| Reducing Transportation Risk for Assisted Living Communities | <p><img src="/Articles/PublishingImages/740%20x%20740/transpo.jpg" alt="health care transportation" class="ms-rtePosition-2" style="margin:5px;width:350px;height:350px;" />Transportation services are an essential part of the resident experience within assisted living communities, helping support independence, quality of life, and overall well-being. But they also create significant operational risk, particularly when organizations transport medically vulnerable passengers who may require mobility assistance, wheelchair securement, supervision, or specialized accommodations.</p><p>For assisted living operators, reducing transportation exposures requires more than maintaining vehicles and hiring drivers. The strongest programs combine clear policies, thorough documentation, proactive vendor oversight, and consistent accountability. By focusing on several core areas of transportation risk management, organizations can help create a safer resident experience while building the documentation needed to defend the program when incidents occur.</p><h3>Building an Effective Fleet Safety Program</h3><p>Developing a comprehensive fleet safety program is a critical component of transportation risk management. While the specific structure may vary based on fleet size and resident needs, several core practices should be present in every program.</p><h3>1.  Driver Screening and Qualification</h3><p> Driver selection remains one of the most important factors in helping reduce transportation-related losses. Therefore, it's vital to establish formal driver qualification standards that include motor vehicle record (MVR) grading criteria and frequency of MVR reviews, background checks, license verification, medical fitness evaluations where appropriate, and clearly defined criteria for acceptable driving performance.</p><p>MVR review at hire and annually is the minimum. However, employers may miss identifying potentially hazardous drivers in between MVR pulls. A best practice, where available, is continuous MVR monitoring and notification systems. Continuous MVR monitoring systems can quickly identify emerging issues such as repeated moving violations, distracted-driving citations, or license suspensions. These systems can enable corrective action and help prevent serious incidents, as long as they are monitored.</p><p>Driver qualification should not stop at hiring: maintain individual driver qualification files that include employment applications, driving records, training certifications, disciplinary actions, accident histories, and documentation of corrective measures. These files often become valuable evidence when transportation claims enter litigation.</p><p>Drivers who are leased, temporary staff, or independent contractors should all be vetted, trained, and supervised consistently with W-2 employees.</p><h3>2.  Telematics and Cameras</h3><p>Global positioning system (GPS)/telematics systems can monitor location, acceleration, braking, cornering, cell phone use, provide driver scoring, and more, which can help to hold drivers accountable and reinforce safe driving behavior. Cameras can further reinforce safe driving and aid in reconstructing an accident. Exterior cameras can be set up to provide a 360-degree view of the vehicle, while onboard cameras monitor passengers. Systems with AI integrations can help address blind spots, identify issues securing a wheelchair, and alert the driver.</p><p>Similar to the continuous MVR monitoring, the system alone is not a defense; it is the timely and consistent response to the data that is critical. </p><h3>3.  Vehicle Inspection and Preventive Maintenance</h3><p>Maintain documented inspection and preventive maintenance programs for all transportation vehicles, including wheelchair-accessible vans and buses. Complete daily pre-trip and post-trip inspections and retain that documentation; preventive maintenance schedules should address brakes, tires, lifts, securement systems, lighting, and other safety-critical components.</p><p>Maintenance records should document routine servicing, repairs, recalls, inspections, and corrective actions. In litigation, maintenance records often become key evidence regarding whether the organization exercised reasonable care in operating its fleet.</p><h3>4.  Training and Resident Assistance Procedures</h3><p>Many transportation-related claims arise not from vehicle collisions but from incidents that occur during resident-assistance activities such as loading, unloading, wheelchair securement, passenger supervision, or resident transfers.</p><p>Provide hands-on training to all drivers and transportation staff in resident assistance techniques, wheelchair securement procedures, lift operation, passenger supervision, emergency response, fall prevention, and best practices in safe loading and unloading. Training should also address expectations regarding distracted driving, including mobile device use, navigation systems, and other in-vehicle distractions.</p><p>Further, organizations should conduct recurring refresher training and periodic competency evaluations to ensure procedures are followed consistently. Attendance of records, training materials, sign-in sheets, and competency assessments should all be retained as part of the facility's transportation defense file.