| The Two-Minute Drill: Turning Feedback into QAPI Action Plans | <p><img src="/Articles/PublishingImages/2026/stopwatch.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:300px;height:300px;" />A few years ago, I was in my office reviewing the results of a recent employee satisfaction survey. The report contained data trends and colorful graphs associated with the questions asked in the survey. However, there was something missing. There was almost no usable information contained in the report that would explain “why” staff were rating various questions the way that they did. There was nothing usable to address employee perceptions of their work environment and satisfaction levels.</p><p>With this in mind, I decided to create something different where staff engagement would be high and the information they provided could be useful in making improvements. I began thinking about the two-minute drill during football games. The two-minute drill is a two-minute period at the end of the first half and end of the game that compels teams to take quick action.</p><p>Next, I took the two-minute drill concept and applied it to a mandatory all-staff meeting. I made this concept interactive with the staff.</p><h3>Before the Meeting</h3><p>Before the all-staff meeting, I wrote down 10 questions that I wanted feedback on from the employees. Here is a sample of questions that I have used:<br></p><ul><li>How can we reduce turnover? Increase staff retention? Why do you think employees leave?</li><li>How can we improve communication? Between departments? Within a department? Between shifts?</li><li>How can we improve our relationships with residents and their families?</li><li>How can we improve teamwork?</li><li>How can we improve the quality of care and services we provide?</li><li>How can we improve orientation and training? Staff skills and competency?</li><li>How can we improve employee attendance and reduce staff absenteeism?</li><li>How can we show more appreciation and recognition to our staff?</li><li>How can we create a more positive work environment?</li><li>How can we create more accountability for the jobs we do?</li><li>How can we improve customer satisfaction?</li><li>How can we better organize employee workloads or assignments?</li><li>How can we achieve better regulatory survey outcomes?</li><li>How can we reduce our operating expenses?</li><li>How can we increase our census and revenues?</li><li>What can the management team do to better support our team?</li><li>How can we improve the appearance of our facility? Resident rooms?</li><li>How can we provide more/better feedback to staff on their performance (30-60-90 days and annual performance evaluations)?</li><li>How can the facility better meet your personal and professional needs? </li><li>How can the facility give more voice or involvement in decision making?</li><li>How can the facility further show a commitment to our employees?</li><li>How can the facility show more value to our employees?</li><li>How can we develop or increase the level of connectedness between everyone? How can we bond together as a team?</li><li>How would you describe the “culture’ in our facility?</li><li>What do you need regarding your work schedule? What are your work schedule needs?</li><li>What do you need to do your job well?</li></ul><h3>During the Meeting</h3><p>Once you have decided which questions to use, write one question on a large piece of paper or posterboard. Hang or post them on the walls around your all-staff meeting location. Make sure each paper posted has only one question written at the top and that each station has markers.  Repeat until all 10 of your selected questions are posted.</p><p>To keep the meeting light and active, consider providing food and drinks or using a stopwatch and whistle.</p><p>Once you have these items all in place, divide all the employees attending the meeting into 10 teams. This includes department managers as well. You will then assign each team to one of the questions. Once the exercise begins, each team will have 2 minutes to write all of the ideas, thoughts, solutions or changes they can think of regarding that question. Each team will then rotate to the next question. This continues until all teams have answered all 10 questions. </p><p>Before you begin, let staff know that you want feedback on the questions listed on the flip charts. Ask them to keep their responses professional but honest. Inform them that you will be working with each department manager to address any identified concerns or requests by developing an action plan for follow-up. Please make sure to let them know that there will not be disciplinary action or retaliation for their responses. Thank them for their honest feedback</p><p>If you are prepared, all of this can be accomplished in less than an hour. After this exercise is completed, you may want to leave the questions up for a little while to give other employees who were assigned to work during the meeting to have a chance to respond.