoming increasingly important as senior living communities work to balance three connected pressures: higher resident acuity, constrained staffing resources, and rising costs.</p><h3>Higher Acuity Requires Stronger Clinical Oversight</h3><p>Residents managing multiple chronic conditions often rely on multiple medications, which can increase the risk of drug interactions, duplicative therapy, side effects, falls, confusion, and avoidable hospitalizations. Clark points out that because a resident’s clinical profile constantly evolves, the individualized care plan must evolve, as well.</p><p>For operators, this means pharmacy support should go beyond dispensing. Communities should expect a pharmacy partner to bring proactive medication review, geriatric expertise, and close collaboration with prescribers and care teams. The goal is not simply to manage a list of medications but to help ensure each resident’s therapy remains safe, appropriate, and aligned with evolving care needs.</p><p>Clark explains, “Regular medication reviews are one of the most impactful things we can do. They allow us to identify opportunities such as needed dose adjustments and discontinuation of medications if they are no longer needed. This equates to better disease control and improved quality of life for residents.”</p><p>This is where specialized pharmacy expertise matters. Older adults respond differently to medication, and their conditions can interact in ways that require careful clinical oversight. Clark stresses that by combining specialized geriatric training with the work of an interdisciplinary care team, consultant pharmacists help ensure that therapy remains safe and deeply aligned with the resident’s overall goals of care. A partner with this experience can help communities identify clinical risks earlier, support regulatory compliance, and give care teams more confidence that medication therapy is being managed with the right level of clinical rigor.</p><h3>Pharmacy Providers Should Help Ease the Burden on Staff</h3><p>Higher acuity would be challenging enough in a fully staffed environment. But many senior living communities are still operating with lean teams, competing priorities, and caregivers who are asked to manage more complexity with limited time. That makes operational support from a pharmacy partner just as important as clinical support.</p><p>Operators should expect pharmacy workflows that reduce manual work, simplify routine tasks, and help staff spend less time chasing down medication-related issues. Reliable medication delivery, clear communication, refill support, integration with community systems, and responsive local service all contribute to a more predictable day-to-day experience.</p><p><img src="/Issues/2026/Fall/PublishingImages/Pharmerica_KelseyHaan_r.jpg" alt="Kelsey Haan" class="ms-rtePosition-2" style="margin:5px;width:147px;" />One example is cycle fill, which helps communities begin each medication cycle with the exact medications they need. Kelsey Haan, director of account management at PharMerica Senior Living, notes that this process gets caregivers started on the right track at the beginning of each cycle, eliminating last-minute follow-ups. She explains that by actively chasing down pending authorizations before they delay treatment, the pharmacy team proactively removes administrative tasks from stretched nursing staff.</p><p>A pharmacy partner can also support staff through on-site or in-community resources. Mobile technicians, clinical consultants, and nurse-led education can help with medication pass efficiency, cart audits, compliance support, and staff training.</p><p>Education is another critical part of staff support. As regulations, resident needs, and medication standards evolve, communities benefit from pharmacy partners that help translate clinical and regulatory changes into practical guidance for care teams. PharMerica’s <a href="http://www.pharmerica.com/illuminate" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Illuminate">Illuminate</a> education platform and continuing education resources are examples of how a pharmacy provider can support staff development while helping communities stay current on best practices. Haan notes that investing in staff through these educational platforms is also a powerful tool for caregiver retention.</p><p>The larger point for operators is simple: pharmacy should not create more work for already stretched teams. It should help remove obstacles, improve consistency, and allow staff to stay focused on residents.</p><h3>Cost Containment Starts with Better Medication Management</h3><p>Operating cost pressure is another area where pharmacy can play a meaningful role. Operators should expect their pharmacy partner to help identify practical ways to make medication management more predictable, affordable, and efficient.</p><p>That support can take several forms. Over-the-counter formularies can help residents access commonly used products at lower, more predictable prices. Additionally, financial navigation programs—such as helping families enroll in the Medicare Prescription Payment Plan—can space out out-of-pocket costs while streamlining administrative work for community staff.</p><p>But one of the most important cost levers is medication optimization. When pharmacists work closely with providers and care teams to identify unnecessary, duplicative, or redundant medications, the result can be meaningful for both residents and communities. Fewer unnecessary medications reduce cost exposure, simplify administration, and decrease the risk of adverse events.</p><p>As Haan reflects, the ultimate goal is to ensure residents are receiving only the most appropriate, highly targeted therapies: “We’re not filling an average of twenty scripts per resident; we’re filling ten, and their well-being is improved.”</p><h3>What This Means for Operators</h3><p>For senior living operators, the “so what” is not that pharmacy support exists; it is whether that support comes together in a way that makes daily operations easier, safer, and more predictable. Many providers can offer medication delivery, clinical support, or education. The more meaningful question is whether those capabilities work together consistently when staffing is tight, resident needs change, and small medication issues become larger operational disruptions.</p><p>As Haan emphasizes, a dedicated partner must remain highly adaptable, constantly evolving to address new operational challenges as they arise. When proactive clinical oversight, responsive local support, and clear workflows work together, pharmacy becomes less of a burden to manage and more of an extension of the care environment. </p><p><br></p><p style="text-align:center;"><a href="https://pharmerica.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083"><img src="/Issues/2026/Fall/PublishingImages/PharMerica.jpg" alt="PharMerica" style="margin:5px;width:300px;height:45px;" /></a> </p>	Senior living operators are navigating a more complex care environment than ever before. Residents are entering communities with higher acuity, more chronic conditions, and more complicated medication regimens.	2026-09-04T04:00:00Z	<img alt="PharMerica" src="/Issues/2026/Fall/PublishingImages/PharMerica-740.jpg" style="BORDER:0px solid;" />	Caregiving	Special Feature		53	3