</p><h3>5.  Incident Response and Documentation</h3><p>Establish written incident-response procedures that clearly outline what staff members must do following any transportation-related event. These procedures should identify reporting responsibilities, escalation requirements, evidence-preservation expectations, and communication protocols.</p><p>At a minimum, staff should be trained to gather photographs, document roadway and weather conditions, obtain witness statements, preserve available video footage, record resident and employee accounts, and promptly notify designated leadership personnel. Telematics data, dash camera footage, vehicle inspection records, and maintenance records should also be preserved whenever an incident occurs.</p><p>Consistency is critical. Incomplete reports, missing photographs, or delayed investigations often create significant challenges when defending claims. Thorough incident documentation can substantially strengthen an organization's legal position if litigation follows.</p><h3>6.  Managing Third-Party Transportation Risk</h3><p>While outsourcing transportation may reduce certain operational burdens, it does not eliminate risk. Assisted living facilities can still be named in lawsuits if residents are injured during transportation, particularly when allegations involve negligent selection, supervision, or oversight of a transportation provider.</p><p>Before engaging any transportation vendor, conduct a formal review process that evaluates licensing, safety records, driver-screening practices, vehicle-maintenance protocols, insurance coverage, and incident-reporting procedures.</p><p>Maintain current certificates of insurance, additional insured endorsements, contractual indemnification agreements, and documentation of periodic vendor reviews. These records can become critical evidence if questions arise regarding vendor selection or oversight following an accident.</p><p>Non-owned auto liability coverage is a critical component of an assisted living facility insurance program. This coverage can help protect the organization when employees use personal vehicles for business purposes.</p><p>Facilities should establish clear policies defining acceptable business use of personal vehicles, especially regarding client transportation. Ideally, transporting clients in personal vehicles should be avoided. Employees who are allowed to transport residents in personal vehicles should maintain at least the state-specified minimum liability limits, preferably higher limits, and provide proof of insurance on a regular basis. Risk managers should also review hired and non-owned auto (HNOA) exposures, subcontracting arrangements, and policy exclusions related to passenger assistance, loading and unloading, or medical transportation activities.<br></p><h3>Operational Oversight and Defensibility</h3><p>Transportation risk management is ultimately an operational discipline. Policies, training, inspections, telematics, and vendor oversight are only effective when implemented consistently and documented thoroughly.</p><p><img src="/Articles/PublishingImages/2026/John-Hague.jpg" alt="John Hague" class="ms-rtePosition-1" style="margin:5px;width:125px;height:154px;" />Organizations that audit their transportation programs, monitor performance trends, enforce policies, and preserve critical records are better positioned to protect residents and reduce the legal and financial consequences of transportation-related claims.<br> <br><a href="https://www.linkedin.com/in/hague-john/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Contact John Hague"><em>John Hague</em></a><em> is an executive underwriter at </em><a href="https://www.cfins.com/?utm_source=press_release&utm_medium=referral" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Crum & Foster"><em>Crum & Forster,</em></a><em> a national property, casualty, and accident and health insurer providing specialty insurance products through its admitted and surplus lines insurance companies.</em></p><p><em><br></em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">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 Provider 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;"><a href="/About/Pages/Submit-Article.aspx" target="_blank" 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" style="color:#96607d;margin-top:0px;margin-bottom:0px;"><em><span style="text-decoration:underline;">Learn how to submit an article.</span></em></a></span><br></em></p> | 2026-09-03T04:00:00Z | <img alt="health care transportation" src="/Articles/PublishingImages/740%20x%20740/transpo.jpg" style="BORDER:0px solid;" /> | Assisted Living;Management | John Hague | For assisted living operators, reducing transportation exposures requires more than maintaining vehicles and hiring drivers. The strongest programs combine clear policies, thorough documentation, proactive vendor oversight, and consistent accountability. |
