| Breaking the Polypharmacy Cycle in LTC: Strategies for Clinical and Financial Success | <p>
<strong class="ms-rteForeColor-2">ADVERTORIAL</strong></p><a href="https://guardianpharmacy.com/provider-resources/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><img src="/SiteCollectionImages/logos/Guardian-Pharmacy-Services-.png" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:107px;" /></a>
<p>Polypharmacy, broadly defined as the use of multiple medications, poses a formidable challenge in long term care (LTC), with negative financial implications for communities and potentially harmful consequences for residents. As the older population in the U.S. continues to grow at an exponential rate and develops many of the medical conditions associated with aging, the reliance on multiple medications to address these issues has surged. As a result, the prevalence of polypharmacy in LTC communities has reached daunting levels. </p><p>The consequences of polypharmacy not only include an increased risk of adverse drug reactions, drug interactions, hospitalizations, and falls among residents, but it also imposes a substantial financial strain on LTC operators as residents require a greater level of care.</p><h3>Defining Polypharmacy and Its Drivers<br></h3><p>Polypharmacy is a complex topic with varying perspectives. While no standard definition exists, it commonly refers to the use of five or more medications daily. A systematic review published in the
<em>Journal of Post-Acute and Long-Term Care</em> revealed that among residents in these communities, 91 percent were taking more than five medications, while 65 percent were taking more than 10. With the Lown Institute predicting that inappropriate polypharmacy will cost the healthcare system an additional $62 billion between 2020 and 2030, it’s crucial to understand the drivers behind polypharmacy.</p><h3>Factors That Contribute to Polypharmacy</h3><p>
<strong>Prescribing cascades:</strong> These occur when a medication causes a side effect that is mistaken for a new medical condition, leading to additional prescriptions. This creates a cycle of escalating medication use.</p><p>
<strong>Clinical practice guidelines and limited deprescribing guidance:</strong> Guidelines often recommend multiple medications for residents with complex conditions, increasing the risk of polypharmacy. Meanwhile, few guidelines exist to support deprescribing—the supervised reduction or discontinuation of unnecessary or harmful medications—so residents may continue taking drugs they no longer need.</p><p>
<strong>Increased availability of condition-specific medications: </strong>The expanding number of available drugs, combined with direct-to-consumer marketing and resident requests, drives up prescribing. Use of multiple prescribers, such as specialists, and guideline recommendations for multiple medications per medical condition further compound the issue.</p><h3>The Detrimental Effects of Polypharmacy on Resident Outcomes </h3><p>Polypharmacy has serious consequences for residents, leading to a range of negative outcomes that affect their health and well-being. It increases the risk of falls, adverse drug reactions, medication interactions, and non-adherence. This results in longer hospital stays, more frequent readmissions, and even higher mortality rates. In fact, polypharmacy is responsible for nearly 30percent of all hospital admissions an</p><p>d ranks as the fifth leading cause of death in the United States, according to Health Research Funding.</p><p>But the consequences of polypharmacy go beyond health outcomes. Residents dealing with polypharmacy also face higher healthcare costs, with expenses nearly doubling compared to those without polypharmacy.</p><h3>The Financial Impact of Polypharmacy on LTC Communities</h3><p>
<strong>Increased Labor Costs</strong><br>With staffing challenges already straining the LTC industry, managing complex medication regimens adds to labor demands and costs. Polypharmacy results in longer med passes, more frequent monitoring, and increased risk of adverse drug events—all of which consume valuable staff time and limit their ability to complete other responsibilities. Often, communities must hire additional staff to manage the workload, compounding financial pressures.</p><p>
<strong>More Care Transitions, Shorter Lengths of Stay</strong><br>Keeping residents in lower-acuity settings is both cost-effective for operators and beneficial for residents. However, polypharmacy increases hospitalizations, emergency visits, and transitions to skilled nursing, shortening length of stay in assisted living. This creates added expenses—such as discharge and readmission coordination, extra nursing hours, and ongoing marketing efforts to replace residents and maintain occupancy—directly impacting the bottom line.</p><h3>Strategies to Reduce Polypharmacy</h3><p>Reducing polypharmacy in LTC settings can be challenging, but several effective strategies can help:<br></p><ol><li>