Modernizing Physician Leadership

https://www.providermagazine.com/Issues/2026/Fall/Pages/Modernizing-Physician-Leadership.aspx

Modernizing Physician Leadership

<img src="/Issues/2026/Fall/PublishingImages/Leadership2_Fall26.jpg" alt="leadership" style="margin:5px;width:907px;height:272px;" /> In December 2019, Elizabeth Burns, MD, accepted the role of chief medical officer (CMO) at Avamere Living, a role her boss, Avamere founder and former CEO Rick Miller, could not yet describe. “We know we need a chief medical officer,” he told her. “We’re just not exactly sure what we need, but we know we need one.” Within months, the COVID-19 pandemic settled the issue for the entire sector. “COVID became a pivotal moment that fundamentally reshaped physician leadership in post-acute and long term care,” Burns reflected. “It demonstrated that physicians are essential, not only during times of crisis, but also in shaping strategy, driving innovation, improving quality, and preparing organizations for the future.” For decades, federal regulation has required a medical director in every skilled nursing facility. As residents’ needs grow more complex, providers are modernizing their physician leadership models and ensuring that the medical director’s role at the facility level is effectively supported by the C-suite.<h3>More Complexity, More Responsibility</h3>Long term care professionals know all too well what’s driving these changes. With more older adults living at home longer, resident acuity continues to steadily climb. “Providers are increasingly asked to serve residents with greater clinical and behavioral needs while demonstrating measurable outcomes and reliably managing transitions to and from hospitals,” Mark Prifogle, chair of the American College of Health Care Administrators, told Provider earlier this year.As facility operators adapt, their medical directors have taken on more and more responsibility. “The medical director role is a role that’s been defined by federal regulation for decades, and it is very specific from a regulatory standpoint,” observed Richard Feifer, MD, MPH, FACP, a PALTmed director at large who served as chief medical officer and executive vice president at Genesis HealthCare. “The day-to-day reliance on the medical director, the engagement, the involvement—that’s what’s been increasing over the last number of years.”<img src="/Issues/2026/Fall/PublishingImages/Leadership_LizBurns.jpg" alt="Elizabeth Burns" class="ms-rtePosition-1" style="margin:5px;" />Burns, who was named chief medical officer at American Health Care Association/National Center for Assisted Living in 2025, described a role that expanded far past its statutory remit. “The medical director role has evolved well beyond regulatory oversight and clinical compliance,” she said. “Today’s medical directors are increasingly expected to lead quality improvement, champion evidence-based care, foster interdisciplinary collaboration, leverage data and technology, and help organizations succeed in an increasingly complex health care environment.”Masonicare, a Connecticut provider whose services span independent living through hospice, shows just how much responsibility the modern medical director shoulders. As CEO JP Venoit told Provider, Masonicare has three medical directors: one for its behavioral health hospital, one for hospice and home care, and a third who oversees everything else—nursing homes, assisted living, and independent living. “Our residents now have more choice,” he explained. “People who would have been in a nursing home ten or twelve years ago, they’re in assisted living, residential living, or their home. We’ve taken the approach that our medical directors help us keep them in the setting they call home longer and safer.”<h3>From the Bedside to the Boardroom</h3>There’s no single threshold at which a provider needs a CMO. Feifer pointed to scale: “For organizations that operate multiple facilities and have more overarching needs for medical oversight and medical leadership, that’s where the CMO comes in,” he said. Titles vary, as well, as some organizations opt for a chief clinical officer label or simply elevate their medical director to a senior management role. Masonicare’s three medical directors, for instance, work alongside the C-suite.No matter the title, the role requires a bird’s-eye view. A CMO (or equivalent) fields clinical issues across the entire organization rather than at a single facility, tying those issues to broader strategic concerns. <img src="/Issues/2026/Fall/PublishingImages/Leadership_RichFeifer.jpg" alt="Rich Feifer" class="ms-rtePosition-1" style="margin:5px;" />“The CMO role is one that often involves the wearing of two hats simultaneously,” Feifer explained. “There’s the medical leadership hat that’s focused on quality of care and medical care and appropriate staffing. And then there’s the business hat, helping the enterprise succeed. The enterprise needs to be successful to fulfill its mission, and it needs to do so in a medically responsible way.”