</p><p>I can assure you that you will receive useable feedback from your staff and engage a large number of them through this exercise. This is an excellent way to also validate any employee concerns and engage them in finding good solutions to improve their work environment. </p><h3>After the Meeting</h3><p>Once the feedback is gathered, write an action plan to address concerns or implement solutions. I recommend using the following format for each question. <br><br></p><table cellspacing="0" width="100%" class="ms-rteTable-2"><tbody><tr class="ms-rteTableEvenRow-2" style="text-align:center;"><td class="ms-rteTableEvenCol-2" colspan="5" style="width:20%;"><h3>QAPI ACTION PLAN<br>DATE:<br></h3></td></tr><tr class="ms-rteTableOddRow-2"><td class="ms-rteTableEvenCol-2" colspan="5"><h3 style="text-align:center;"> Confidential Quality Assurance Document</h3></td></tr><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2"><strong>IDENTIFICATION OF PROBLEM OR CONCERN</strong></td><td class="ms-rteTableOddCol-2"><strong>ROOT CAUSE ANALYSIS</strong></td><td class="ms-rteTableEvenCol-2"><strong>CORRECTIVE ACTION OR SYSTEMIC CHANGES TO BE MADE</strong></td><td class="ms-rteTableOddCol-2"><strong>INDIVIDUAL(S) RESPONSIBLE FOR COMPLETION</strong></td><td class="ms-rteTableEvenCol-2"><strong>TARGET COMPLETION DATE</strong></td></tr><tr class="ms-rteTableOddRow-2"><td class="ms-rteTableEvenCol-2">Insert Question # 1</td><td class="ms-rteTableOddCol-2">List responses provided by staff.</td><td class="ms-rteTableEvenCol-2">Develop specific action plans to address the root causes that you listed.</td><td class="ms-rteTableOddCol-2">Assign department managers, staff or administrator.</td><td class="ms-rteTableEvenCol-2">Develop a target completion date to address concerns.</td></tr><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2">Insert Question # 2. Complete this process for all 10 questions.</td><td class="ms-rteTableOddCol-2">List responses provided by staff.</td><td class="ms-rteTableEvenCol-2">Develop specific action plans to address the root causes that you listed.</td><td class="ms-rteTableOddCol-2">Assign department managers, staff or administrator.</td><td class="ms-rteTableEvenCol-2">Develop a target completion date to address concerns.</td></tr></tbody></table><p><br>This exercise will also be an excellent QAPI project for your facility. As you make progress with your action plan, make sure that your QAPI meeting minutes reflect discussion on any progress made.</p><p>Lastly, have fun and involve your staff and department managers in responding to the needs or perceptions that your staff have in your facility.</p><p>Consider using this format every six months to measure your progress through staff feedback. I have had many employees tell me how much they appreciated the chance to provide constructive feedback.</p><p><em><img src="/Articles/PublishingImages/2026/Mark-Trangsrud.jpg" alt="Mark Trangsrud" class="ms-rtePosition-2" style="margin:5px;width:150px;" />Mark Trangsrud is a retired skilled nursing home administrator with experience in for-profit, nonprofit, and public sector settings, rural and metropolitan markets, and in various size facilities. He has practiced for over 41 years and has been licensed in 8 different states as a nursing home administrator as well as serving on the South Dakota and Colorado Health Care Association Boards. He can be reached at </em><a href="mailto:Metrangsrud57@msn.com" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><em>Metrangsrud57@msn.com</em></a><em>.</em></p><p><em></em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">Provider<span class="Apple-converted-space"> </span><em>magazine includes information from a variety of sources, such as contributing experts. The views expressed by external contributors do not necessarily reflect the views of<span class="Apple-converted-space"> </span></em>Provider<em> magazine and AHCA/NCAL.<span class="Apple-converted-space"> </span></em></span><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#96607d;"><em><span style="text-decoration:underline;"><a href="/About/Pages/Submit-Article.aspx" title="https://www.providermagazine.com/About/Pages/Submit-Article.aspx" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="color:#96607d;margin-top:0px;margin-bottom:0px;">Learn how to submit an article.</a></span></em></span><br></p> | 2026-03-03T05:00:00Z | <img alt="" height="740" src="/Articles/PublishingImages/2026/stopwatch.jpg" width="740" style="BORDER:0px solid;" /> | Quality Assurance and Performance Improvement;Quality | Mark Trangsrud | After finding traditional employee satisfaction surveys lacked meaningful insight into the “why” behind staff responses, Trangsrud developed an interactive feedback exercise inspired by the football two-minute drill. |