<strong>Know your residents, their conditions, and medication purposes. </strong>Staff should have a thorough understanding of each resident’s conditions and the purpose behind every medication. This insight helps flag medications that lack a clinical justification or are dosed inappropriately. Staff should feel empowered to consult prescribers or pharmacists, remain alert to side effects, and question prescribing patterns when needed. A team-based, inquisitive approach is key to addressing unnecessary medications.</li><li>
<strong>Engage residents and their families to assess preferences and concerns. </strong>Proactive, face-to-face conversations with residents and families can uncover insights about medication preferences and concerns. Research shows residents are often open to reducing medications—but these discussions typically need to be initiated by clinical staff. By actively listening and relaying feedback to prescribers, staff help tailor safer, more personalized regimens and reduce the risk of adverse events linked to polypharmacy.</li><li>
<strong>Utilize an LTC pharmacy partner and a collaborative approach to reduce polypharmacy.</strong></li></ol><p></p><p>In skilled nursing, the required monthly pharmacist medication regimen reviews focus on identifying and addressing polypharmacy. In assisted living—where consultant pharmacist involvement varies by state—savvy operators partner with LTC pharmacies and adopt a collaborative approach with the broader healthcare team to gain similar benefits. Across all settings, operators should expect their LTC pharmacy partner to:<br></p><ul><li>
<strong>Be an active part of the multidisciplinary care team.</strong> LTC pharmacists are experts in spotting polypharmacy risks. They conduct medication reconciliations during care transitions, simplify regimens, and work collaboratively with residents, families, and the broader healthcare team—including primary care physicians, specialists, and nursing staff—to improve prescribing practices. Consultations should cover high-risk medications, antibiotic and psychotropic use, and prioritize deprescribing opportunities. In assisted living, even quarterly medication regimen reviews can significantly reduce polypharmacy. </li><li>
<strong>Use technology to enhance safety. </strong>LTC pharmacies combine technology and clinical expertise to detect interactions and duplicate therapies. While technology is essential, human oversight ensures its safe and effective use.</li><li>
<strong>Provide proactive interventions and data-driven insights. </strong>Pharmacists should intervene early—before a new medication is dispensed—to monitor outcomes and ensure drug combinations are safe and appropriate. LTC operators benefit from this type of reporting that tracks the pharmacy team’s clinical impact, offering valuable insights to improve resident care.</li></ul><p>
<em>For example, in 2024, Guardian Pharmacy’s proprietary Clinical Intervention program reported more than 112,000 pharmacist-led interventions—identifying over 11,000 instances of duplicate therapy, more than 9,000 cases of unusual dosing (such as doses too high or too low for a resident), and over 28,000 orders that required clarification before dispensing.</em></p><h3>Conclusion</h3><p>Breaking the cycle of polypharmacy is key to improving outcomes and reducing costs. By eliminating unnecessary medications, communities lower the risk of side effects, drug interactions, falls, and hospitalizations. A pharmacist-led, collaborative approach helps optimize regimens and ensure safe, effective care. Communities should rely on their LTC pharmacy partners to lead in this area of expertise, promoting better resident health and long-term financial stability.</p><p>To learn more visit us at <a href="https://guardianpharmacy.com/provider-resources/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">https://guardianpharmacy.com/provider-resources/</a>.<br><br><span class="ms-rteStyle-Normal">References</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">Nguyen PV, Spinelli C. Prescribing cascade in an elderly woman. Can Pharm J (Ott). 2016 May;149(3):122-4. doi: 10.1177/1715163516640811. Epub 2016 Apr 1. PMID: 27</span></p><p>