| Building Career Pathways in Long Term Care | <p style="text-align:center;"><img src="/Articles/PublishingImages/2026/healthcare%20staff.jpg" alt="health care staff" style="margin:5px;width:650px;height:351px;" /><br></p><p>Across the United States, skilled nursing facilities continue to struggle with staffing shortages, rising turnover, increasing regulatory complexity, higher resident acuity, and an aging workforce. Organizations have responded by investing heavily in recruitment campaigns, sign-on bonuses, agency staffing, wage increases, and referral incentives. Although these initiatives may provide temporary relief, they often fail to address a deeper issue: many employees cannot envision a future for themselves within the organization.</p><p>Too often, long term care positions are viewed as endpoints rather than beginnings. A certified nursing assistant may spend years providing outstanding resident care without understanding how to become a licensed nurse, restorative nurse, staff educator, unit manager, or nursing home administrator. A dietary aide may never realize that a career in food service management is attainable. A housekeeper may possess exceptional organizational and leadership skills yet never receive mentoring or training for supervisory positions. The result is predictable. Employees begin to believe that growth is only possible by leaving the organization.</p><p>If long term care is to meet future labor needs, the profession must shift its focus from simply filling vacancies to intentionally building careers. Every employee should understand, from the first day of employment, that the organization remains committed to helping them grow professionally. Career development should become a strategic organizational priority rather than an occasional human resources initiative.</p><p>The financial cost of turnover is well documented. Recruiting, onboarding, training, overtime, agency staffing, and replacing employees consume significant resources. Turnover additionally disrupts relationships between residents and caregivers, reduces continuity of care, increases supervisory workload, and contributes to burnout. Yet an equally important cost often goes unnoticed: career stagnation.</p><p>Career stagnation occurs when employees believe they have reached the highest position they can reasonably attain. Even highly engaged employees may become disengaged when they no longer see opportunities to learn, contribute, or advance. The consequences include lower engagement, higher absenteeism, decreased innovation, loss of future leaders, and increased dependence on external recruitment.</p><p>Many leaders assume employees leave primarily for higher wages. Compensation certainly matters, but people also pursue purpose, recognition, education, and advancement. Organizations that show a genuine investment in employee growth frequently foster stronger loyalty than those that rely solely on financial incentives.</p><p>Imagine if every new employee received not only an orientation schedule but also a career roadmap. Rather than focusing exclusively on current job responsibilities, leaders would explain where each position could lead over the next five, ten, or even twenty years. Employees would understand the certifications, competencies, mentoring relationships, educational opportunities, and experiences required for advancement. Instead of asking, “How long will I remain in this position?” employees would begin asking, “What should I learn next?”</p><p>Career pathways should exist across every department because every employee contributes to resident outcomes. Nursing, dietary, environmental services, housekeeping, laundry, maintenance, activities, admissions, social services, business office, human resources, therapy support, and administration should all include visible advancement opportunities. Each pathway should identify entry positions, intermediate positions, leadership opportunities, recommended education, required competencies, mentoring expectations, and estimated timelines.</p><p>Equally important is leadership development. One of the most common organizational mistakes is promoting technically excellent employees without preparing them to lead others. Clinical expertise does not necessarily automatically translate into leadership effectiveness. Future supervisors should be intentionally developed through mentoring, committee participation, project leadership, quality improvement initiatives, communication training, conflict resolution, financial literacy, regulatory education, and coaching. Leadership development should begin long before vacancies occur, strengthening succession planning while reducing the stress associated with executive transitions.</p><p>Education is the foundation of every successful career path. Unfortunately, education in many facilities is still viewed primarily as a regulatory obligation centered on annual mandatory in-service training. Even though regulatory compliance remains essential, organizations that view education solely through a compliance lens miss an enormous opportunity. Continuous learning should include tuition assistance, certification support, cross-training, leadership academies, conference participation, professional association involvement, quality improvement projects, and structured mentoring programs.