“I liken it to being a bridge between the bedside and the boardroom,” said Shealynn Buck, MD, CMO at Lockton Companies, where she helps organizations design clinical strategies that improve outcomes, quality, and value. “As you think about both clinical and financial outcomes, having that expertise that can bridge those pieces, that’s really important.” She argued that whether an organization needs a CMO is less about size than about complexity.She also described the CMO as an ambassador to the health care ecosystem itself. “Whenever there is the need for ensuring clinical integrity, clinical leadership, and representing that in the health care market, a CMO can be really valuable for that,” she said.<h3>What Providers Look For</h3>As providers expand their physician leadership models, they’re looking for a few key competencies in potential CMOs. Perhaps most important is the ability to synthesize that bird’s-eye view of the health care industry with the granular concerns of a company or even a facility.“CMOs sit at an intersection point between patient care and the business,” Buck explained. “Having some business acumen but also understanding technology and how technology is impacting health care is really important.” She stressed the need for a “dot-connector mindset” that makes it possible to see where an individual community’s needs fit within the larger system, and how that system can be used to meet those needs.<img src="/Issues/2026/Fall/PublishingImages/Leadership_JPVenoit.jpg" alt="JP Venoit" class="ms-rtePosition-1" style="margin:5px;" />For Feifer, the ideal CMO candidate is someone with a high level of leadership experience. “One of the most important qualities is someone who has led organizations and has been responsible for the overall performance, medical and otherwise, of large teams,” he said. “This is not something that necessarily comes naturally to an individual physician who’s been providing direct patient care all of their career. This is a different skill set that takes training and mentorship to develop.”Then there’s fluency in the myriad tongues one must speak to lead a health care business—another trait that distinguishes CMOs from medical directors. “The CMO needs to speak the language of the frontline doctor; that’s a medical language,” Feifer explained. “Then the CMO needs to speak the language of the chief financial officer; that’s a financial language. Then they need to speak the language of the head of business development; that’s a sales language. For a CMO to be highly successful, they need to be fluent in all of those languages and more.”Buck identified one competency that may seem counterintuitive. “As clinicians, as physicians, we’re often trained to be the decision-maker,” she said. “But as complex as health care is, not one person has all the answers. As a physician leader and CMO, it’s important to have a network of folks that you’re not afraid to ask questions of and have some of your blind spots tested.”<h3>A Seat at the Table</h3>A CMO can support the medical team only if the organization supports the CMO. Feifer’s advice in that regard is simple: “Ensure that they have a seat at the table and are invited to offer their unique perspective on all matters pertaining to the enterprise,” he said. “They should never be pigeonholed or just restricted to the one corner of the organization that is medical care, but they should be a full-fledged leader that comes at every issue with a unique lens.”For Burns, a successful physician leadership model is a holistic one, with the high-level and facility-level roles working in tandem toward the same objectives. “Rather than thinking of the medical director and CMO as separate roles, I view them as part of a continuum of physician leadership,” she said. “The medical director remains the clinical leader closest to resident care, while the CMO extends that clinical perspective across the organization, translating frontline insights into enterprise-wide strategy.”<img src="/Issues/2026/Fall/PublishingImages/leadership_quote1.jpg" alt="leadership" class="ms-rtePosition-2" style="margin:5px;width:248px;height:235px;" />Feifer echoed her perspective, arguing that an enterprise physician leader’s first responsibility is “ensuring that every facility has a strong medical director performing at the top of their abilities.” From there, the job is to foster a culture of “continuous performance improvement,” one where the clinical team is working collaboratively to deliver the highest quality of care. Done right, this approach naturally turns the care team into a training ground for future physician leaders, whether at the facility or enterprise level.Reflecting on the evolving role of physician leadership, Burns cited a line credited to quality-improvement scholar Paul Batalden: “Every system is perfectly designed to get the results it gets.”“If we want different outcomes for residents, families, and providers, we must intentionally redesign the way physician leadership is integrated into our organizations,” Burns concluded. “That means modernizing both the medical director role and the chief medical officer role so physician leaders have the influence and support within the leadership team to improve quality, access, and innovation in person-centered care across the continuum.” Steve Manning is a journalist based in New York City.