<span class="ms-rteStyle-Normal">212961; PMCID: PMC4860747.</span><br><br><em><img src="/Articles/PublishingImages/2025/Erin%20Marriott.png" alt="Erin Marriott" class="ms-rtePosition-1" style="margin:5px;width:160px;height:160px;" />Erin Marriott is a board-certified geriatric pharmacist and a seasoned LTC clinical consultant pharmacist. A graduate of the University of Toledo School of Pharmacy and board certified in geriatrics, Marriott has more than 20 years of experience in the long term care industry. She currently serves as the senior director of clinical and regulatory support for
<a href="https://guardianpharmacy.com/provider-resources/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Guardian Pharmacy Services </a>in Atlanta, Georgia, and has an extensive background as a clinical consultant pharmacist, directly serving long-term care and senior living communities for more than 15 years. She is an active member of the American Society of Consultant Pharmacists and has received advanced training in antimicrobial stewardship and anticoagulation management.</em></p> | 2025-05-06T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/medications_4.jpg" style="BORDER:0px solid;" /> | Finance;Management | Erin Marriott | As the older population in the U.S. continues to grow at an exponential rate and develops many of the medical conditions associated with aging, the reliance on multiple medications to address these issues has surged. |
| AI as an Equalizer Building Accessible Telehealth Platforms | <p><img src="/Articles/PublishingImages/2025/senior_telehealth.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:200px;" />The rise of telehealth has reshaped modern health care, offering patients unprecedented access to remote care. Yet for millions of people with disabilities, these platforms often fall short. Complex interfaces, poorly designed tools, and a lack of adaptability exclude those who need telehealth the most. Artificial intelligence (AI) is poised to change this narrative by powering solutions that prioritize accessibility—but only if developers, clinicians, and policymakers collaborate to ensure these tools are equitable, ethical, and universally beneficial.</p><h3>The Silent Barriers in Telehealth</h3><p>Despite advancements, many telehealth platforms remain inaccessible to individuals with disabilities. Studies and audits have highlighted significant accessibility issues in health care platforms, particularly regarding screen readers and keyboard navigation compatibility. For example, research on open-source electronic health record (EHR) systems found partial accessibility, with challenges in screen reader compatibility and keyboard navigation. For someone with low vision, an unlabelled graph detailing medication instructions becomes a roadblock. For a person with ALS, a multi-step login process requiring precise mouse clicks can derail an entire appointment.</p><p>Regulatory changes are pushing health care providers to address these gaps. The Department of Health and Human Services issued a final rule requiring entities receiving federal funding to meet WCAG 2.1 Level AA standards for digital accessibility, with compliance deadlines set for May 11, 2026, or May 10, 2027, depending on the size of the organization. This shift reflects a growing recognition that digital accessibility is not optional, but it is a fundamental component of equitable care.</p><p>In long term and post-acute care (LTPAC) settings, the stakes are even higher. Patients with cognitive impairments, such as dementia, may struggle with voice-activated tools, while those recovering from strokes often face communication barriers that standard telehealth interfaces cannot accommodate.</p><h3>AI-Powered Solutions Breaking Down Barriers</h3><p>AI offers unique opportunities to address these challenges by automating accessibility adaptations and personalizing user experiences. Below are three critical areas where AI is making a difference:</p><h4>1.    Simplifying Medical Communication.</h4><p>Patients with cognitive disabilities or limited health literacy often encounter dense, jargon-filled content in telehealth portals. Natural language processing models can analyze complex medical text and generate plain-language summaries. For example, AI can rephrase “Administer 5 mg of rivaroxaban daily for venous thromboembolism prophylaxis” to “Take one 5 mg blood thinner pill daily to prevent blood clots.” Early implementations show such adaptations reduce patient confusion and improve adherence to treatment plans.</p><h4>2.    Making Visual and Auditory Content Accessible.</h4><p>Medical imaging is vital for diagnostics, but without descriptions, blind patients miss critical information. AI-driven computer vision tools can automatically generate alt-text for X-rays, MRIs, and ultrasounds. A chest X-ray might be described as “showing a 3 cm shadow in the lower right lung, possibly indicating pneumonia.” Similarly, speech recognition models tailored to atypical speech patterns that are common in conditions like Parkinson’s disease are improving transcription accuracy, ensuring patients’ voices are accurately captured during virtual visits.