</p><p>Facilities that invest in education simultaneously strengthen resident care, employee engagement, survey readiness, and institutional resilience. Employees become more secure in their roles, managers spend less time correcting errors, and multidisciplinary collaboration improves. Residents ultimately benefit from higher quality, more reliable care delivered by competent and committed professionals.</p><p>Career pathways additionally reinforce organizational culture. Employees who believe they have a future are more willing to contribute ideas, participate in innovation, mentor colleagues, and continue committed during periods of change. Families notice greater staff dependability and durability. Surveyors observe stronger competency, documentation, and multidisciplinary collaboration. Stable teams create stronger relationships with residents, producing an environment where assurance and compassion flourish.</p><p>Administrators can begin implementing career pathways immediately. The first step is to identify opportunities for progression within every department. The second is to match experienced employees with mentors who can guide their professional development. Third, facilities should establish annual career conversations alongside performance evaluations. Finally, leadership teams should publicly celebrate educational achievements and internal promotions, strengthening the message that growth is appreciated and expected.</p><p>This approach additionally strengthens recruitment. Prospective employees increasingly seek employers who invest in long term development rather than merely offering a paycheck. Facilities known for promoting from within develop a reputation as employers of choice. That reputation becomes a distinct advantage in an increasingly challenging labor market.</p><p>The future leaders of long term care are already working within our facilities. They are serving meals, transporting residents, cleaning rooms, maintaining equipment, assisting with activities of daily living, answering telephones, coordinating admissions, and supporting residents every single day. The question is not whether future leaders exist. The question is whether organizations will intentionally identify, encourage, educate, and develop them.</p><p>Building career pathways is far more than an employee retention strategy. It represents a philosophy of leadership that recognizes potential before titles change. It exhibits a commitment to investing in people, strengthening communities, and guaranteeing exceptional resident care for generations to come. As the long term care profession continues to evolve, organizations that cultivate talent from within will be better equipped to achieve regulatory success, financial soundness, workforce resilience, and clinical excellence.</p><p><img src="/Articles/PublishingImages/2026/Julius-Sengendo.jpg" alt="Julius Senendo, LNHA" class="ms-rtePosition-2" style="margin:5px;width:150px;height:184px;" />When employees can clearly see a future within the organization, they are far more likely to build that future there. By replacing career uncertainty with career opportunity, long term care can transform its greatest workforce challenge into one of its greatest strengths.<br><br><em>Julius Sengendo, MSM, Ed.D., LNHA, is the executive director at Alliance Health at Maples in Wrentham, MA, and a licensed nursing home administrator. He holds a Doctor of Education in Leadership with a concentration in Professional Practice and Healthcare Administration and a Master of Science in Management. </em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">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 Provider magazine and AHCA/NCAL.</em><span class="Apple-converted-space"> </span></span><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#96607d;"><a href="/About/Pages/Submit-Article.aspx" target="_blank" title="Submit an article" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" style="color:#96607d;margin-top:0px;margin-bottom:0px;"><em><span style="text-decoration:underline;">Learn how to submit an article.</span></em></a></span><br></em></p> | 2026-08-27T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/healthcare-staff1.jpg" style="BORDER:0px solid;" /> | Management;Workforce | Julius Sengendo, LNHA | Career stagnation occurs when employees believe they have reached the highest position they can reasonably attain. Even highly engaged employees may become disengaged when they no longer see opportunities to learn, contribute, or advance. |