| 5 CMS Staffing Compliance Issues To Address Before Survey | <p><img src="/Articles/PublishingImages/740%20x%20740/survey.jpg" alt="survey" class="ms-rtePosition-2" style="margin:5px;width:400px;height:400px;" />Staffing-related survey findings rarely result from a lack of effort or intent. More often, they reflect small operational gaps that develop gradually as staffing practices, documentation, and reporting evolve at different speeds. Over time, those misalignments can leave facilities exposed during survey, even when leaders believe they are compliant.</p><p>Because staffing compliance spans multiple functions, including scheduling, payroll, credentialing, agency oversight, and reporting, it benefits from periodic, intentional review. The following CMS staffing compliance areas frequently surface during surveys and represent practical opportunities for facilities to reduce risk through manageable operational checks.</p><ol><li><strong>Registered nurse coverage is one area that consistently draws scrutiny.</strong> CMS requires facilities to maintain and document RN coverage in accordance with federal and state requirements, including weekends and holidays. In practice, schedules often reflect planned coverage, but last-minute call-offs, substitutions, or coverage adjustments are not always reconciled in supporting documentation. Facilities can reduce exposure by confirming that RN coverage logs align with payroll and timekeeping records, particularly when coverage changes occur. In many organizations, this review is most effective when responsibility for reconciliation is clearly defined rather than assumed.</li><li><strong>Payroll-Based Journal reporting is another common source of findings.</strong> CMS expects PBJ submissions to accurately reflect staffing hours worked, categorized correctly by role. While many facilities generate PBJ files directly from payroll systems, discrepancies can occur when job codes change, classifications are updated, or agency staff hours are not mapped consistently. Facilities that perform routine internal reviews comparing PBJ submissions to payroll records before filing tend to identify inconsistencies earlier, especially during periods of staffing transition.</li><li><strong>Credential and licensure tracking presents similar challenges.</strong> Most facilities verify credentials at hire, but renewal monitoring can become fragmented over time, particularly when staff change roles or when agency clinicians rotate frequently. CMS expects facilities to demonstrate that licensed staff maintain current credentials and that documentation is readily accessible. A centralized review process that periodically verifies license status across both employee and contract staff, rather than relying on individual reminders, helps prevent last-minute gaps during survey.</li><li><strong>Agency and contract staffing documentation also warrants regular attention.</strong> CMS expects facilities to maintain records demonstrating qualifications, hours worked, and compliance for non-employee staff. In practice, agencies may provide credentials at onboarding, but updates are not always captured consistently. Additionally, agency hours may be tracked separately from employee records, creating reconciliation challenges. Facilities that clearly define documentation responsibilities in agency agreements and periodically reconcile agency hours with payroll and PBJ data are better positioned to demonstrate consistency during review.</li><li><strong>Finally, staffing-related policies should be reviewed with operational reality in mind.</strong> Policies may technically exist but no longer reflect current staffing models or workflows. Surveyors often identify disconnects between written policy and day-to-day practice, even when care delivery itself is appropriate. Facilities that review staffing policies on a regular cadence, particularly following workforce or scheduling changes, are better able to explain how policies are operationalized.</li></ol><p><img src="/Articles/PublishingImages/2026/Kelly-Brooks.jpg" alt="Kelly Brooks" class="ms-rtePosition-1" style="margin:5px;width:150px;" />Taken together, these areas highlight a broader pattern: staffing compliance risk tends to build quietly when documentation, data, and operational practice drift out of sync. Facilities that conduct focused, periodic reviews across these domains are better positioned to demonstrate preparedness and consistency during survey.</p><p>Approaching CMS staffing compliance as an ongoing operational discipline, rather than a survey-driven response, allows leaders to address issues early and with less disruption, supporting both regulatory readiness and workforce stability.<br><br><em>Kelly Brooks is an SPHR-certified HR leader and founder of <a href="http://ablepbj.