</p><h4>3.    Reducing Administrative Burdens.</h4><p>Clinicians in LTPAC settings spend significant time on documentation, diverting attention from patient care. AI scribes trained on diverse datasets can automate visit summaries, flagging urgent needs like a nonverbal patient’s gestures signalling pain. Facilities piloting these tools report a 30 percent reduction in charting time, allowing staff to prioritize direct interactions with residents.</p><h3>Navigating Ethical Challenges</h3><p>While AI holds immense promise, its implementation requires careful consideration of ethical risks. Many speech recognition systems struggle with accents or speech impairments, leading to errors that disproportionately affect patients with disabilities. Training AI models on datasets inclusive of diverse voices including those with speech disorders is essential to prevent bias.</p><p>Privacy is another critical concern. Voice-activated tools and personalized interfaces often require sensitive health data. Developers must ensure compliance with regulations like HIPAA while maintaining transparency about how data is used. For example, AI systems should allow patients to opt out of data collection without losing access to core features.</p><p>Transparency in AI decision-making is equally vital. Patients deserve clear explanations when AI modifies their experience, such as adjusting font sizes for readability or enabling voice navigation.<br></p><h3>Practical Steps for LTPAC Providers</h3><h4>1.    Prioritize Inclusive Design.</h4><p>Involve people with disabilities in the development and testing of AI tools. Feedback from users with lived experience can uncover overlooked barriers, such as the need for customizable interface layouts or alternative input methods like eye-tracking.</p><h4>2.    Train Teams on Accessibility Standards.</h4><p>Equip staff with guidelines to evaluate AI tools, such as checking compatibility with screen readers or testing color contrast ratios for patients with visual impairments. Simple audits can prevent costly redesigns later.</p><h4>3.    Advocate for Supportive Policies.</h4><p>Push for regulatory changes incentivizing accessibility, such as CMS reimbursements for AI tools that demonstrably improve patient outcomes. Collaboration with industry groups can amplify these efforts.</p><h3>The Future of Inclusive Telehealth</h3><p>The next generation of telehealth platforms will rely on adaptive AI systems that learn from user interactions and evolve to meet individual needs. Imagine interfaces that automatically adjust text size for patients with macular degeneration or AI avatars that provide real-time sign language translation during virtual visits.</p><p>However, technology alone cannot solve systemic inequities. Success hinges on a commitment to human-centered design, where accessibility is not an afterthought but a foundational principle. By fostering partnerships between developers, clinicians, and disability communities, the health care industry can ensure AI serves as a true equalizer, empowering every patient to access care with dignity and ease.<br><br><span class="ms-rteStyle-Normal">References</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">•    Centers for Disease Control and Prevention. Disability and Health Data System.https://www.cdc.gov/media/releases/2024/s0716-Adult-disability.html</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">•    U.S. Department of Health and Human Services. (2024). Telehealth Accessibility Report.</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">•    World Health Organization. (2023). Global Report on Health Equity for Persons with Disabilities.</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">•    Journal of Medical Systems. (2024). AI Applications in Medical Imaging Accessibility.</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">•    HIPAA Journal. (2023). Ensuring Compliance in AI-Driven Health care Tools.</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">•    Google. (2023). Project Guideline: Open-Source AI for Accessibility.</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">•    Centers for Medicare & Medicaid Services. (2024). Health IT Accessibility Standards Update.</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">•    Health Affairs. (2023). Overcoming Telehealth Barriers for Vulnerable Populations.</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">•    New England Journal of Medicine AI. (2024). Addressing Bias in Health care AI.</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">•    W3C. (2024). Web Content Accessibility Guidelines (WCAG) 2.2.