| Beyond Survey Readiness: Building Continuous Quality Accountability in Long Term Care | <p><img src="/Articles/PublishingImages/740%20x%20740/survey.jpg" alt="survey" class="ms-rtePosition-2" style="margin:5px;width:400px;height:400px;" />Regulatory compliance surveys are essential to ensuring that health care organizations continue to provide safe, high-quality care to residents. Preparing for these surveys can be resource-intensive because it brings frontline staff, interdisciplinary professionals, and leaders together to review shared standards and priorities.</p><p>Nursing homes, assisted living communities, and post-acute care organizations can extend the benefits of this process throughout the year by embedding clear accountabilities into routine workflows. When expectations are clearly outlined for frontline teams, supported through management oversight, and reviewed through established governance processes, teams are better positioned to identify emerging concerns, address them promptly, and sustain improvements. Survey preparedness can then become a natural outcome of everyday practice rather than an intensive, episodic activity.<sup>1</sup><br></p><h3>Extending the Benefits of Survey Readiness</h3><p>Survey or audit preparation brings the team together around a common purpose: ensuring that everyone’s efforts support the best interests of residents and resident-centered care. Team members review care plans, policies, documentation practices, and other key processes to ensure they meet required standards. When these activities are incorporated into day-to-day workflows, responsibilities become clear and compliance expectations are more likely to become sustained practices throughout the year.<sup>2</sup></p><p>Organizations can gain greater value from survey preparation by carrying its most effective practices into routine operations. This can reduce last-minute pressure, improve staff confidence, support timely problem-solving, strengthen consistency, and maintain visibility of important resident-care risks. Continuous readiness does not mean constant inspection or additional paperwork. It means embedding regular quality checks into existing management routines to confirm that accountabilities are completed and to identify trends that may require improvement.<sup>4</sup><br></p><h3>Making Quality Expectations Easier to Act On</h3><p>Regulatory standards are often broad, making it difficult for frontline teams to understand how they should be applied in daily practice. Leadership therefore needs to translate these standards into clear role expectations and specific accountabilities.</p><p>One example is the workflow followed when frontline staff notice a change in a resident’s condition. A significant status change should have a clear pathway from assessment to documentation, notification of the appropriate team members and family, and escalation of unresolved clinical concerns to the appropriate interdisciplinary team member or manager.</p><p>Standards can also be organized into daily, weekly, and monthly accountabilities. Frontline actions can occur daily, care managers or unit managers can review implementation weekly and address identified gaps, and senior management can analyze broader trends monthly across care practices, nursing practices, and policy implementation. These patterns can help leaders strengthen weaker areas of the accountability model and guide quality improvement initiatives.<sup>3</sup><br></p><h3>Using Early Signals to Support Timely Improvement</h3><p>An embedded accountability approach can help organizations identify leading indicators early. Survey findings, hospitalization rates, falls with injury, and missed clinical performance targets lagging indicators because they provide information after an event or outcome has occurred. Leading indicators provide earlier signals that a process or clinical concern may require attention.<sup>1</sup></p><p>For example, repeated documentation gaps may indicate that a process is unclear, difficult to complete, or not well integrated into routine workflow. Leaders can respond with clarification, coaching, workflow adjustments, or additional resource support before the issue affects resident outcomes or regulatory performance.<br></p><h3>Closing the Loop from Identification to Improvement</h3><p>Identifying a concern is only the first step in quality improvement. Organizations need a clear accountability loop that moves from identification to action, verification, and follow-up. When a gap or emerging risk is identified, responsibility for the next step should be assigned to the appropriate team member or leader, along with an expected completion timeline.</p><p>Once action has been taken, management oversight is needed to confirm that the concern was addressed and the intended outcome achieved. This may include reviewing updated documentation, confirming communication with team members or family, reassessing the resident’s condition, or determining whether a workflow change has been implemented consistently.</p><p>Verification should not be viewed as monitoring staff for mistakes. It ensures that important concerns are not left unresolved and that staff receive the support needed to complete their accountabilities. If the same concern continues, leaders can reassess the process, identify barriers, and provide further clarification, coaching, or quality improvement support.<br></p><h3>Strengthening Quality Without Adding New Technology</h3><p>This approach does not require new technology, software integration, or expensive system add-ons. It can be implemented by creating clear workflows for each level of care delivery. Nursing assistants and other direct care staff provide day-to-day care, while licensed practical nurses and registered nurses help ensure that care reflects each resident’s needs. Care manager or unit manager workflows provide follow-up and oversight, while senior management workflows support trend identification and evaluation.