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">AblePBJ.com</a> with decades of experience in skilled nursing and assisted living. </em></p><p><em><br></em></p><h4><em>Provider</em> magazine includes information from a variety of sources, such as contributing experts. The views expressed by external contributors do not necessarily reflect the views of <em>Provider</em> magazine and AHCA/NCAL. <a href="/About/Pages/Submit-Article.aspx" title="https://www.providermagazine.com/About/Pages/Submit-Article.aspx" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Learn how to submit an article.</a><br></h4> | 2026-02-24T05:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/survey.jpg" style="BORDER:0px solid;" /> | CMS;Workforce | Kelly Brooks | Because staffing compliance spans multiple functions, including scheduling, payroll, credentialing, agency oversight, and reporting, it benefits from periodic, intentional review. |
| Integrated Heating Systems Provide Comfort, Safety In Winter | <p><img src="/Articles/PublishingImages/2026/hvac_363510475.jpeg" class="ms-rtePosition-2" alt="" style="margin:5px;width:500px;height:273px;" />In senior living and extended care facilities, dependable heating is more than a matter of comfort. It’s also a core requirement for resident safety and a major regulatory issue. That’s because older adults are especially vulnerable to temperature fluctuations, making it critical for facilities teams to maintain a reliable system.</p><p>With aging infrastructure, extreme weather events, and rising utility costs, many senior care facilities are reevaluating how they heat their buildings and protect residents during the coldest parts of the year. An integrated approach, combining central heating with supplemental systems and proactive maintenance, can significantly reduce health and safety risks while ensuring operational continuity throughout the seasons.</p><h3>Complementing Central Heating Systems</h3><p>Central heating systems form the backbone of most senior care facilities, yet on their own they may be insufficient for keeping residents comfortable. Long corridors, older wings, and perimeter rooms often struggle to maintain consistent temperatures, especially when outside temperatures dip significantly. When deployed correctly, unit heaters and infrared heaters can serve as effective supplemental solutions. </p><p>Unit heaters can provide quick, localized heat and reduce the strain on central boilers or furnaces during high-demand periods. When integrated with thermostatic controls, unit heaters can maintain even temperatures without overheating adjacent areas. They can be especially good in dining rooms and other open, common spaces, where heat loss tends to be a more pressing concern.</p><p>Meanwhile, infrared heaters warm people and surfaces directly rather than heating the air itself. This makes them well-suited for entryways and vestibules, as well as spaces that have higher ceilings or more frequent door openings.</p><p>With either type of heater, it’s important to ensure proper installation. Some general tips and best practices include:<br></p><ul><li>Proper sizing to avoid overheating.</li><li>Professional installation to verify code compliance.</li><li>Integration with existing electrical or gas infrastructure.</li><li>Clear placement away from residents and combustible materials.</li></ul><h3>Improving Ventilation and Air Quality</h3><p>Heating performance is closely tied to ventilation. As senior living facilities become more energy efficient and airtight, airflow can suffer. This contributes to pressure imbalances, stale air, and increased strain on heating equipment.</p><p>Make-up air systems address these concerns by introducing controlled, tempered outdoor air to replace air exhausted by kitchen hoods, bathroom fans, and laundry systems, as well as air lost to frequently opened doors and breezeways.</p><p>For senior care environments, make-up air systems offer several critical advantages:<br></p><ul><li>Improved indoor air quality for residents and staff alike.</li><li>Reduced drafts and cold air infiltration.</li><li>Balanced building pressure for consistent heating.</li><li>Lower risk of backdrafting from combustion appliances.</li></ul><p>By preheating incoming air, these systems prevent cold air from disrupting room temperatures or overloading centralized heating structures. This is especially important during winter months when untreated outside air can significantly affect internal comfort levels.</p><p>One additional note: good ventilation supports infection control efforts, reducing airborne contaminants while also maintaining thermal comfort. For facilities balancing air exchanges with energy efficiency, modern make-up air units can provide long-term operational benefits above and beyond temperature regulation.</p><h3>Prioritizing Maintenance and Insulation</h3><p>Even the most reliable heating equipment will underperform without regular maintenance and proper insulation. Preventative care not only reduces breakdowns but also extends equipment life, ensuring predictable comfort and safety for many years to come.