</span><br><br><em><img src="/Articles/PublishingImages/2025/Aashim%20Upadhaya.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:175px;height:175px;" />Ashim Upadhaya is a software engineer with over eight years of experience in full-stack development, specializing in building accessible and high-performance user interfaces and backend systems to ensure compliance with WCAG 2.0 and A11Y standards. His work focuses on creating inclusive digital health solutions that make wellness programs accessible to all users, including older adults and individuals with disabilities. Contact Ashim on LinkedIn at </em><a href="https://www.linkedin.com/in/ashimupadhaya/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><em>https://www.linkedin.com/in/ashimupadhaya/</em></a><em>.</em><br></p> | 2025-05-01T04:00:00Z | <img alt="© <a href='https://www.123rf.com/profile_rawpixel'>rawpixel</a>, <a href='https://www.123rf.com/free-images/'>123RF Free Images<" src="/Articles/PublishingImages/2025/senior_telehealth.jpg" style="BORDER:0px solid;" /> | Technology;Telemedicine | Aashim Upadhaya | Complex interfaces, poorly designed tools, and a lack of adaptability exclude those who need telehealth the most. Artificial intelligence (AI) is poised to change this narrative by powering solutions that prioritize accessibility. |
| Increasing Security Mitigates Risks and Enhances Marketing | <p><img src="/Articles/PublishingImages/740%20x%20740/0620_News2.jpg" class="ms-rtePosition-2" alt="nursing facility risks, security" style="margin:5px;width:200px;height:200px;" />Skilled nursing facilities (SNFs) and assisted living facilities face increasing scrutiny regarding patient safety, regulatory compliance, and operational efficiency. Security risks—such as resident elopement, unauthorized access, and staff shortages—can lead to severe fines, legal liabilities, and reputational damage. However, facilities that implement a structured risk assessment program and modern security enhancements can mitigate these risks while using enhanced security as a marketing tool to attract new residents and improve employee productivity.</p><p>This article explores how upgraded security measures can reduce financial penalties, improve patient care, and position SNFs as preferred choices for families and health care partners.</p><h3>Risk Assessment: The Key to Cost-Effective Security</h3><p>A risk assessment serves as the foundation for security improvements by identifying vulnerabilities and implementing targeted, cost-effective solutions.</p><p>Steps in a risk assessment:<br></p><ol><li><strong>Facility Walkthrough and Threat Analysis:</strong> Identify security gaps in entrances, exits, surveillance, and resident movement patterns.</li><li><strong>Staff and Emergency Preparedness Review: </strong>Evaluate training, response times, and incident reporting procedures.</li><li><strong>Access Control and Monitoring Evaluation:</strong> Assess visitor management, entry points, and tracking systems.</li><li><strong>Technology Audit:</strong> Review surveillance cameras, motion sensors, and tracking solutions.</li><li><strong>C</strong><strong>ompliance Check: </strong>Ensure adherence to CMS guidelines, OSHA safety regulations, and state-level nursing home laws.</li></ol><p>How risk assessments reduce costs:</p><ul><li>Prevents expensive fines and legal claims related to elopement, neglect, and security breaches.</li><li>Identifies low-cost interventions (e.g., better staff training, policy changes) before investing in expensive upgrades.</li><li>Reduces the likelihood of lawsuits and insurance premium increases by addressing risks proactively.</li></ul><h3>Modern Security Upgrades: Preventing Fines & Boosting Admissions</h3><p>Implementing state-of-the-art security solutions not only prevents regulatory violations but also enhances the facility’s reputation, making it more attractive to residents and families.<br></p><p><strong>1.    Access Control and Visitor Management</strong></p><ul><li>Keypad or Keycard Entry Systems: Restrict unauthorized personnel and track visitor movements.</li><li>Digital Visitor Logs: Automate sign-ins to enhance monitoring and audit trails.</li><li>Biometric Scanners or Facial Recognition: Enhance security while streamlining entry for authorized staff and visitors.</li></ul><p>Benefit: Reduces incidents of unauthorized access, minimizing liability risks.<br></p><p><strong>2.    Air-Driven Resident Tracking Software</strong></p><p>Modern air-driven tracking technology offers non-invasive, real-time monitoring of residents, reducing elopement risks. These systems use air-pressure sensors instead of traditional RFID or GPS, allowing seamless tracking without wearable devices.