</p><p>The model can be introduced gradually by focusing on a limited number of high-priority areas. A facility may begin by selecting up to three recurring quality risks, defining the frontline actions expected for each risk, establishing when concerns must be escalated, assigning weekly management review, and updating existing huddles, checklists, or audit tools. Progress can be reviewed monthly to determine whether the workflow is effective and sustainable.</p><p>Continuous accountability can be built using tools already in place, including shift reports, huddles, unit meetings, clinical rounds, quality boards, audit forms, leadership rounds, and interdisciplinary reviews.<br></p><h3>Making Continuous Readiness Part of the Culture</h3><p>Survey readiness and continuous quality improvement should complement one another. Small, consistent routines can be more sustainable than large periodic initiatives. Clear accountabilities provide staff with direction and support rather than blame. Proactive identification and timely follow-through can strengthen resident care, increase organizational confidence, and contribute positively to regulatory outcomes and resident and family satisfaction.</p><p>Long term care organizations do not need to recreate the intensity of survey preparation every day. They can preserve its strongest elements: shared priorities, clear responsibilities, visible leadership, and timely follow-through. When these practices become part of routine operations, survey readiness becomes a natural outcome of a stronger quality culture rather than a separate organizational event.<br><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">References</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">1. Centers for Medicare & Medicaid Services. QAPI at a Glance: <em>A Guide for Nursing Homes.</em> Centers for Medicare & Medicaid Services. Accessed July 18, 2026. </span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">2.  National Academies of Sciences, Engineering, and Medicine. <em>The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff.</em> The National Academies Press; 2022. doi:10.17226/26526. </span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">3. Ivers N, Yogasingam S, Lacroix M, et al. Audit and feedback: effects on professional practice. <em>Cochrane Database of Systematic Reviews.</em> 2026;(6):CD000259. doi:10.1002/14651858.CD000259.pub5.</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">4. Zonneveld N, Pittens C, Minkman M. Appropriate leadership in nursing home care: a narrative review. <em>Leadership in Health Services.</em> 2021;34(1):16-36. doi:10.1108/LHS-04-2020-0012. </span><br><br><em><img src="/Articles/PublishingImages/2026/Prachi-Patel.jpg" alt="Prahi Patel" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" />Prachi Patel, RN, CHE, MHA, is director of care at a large continuing care campus in Calgary, Alberta, where she provides leadership across complex care environments and supports interdisciplinary teams in strengthening resident-centered care, accountability, and sustainable quality practices. </em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">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 Provider 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;"><a href="/About/Pages/Submit-Article.aspx" target="_blank" title="Submit an article" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" style="color:#96607d;margin-top:0px;margin-bottom:0px;"><em><span style="text-decoration:underline;">Learn how to submit an article.</span></em></a></span><br></em></p> | 2026-08-20T04:00:00Z | <img alt="survey" src="/Articles/PublishingImages/740%20x%20740/survey.jpg" style="BORDER:0px solid;" /> | Management;Survey and Certification | Prachi Patel, RN | Survey or audit preparation brings the team together around a common purpose: ensuring that everyone’s efforts support the best interests of residents and resident-centered care. |
| Embracing the Evolution of Skilled Nursing Admissions | <p style="text-align:center;"><img src="/Articles/PublishingImages/740%20x%20740/dr_staff.jpg" alt="skilled nursing staff" style="margin:5px;" /></p><p style="text-align:center;"><br></p><p style="text-align:left;">If you want to understand where skilled nursing is headed, spend a day in skilled nursing admissions.</p><p>Behind every referral is a person whose health care journey is continuing, not ending. Families are making some of the most difficult decisions of their lives. Hospital case managers are coordinating increasingly complex transitions. Skilled nursing teams are preparing to care for patients whose needs continue to evolve.</p><p>Working in admissions provides a unique perspective because we witness these moments every day. We stand at the intersection of hospitals, patients, families, and post-acute care. From that vantage point, one thing has become increasingly clear to me.</p><p>Health care isn’t changing. Health care has already changed.