</p><p>Facilities teams should establish a seasonal maintenance checklist that includes:<br></p><ul><li>Inspecting boilers, furnaces, and heat exchangers.</li><li>Cleaning burners and heat transfer surfaces.</li><li>Testing thermostats and control systems.</li><li>Checking belts, motors, and electrical connections.</li><li>Replacing or cleaning air filters regularly.</li></ul><p>Routine inspections help identify small issues, whether failing sensors or restricted airflow, before they snowball into system-wide failures, something that can be especially disastrous when it happens in the thick of winter.</p><p>Meanwhile, insulation plays a critical role in maintaining consistent indoor temperatures. Key areas to assess include:<br></p><ul><li>Exterior walls and roofing.</li><li>Mechanical rooms and exposed piping.</li><li>Windows and doors, where air leakage can be common.</li><li>Attics, crawl spaces, and utility penetrations.</li></ul><p>Sealing gaps, replacing weatherstripping, and insulating any visible piping can significantly reduce heat loss. For older facilities, targeted insulation upgrades often pay off quite quickly, both in terms of comfort improvements as well as energy savings.</p><h3>Ensuring Safety and Protecting Residents</h3><p>Safety is paramount when introducing or maintaining heating equipment in senior living or extended care facilities. Supplemental heaters must be selected and installed with resident protection in mind. <br><br>There are a few particular considerations worth noting:<br></p><ul><li>Avoid portable space heaters in resident facilities; mounted unit heaters are the safer option.</li><li>Be strategic in placement, ensuring units are not faced toward combustibles.</li><li>Keep a safe distance between unit heaters and any furniture or medical equipment.</li><li>Consider the use of protective guards or enclosures where necessary.</li><li>Be sure surface temperatures are kept low, minimizing the risk of scalding.</li><li>Train all staff members, and especially maintenance staff, in safe heater operation.</li><li>Respond quickly to any complaints about overheating, as well as cold spots.</li></ul><p>Providing safe and dependable heating in a senior living facility requires a multi-pronged strategy. Central heating systems are important, but they should be augmented with supplemental heaters, improved ventilation, preventative maintenance, and safety-first design. This kind of layered approach builds resilience against both routine challenges and unexpected disruptions.</p><p><img src="/Articles/PublishingImages/2026/Jamie-Tuinstra.png" alt="Jamie Tuinstra" class="ms-rtePosition-2" style="margin:5px;width:150px;" />With these strategic investments, facilities teams can maintain safe, comfortable environments that support resident wellbeing throughout the coldest months of the year.<br><br><em>Jamie Tuinstra is a product manager at <a href="https://www.modinehvac.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Modine Manufacturing,</a> where he oversees product development, profit optimization, and customer satisfaction for both new and established product lines. </em><br></p><p><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">Provider<span class="Apple-converted-space"> </span><em>magazine includes information from a variety of sources, such as contributing experts. The views expressed by external contributors do not necessarily reflect the views of<span class="Apple-converted-space"> </span></em>Provider<em> magazine and AHCA/NCAL.<span class="Apple-converted-space"> </span></em></span><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#96607d;"><em><span style="text-decoration:underline;"><a href="/About/Pages/Submit-Article.aspx" title="https://www.providermagazine.com/About/Pages/Submit-Article.aspx" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="color:#96607d;margin-top:0px;margin-bottom:0px;">Learn how to submit an article.</a></span></em></span><br></p> | 2026-02-10T05:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/hvac.png" style="BORDER:0px solid;" /> | Caregiving;Management | Jamie Tuinstra | With aging infrastructure, extreme weather events, and rising utility costs, many senior care facilities are reevaluating how they heat their buildings and protect residents during the coldest parts of the year. |