</p><p>How It Works:<br></p><ul><li>Residents are tracked based on movement patterns and room locations.</li><li>Alerts are triggered if a high-risk patient moves toward an exit or restricted area.</li><li>No need for wearable devices, reducing resident discomfort and non-compliance.</li></ul><p>Impact on Fines and Legal Exposure:<br></p><ul><li>Prevents elopement-related penalties (which can exceed $50,000 per incident).</li><li>Improves compliance with CMS Immediate Jeopardy standards, avoiding facility shutdowns.</li><li>Reduces staff workload, allowing caregivers to focus on patient-centered care instead of constant monitoring.</li></ul><p>Marketing Advantage:</p><ul><li>Families seeking care for Alzheimer’s and dementia patients prioritize secure environments.</li><li>Highlighting advanced resident safety features differentiates SNFs in a competitive market.</li></ul><p><strong>3.    Surveillance and AI-Driven Security Monitoring</strong><br></p><ul><li>Motion-Activated Cameras: Reduce security costs by eliminating 24/7 manual monitoring.</li><li>AI-Powered Video Analytics: Detect unusual resident behavior, preventing accidents and injuries.</li><li>Automated Emergency Alerts: Instantly notify staff when safety breaches occur.</li></ul><p>How It Enhances Admissions:<br></p><ul><li>Families feel reassured by 24/7 monitoring and real-time security alerts.</li><li>Marketing messaging can focus on “state-of-the-art security for peace of mind.”</li></ul><h3>The Financial Impact: How Security Enhancements Increase Revenue</h3><p>Beyond reducing fines, upgraded security measures drive financial benefits by improving occupancy rates, operational efficiency, and staff retention.</p><p><strong>A. Increased Admissions Through Reputation and Trust</strong><br></p><ul><li>Facilities with strong security measures attract higher-paying private-pay residents who prioritize safety.</li><li>Enhanced security features become a selling point for referral sources (hospitals, case managers, and elder law attorneys).</li><li>Online reviews and family testimonials improve when security concerns are proactively addressed.</li></ul><p><strong>B. Improved Staff Productivity and Retention</strong><br></p><ul><li>Automated tracking and surveillance tools reduce manual security duties for nurses and caregivers.</li><li>Lower stress levels improve employee satisfaction and retention rates.</li><li>Well-trained staff working in safe environments are more engaged and efficient.</li></ul><p><strong>C. Compliance-Driven Cost Savings</strong></p><h4>Security Upgrade Average Cost Potential Savings<br></h4><table cellspacing="0" width="100%" class="ms-rteTable-3 "><tbody><tr class="ms-rteTableEvenRow-3"><td class="ms-rteTableEvenCol-3" style="width:33.3333%;"><br></td><td class="ms-rteTableOddCol-3" style="width:33.3333%;"><span>Cost to Implement</span></td><td class="ms-rteTableEvenCol-3" style="width:33.3333%;"><span>  Benefits</span></td></tr><tr class="ms-rteTableOddRow-3"><td class="ms-rteTableEvenCol-3"><span>Keypad/Keycard Entry Systems <br></span></td><td class="ms-rteTableOddCol-3"><span>$2,000–$10,000</span></td><td class="ms-rteTableEvenCol-3"><span>Avoids $50,000+ in elopement fines</span></td></tr><tr class="ms-rteTableEvenRow-3"><td class="ms-rteTableEvenCol-3"><span>AI-Powered Surveillance</span></td><td class="ms-rteTableOddCol-3"><span>$5,000–$20,000</span></td><td class="ms-rteTableEvenCol-3"><span>Reduces staff workload and legal risks</span></td></tr><tr class="ms-rteTableOddRow-3"><td class="ms-rteTableEvenCol-3"><span>Air-Driven Tracking</span></td><td class="ms-rteTableOddCol-3"><span>$10,000–$50,000</span></td><td class="ms-rteTableEvenCol-3"><span>Eliminates costly wearable GPS tracking</span></td></tr><tr class="ms-rteTableEvenRow-3"><td class="ms-rteTableEvenCol-3"><span>Staff Training on Security</span></td><td class="ms-rteTableOddCol-3"><span>Free–$500</span></td><td class="ms-rteTableEvenCol-3"><span>Prevents negligence lawsuits</span></td></tr></tbody></table><p><br>This information is supported by multiple sources detailing the financial impact of regulatory compliance and noncompliance in skilled nursing facilities. The Centers for Medicare and Medicaid Services can impose fines up to $10,000 per day or per instance with noncompliance.<br></p><h3>Using Security as a Marketing Tool</h3><p>Branding and messaging strategies can include:<br>     1. Highlighting Security in Admissions Materials<br></p><ul><li>Brochures, websites, and tours should emphasize enhanced safety protocols.</li><li>Use messaging like: “Your loved one’s safety is our top priority—our facility exceeds industry security standards.”