Chief medical officers are expected to have not only deep clinical skills but also strategic insight, business competency, and team leadership experience.

2026-09-04T04:00:00Z

Management

Cover Feature

Steve Manning

53

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Modernizing the Delivery of Care

https://www.providermagazine.com/Issues/2026/Fall/Pages/Editor's-Desk.aspx

Modernizing the Delivery of Care

<img src="/PublishingImages/default-editor.jpg" alt="Debbie Stadler" class="ms-rtePosition-2" style="margin:5px;width:200px;height:242px;" />The long term care profession is continually evolving and reshaping how care is delivered. In this issue, we explore how providers are rising to meet new needs, from the way providers care for people with dementia to the expanding role of the modern chief medical officer.First, we examine the transformation of care for those with <a href="/Issues/2026/Fall/Pages/Bright-Clearings-Ahead-in-Caring-for-People-with-Dementia.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="Bright Clearings Ahead in Caring for People with Dementia">dementia</a>, which has shifted away from a task-focused, safety-first model toward a person-centered approach. Supported by emerging technology and research, today’s dementia care honors the individuality of each resident and offers real promise for better quality of life. Then we look at how <a href="/Issues/2026/Fall/Pages/Modernizing-Physician-Leadership.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="Modernizing Physician Leadership">physician leadership</a> in long term care is changing. Chief medical officers are expected to bring more than clinical expertise—they must also demonstrate strategic vision, business competency, and the ability to lead teams across complex organizations. Providers who invest in developing this kind of leadership are better positioned to deliver consistent, high-quality care. Don't miss our celebration of the <a href="/Issues/2026/Fall/Pages/30-Years-of-Pursuing-Excellence.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083">30 years of excellence</a> in the AHCA/NCAL National Quality Award Program. In addition, learn how forward-thinking providers are turning <a href="/Issues/2026/Fall/Pages/Operationalizing-OIG-Insight-to-Stay-Ahead-of-Regulatory-Risk.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="Operationalizing OIG Insight to Stay Ahead of Regulatory Risk">Office of Inspector General findings</a> into predictive tools. Discover how AI is becoming an indispensable part of <a href="/Issues/2026/Fall/Pages/AI-Is-Transforming-Rehabilitation-in-Long-Term-Care.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="AI Is Transforming Rehabilitation in Long Term Care">rehabilitation,</a> helping physical, occupational, and speech therapists work more efficiently and intervene earlier. Explore why authenticity is proving to be long term care’s greatest asset on <a href="/Issues/2026/Fall/Pages/Why-Authenticity-Is-Winning-on-Social-Media.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="Why Authenticity Is Winning on Social Media">social media,</a> as audiences increasingly seek genuine human connection over polished content. And find out why <a href="/Issues/2026/Fall/Pages/A-Day-of-Learning,-Leadership,-and-Inspiration-at-NCAL-Day-2026.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="A Day of Learning, Leadership, and Inspiration at NCAL Day 2026">NCAL Day 2026</a> is an essential opportunity to learn, connect, and celebrate the profession.This issue also features our Delivering Solutions 26 section, recognizing <a href="/Issues/2026/Fall/Pages/Inspiring%20Excellence%20and%20Improving%20Lives%20in%20Long%20Term%20Care.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="Inspiring Excellence and Improving Lives in Long Term Care ">Quality Award recipients,</a> <a href="/Issues/2026/Fall/Pages/Behind-the-Program-2026.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="Behind the Program 2026">examiners, sponsors,</a> and <a href="/awards/Pages/2026-ACE-Awards-Recipients.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="ACE Award honorees">ACE Award honorees</a> who represent the best of what this field has to offer. Their contributions are a reminder of the remarkable people who make long term care what it is. <img src="/PublishingImages/bs_DStadtler_sig.jpg" alt="Debbie Stadtler" style="margin:5px;width:175px;height:38px;" /> Deborah Stadtler Editor in Chief

The long term care profession is continually evolving and reshaping how care is delivered. In this issue, we explore how providers are rising to meet new needs, from the way providers care for people with dementia to the expanding role of the modern chief medical officer.

2026-09-08T04:00:00Z

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