| Bringing AI and Person-Centered Care Together in Emotional Vital Signs | <p><img src="/Articles/PublishingImages/2026/186136026.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:500px;height:333px;" />Long term and post-acute care providers are under pressure to manage complex dementia symptoms with fewer staff, rising acuity, and closer scrutiny of psychotropic use. At the same time, interest is growing in whether artificial intelligence (AI) can support person-centered care rather than replace it.</p><p>A multi-site memory care operator in Oregon recently completed a second pilot of AI companions in six secured memory care communities. The goal in this second phase was not simply to see whether residents would talk to an AI avatar, but to understand how this technology might fit inside an already strong person-centered model—and what it might reveal about residents’ day-to-day mood and behavior.</p><h3>Inside Pilot 2</h3><p>Pilot 2 followed 21 residents with diagnosed dementia living in six memory care communities. The residents represented a clinically complex group: varying dementia etiologies (Alzheimer’s, vascular, Lewy body, alcohol-related, and mixed types), multiple chronic comorbidities, high assistance needs with activities of daily living, and existing behavior plans addressing concerns such as sundowning, wandering, trauma-linked distress, depression, and anxiety.</p><p>All participating communities were already operating with an HCBS-aligned, person-centered care model, using a “Best Friends”–style approach that emphasizes knowing the person, preserving autonomy, and prioritizing non-pharmacologic strategies before medications.</p><p>Over a 29-day observation window, the project team integrated five sources of information for each resident: standardized clinical and behavioral summaries, daily mood and sentiment documentation, PRN medication records, AI usage logs, and narrative descriptions of triggers and responses. This design allowed the team to view the AI companion as one intervention among many inside a complex care environment—not a stand-alone solution.</p><h3>Emotional Vital Signs: What the Mood Data Showed</h3><p>For 18 of the 21 residents, complete numeric sentiment scores were available. Staff documented daily mood using descriptors such as calm, cooperative, tearful, or engaged, along with a numeric score on a –2 to +2 scale (–2 = very negative, 0 = neutral, +2 = very positive).</p><p>Across the group, average sentiment scores ranged from 1.5 to 2.5, with an overall mean of 1.97, indicating day-to-day emotional tone was mildly to clearly positive. Notably, no resident had a neutral or negative average mood during the period.</p><p>To make this more actionable for frontline teams, the project categorized residents into three “emotional vital sign” bands: mild positive (1.5–1.89), moderate positive (1.9–2.19), and high positive (2.2 or higher). Most residents clustered in the moderate positive band, with a smaller subset in the high-positive range.</p><p>Qualitative notes frequently included words like pleasant, smiling, redirectable, and cooperative. When negative descriptors appeared—tearful, worried, or irritable—they were usually linked to understandable events such as pain, constipation, noise, personal-care tasks, or concerns about belongings, and they generally resolved with targeted non-pharmacologic approaches.</p><p>Operationally, this suggests that even in a high-acuity memory care population, teams can sustain broadly positive emotional baselines when person-centered, non-pharmacologic care is consistently delivered. The AI companion layered onto that foundation rather than replacing it.</p><h3>How Residents Actually Used the AI</h3><p>AI usage data offered a nuanced picture. Across residents with available data, the average over 29 days was 18.6 total calls and 46.5 total minutes. Many residents engaged with the AI in short, “snack-sized” sessions: a few minutes of conversation, singing, or reminiscing, often paired with another calming activity.</p><p>Some residents used the companion frequently and for longer durations, while others did not engage with the AI at all during the window yet still maintained mildly to clearly positive mood averages. When the team examined only residents with non-zero AI usage and sentiment scores, more minutes tended to correlate with slightly higher average mood, but variability and small sample size prevent any causal claims.</p><p>The practical takeaway for operators is that AI companions appear safe and potentially supportive for some residents, and resident preference will drive usage patterns.</p><h3>PRN Use and Behavior Outcomes</h3><p>A central concern for regulators and families is whether new technology will alter PRN medication patterns, especially for psychotropics. In this pilot, psychotropic PRN use was rare, and when administered, doses were generally effective without escalation.</p><p>Most PRN medications given during the period were for pain, constipation, and other physical comfort needs, not behavioral crises. Serious behavior incidents—severe agitation, aggression, or elopement—were uncommon, even among residents with prior histories of those concerns. Updated behavior plans, consistent routines, and environmental adjustments appeared to carry most of the clinical weight.</p><p>Importantly, there was no evidence that AI usage increased agitation, PRN reliance, or problem behaviors. Instead, staff often used the AI companion as an additional non-pharmacologic option while addressing pain, comfort, or environmental triggers.