</p><p>Today’s skilled nursing patient is very different from the one we cared for just a decade ago. Advances in medicine have allowed people to survive illnesses, injuries, and complex medical conditions that once carried very different outcomes. Hospitals are providing life-saving care more efficiently than ever before, which means patients are transitioning to skilled nursing earlier in their recovery and with greater medical complexity.</p><p>That isn’t something to fear. It’s something to embrace.</p><p>The role of skilled nursing has expanded alongside these advances. We are caring for patients with sophisticated clinical needs, advanced wound care, IV therapies, respiratory conditions, multiple chronic illnesses, and intensive rehabilitation goals. These patients require highly skilled clinicians, strong interdisciplinary collaboration, and seamless coordination with our hospital partners.</p><p>To me, that’s not evidence that skilled nursing is under pressure. It’s evidence that skilled nursing has become an even more essential part of the health care continuum.</p><p>Admissions have evolved as well.</p><p>Many people think admissions is simply about filling beds. Those of us who do this work know it’s much more than that. Every day, admissions professionals collaborate with physicians, nurses, therapists, discharge planners, and case managers to determine whether we can safely meet a patient’s needs. We help families understand what comes next. We identify barriers before they become obstacles and work alongside our clinical teams to create safe, thoughtful transitions.</p><p>The work begins long before a patient ever arrives at our front door.</p><p>Families have evolved, too.</p><p>Today’s families are informed, engaged, and invested in every decision affecting their loved one’s care. They research facilities, review quality ratings, and ask thoughtful questions about treatment, rehabilitation, and outcomes. While these conversations may require more time, they also create opportunities to build trust. When families feel heard, respected, and included, they become valuable partners in the recovery process.</p><p>Perhaps the greatest lesson admissions have taught me is that health care has always been, and always will be, a team effort.</p><p>Successful transitions don’t happen because one person worked harder than another. They happen because hospitals, skilled nursing facilities, physicians, nurses, therapists, case managers, admissions professionals, patients, and families all work toward the same goal: helping someone recover safely and with dignity.</p><p>That collaboration has never been more important.</p><p>Like every generation before us, health care professionals are being asked to adapt. New technology, new treatments, evolving patient populations, and higher expectations are all part of the profession we chose. Rather than asking how we can return to the way things once were, perhaps we should ask a better question:</p><p><strong>How do we continue becoming the providers our patients need us to be?</strong></p><p>For me, the answer begins with embracing change.</p><p>It means investing in our people, strengthening our clinical teams, deepening partnerships with hospitals, listening to families, and recognizing that adaptability has always been one of health care’s greatest strengths.</p><p><span><em><img src="/Articles/PublishingImages/2026/Maritza-Kritz.jpg" alt="Maritza Kritz" class="ms-rtePosition-2" style="margin:5px;" /></em></span>Despite the challenges our profession faces, I believe this is one of the most exciting times to work in skilled nursing.</p><p>Every day, we care for patients whose recovery depends on the strength of the partnerships we build and the expertise we bring to their care. Every day, we have the opportunity to demonstrate why skilled nursing remains an indispensable part of our health care system.</p><p>The next chapter of skilled nursing is not defined by the challenges before us. It is defined by how we choose to meet them. And from where I sit, the future is one worth embracing.<br><br><em>Maritza Kritz is the director of hospital admissions and marketing at PACS Healthcare in Portland, Oregon. She brings more than 15 years of health care experience, with a background in social services, behavioral health, hospital admissions, and post-acute care. She serves as chair of the Oregon Public Health Association Awards Committee, is a volunteer commissioner on the Portland New Portlanders Policy Commission, and serves on the Metro Affordable Housing Bond Community Oversight Committee.</em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">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 Provider 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;"><a href="/About/Pages/Submit-Article.aspx" title="Submit an article" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" style="color:#96607d;margin-top:0px;margin-bottom:0px;"><em><span style="text-decoration:underline;">Learn how to submit an article.</span></em></a></span><br></em></p> | 2026-08-06T04:00:00Z | <img alt="skilled nursing staff" src="/Articles/PublishingImages/740%20x%20740/dr_staff.jpg" style="BORDER:0px solid;" /> | Management | Maritza Kritz | If you want to understand where skilled nursing is headed, spend a day in skilled nursing admissions. Skilled nursing teams are preparing to care for patients whose needs continue to evolve. |