</p><h3>How Teams Integrated the AI Companion</h3><p>Narrative documentation revealed how staff folded the AI into everyday routines. Teams paired AI time with known calming moments—after meals, during sundowning, or while waiting for family visits. Residents who enjoyed conversation, faith-based topics, or music often gravitated toward the AI as another friend.</p><p>Staff noted that laughing, reminiscing, or singing with the avatar sometimes helped reset tense situations, buying time to address underlying needs before medications were considered. At the same time, staff emphasized that the AI companion did not replace human relationships. Rather, it functioned as a consistent, patient conversation partner and a structured way to document and visualize mood trends.</p><h3>Lessons for Providers</h3><p>Several practical lessons emerge for organizations considering similar technologies:<br></p><ul><li><strong>Keep person-centered care first. </strong>Positive mood patterns were rooted in an existing, robust care model. AI sharpened and supported that work but did not substitute for it.</li><li><strong>Treat sentiment as an emotional vital sign.</strong> Simple visuals summarizing average mood by resident and over time can act as an early warning system, prompting earlier non-pharmacologic interventions before small declines become crises.</li><li><strong>Expect wide variation in resident use.</strong> Some residents will engage frequently; others rarely or not at all. Respecting those preferences is essential to person-centered practice.</li><li><strong>Invest in staff training and boundaries.</strong> Short scenario-based training, clear privacy expectations, and reassurance that AI is a support—not a replacement—help ensure the tool feels like a resource rather than a burden.</li><li><strong>Acknowledge limitations.</strong> This pilot had a short time frame, a small analytic sample, and no comparison group, so findings should be viewed as directional rather than definitive.</li></ul><h3>Looking Ahead</h3><p>As dementia prevalence rises and workforce challenges persist, providers are searching for tools that can amplify human care, not automate it away. Early results from this second AI companion pilot suggest that, when implemented within a strong person-centered framework, AI companions may help teams visualize emotional patterns, add another non-pharmacologic option, and maintain positive mood in a clinically complex memory care population.</p><p><img src="/Articles/PublishingImages/2026/Monica-Tsai.png" class="ms-rtePosition-2" alt="" style="margin:5px;" /><span><span><span><strong><img src="/Articles/PublishingImages/740%20x%20740/Chris-Mason.jpg" alt="Chris Mason" class="ms-rtePosition-2" style="margin:5px;width:175px;height:175px;" /></strong></span></span></span>Further work—longer follow-up, larger samples, comparisons with non-AI communities, and staff-focused outcomes—will be essential. For now, emotional vital signs offer a promising way to bring data and person-centered practice together at the bedside.<em><br></em></p><p><em>Christian A. Mason, D.B.A., is managing member of Pacific Living Centers and can be reached at <a href="mailto:chris.mason.shm@gmail.com" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">chris.mason.shm@gmail.com</a>. Monica Tsai, DSocSci, is CEO of CloudMind US Inc. Carl Mason is president and COO of Senior Housing Managers, Caitlin Buckley is chief people officer with Senior Housing Managers, and Michele Nixon is vice president of operations at Pacific Living Centers.</em></p><p><strong class="ms-rteForeColor-2">Listen to our Perspectives in Long Term Care podcast: </strong><a href="/Video-Resources/Podcasts/Pages/Artificial-Intelligence-in-Long-Term-Care.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><strong class="ms-rteForeColor-2">Artificial Intelligence in Long Term Care.</strong></a></p><p><span class="ms-rteFontSize-1">Provider <em>magazine includes information from a variety of sources, such as contributing experts. The views expressed by external contributors do not necessarily reflect the views of </em>Provider <em>magazine and AHCA/NCAL. </em></span><a href="/About/Pages/Submit-Article.aspx" title="https://www.providermagazine.com/About/Pages/Submit-Article.aspx" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><span class="ms-rteFontSize-1"><em>Learn how to submit an article.</em></span></a><br></p><p></p> | 2026-02-03T05:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/dr_senior_tech.png" style="BORDER:0px solid;" /> | Dementia;Caregiving | Christian A. Mason, D.B.A., and Monica Tsai, DSocSci, with Carl Mason, Caitlin Buckley, and Michele Nixon | As dementia prevalence rises and workforce challenges persist, providers are searching for tools that can amplify human care, not automate it away. |