</li></ul><p>     2. Leveraging Online Reviews and Testimonials<br></p><ul><li>Encourage families to share positive experiences regarding resident safety and care.</li><li>Address past security concerns publicly, demonstrating proactive improvements.</li></ul><p>     3. Engaging Referral Networks<br></p><ul><li>Partner with discharge planners, elder law attorneys, and senior living consultants to promote secure environments.</li><li>Offer “Safe Senior Living” seminars showcasing facility security measures.</li></ul><p></p><p></p><h3>Security as a Competitive Advantage</h3><p>Investing in risk assessments and upgraded security transforms skilled nursing facilities into safer, more attractive options for residents and their families. By preventing regulatory fines, reducing liability risks, and improving patient care, SNFs can increase occupancy rates, employee productivity, and financial sustainability.</p><h3><span><img src="/Articles/PublishingImages/2025/Kevin-Dean.jpg" alt="Kevin Dean" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" /></span>Implementing a Security Upgrade Plan</h3><ol><li>Conduct a comprehensive risk assessment to identify vulnerabilities.</li><li>Implement cost-effective security solutions like access control, air-driven tracking, and AI surveillance.</li><li>Train staff on emergency response and security best practices.</li><li>Market enhanced security measures as a differentiator to attract new residents.</li></ol><p>By making security a cornerstone of care, skilled nursing facilities can reduce risk, boost profitability, and provide families with the peace of mind they deserve.<br><br><em>Kevin Dean is a security consultant and an Air Force intelligence veteran. </em><br><br></p> | 2025-04-24T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/0620_News2.jpg" style="BORDER:0px solid;" /> | Management;Technology | Kevin Dean | Facilities that implement a structured risk assessment program and modern security enhancements can mitigate risks while using enhanced security as a marketing tool to attract new residents and improve employee productivity. |
| Medicaid Cuts Would Devastate Providers Serving ID/DD Populations | <p><img src="/Articles/PublishingImages/2025/Medicaid.jpg" class="ms-rtePosition-2" alt="Medicaid cuts" style="margin:5px;width:200px;height:200px;" />Medicaid cuts would be devastating to individuals with intellectual and developmental disabilities (ID/DD) and those who care for them. Virtually all 55,000 individuals with disabilities residing in the nation’s 5,300 intermediate care facilities (ICF) are on Medicaid.</p><p>ICFs provide active treatment and services for people with significant support needs. They offer 24-hour supervision, health care, therapies, activities, and training to maximize residents’ autonomy and independence. </p><p>Despite being the backbone of ID/DD care, Medicaid reimbursement rates often fall short of covering the actual cost of care, regardless of any future cuts. This underfunding has led to longer waitlists for home and community-based services programs, facility closures, and reduced access to timely, essential support that individuals desperately need.</p><p>The drop in ICFs, which has declined by more than 16 percent over the last 10 years, compounds the problem. Furthermore, newer facilities are not being built and certified at nearly the same pace as closures. This ultimately leads to fewer active Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities (ICFs/IID) and patients seeking care elsewhere or not at all.</p><p>Data show ICFs/IIDs are performing well. Centers for Medicare and Medicaid Services (CMS) survey ICFs/IIDs for regulatory compliance. Over 90 percent of surveys conducted in 2024 found zero condition-level deficiencies and demonstrated a commitment to quality care. </p><h3>Medicaid Doesn’t Cover Enough</h3><p>Medicaid does not fully cover the cost of care for individuals with intellectual and developmental disabilities. Access to quality long-term services and supports (LTSS) is at risk without adequate funding.</p><p>Provider taxes are one solution to expand services and support high-quality care. For more than 40 years, provider assessments (also called provider taxes) have helped states stabilize Medicaid funding and maintain care for vulnerable populations. There are 49 states and Washington, D.C., that rely on provider taxes to ensure that providers can continue serving Medicaid beneficiaries, and 32 of such states and D.C. apply these assessments for ICFs/IID.</p><p>Some federal budget proposals aim to lower the “Safe Harbor” limit on provider taxes from the current 6 percent, limiting states’ ability to use provider taxes. This would cut Medicaid funding without a replacement solution and reduce access to essential care for ID/DD populations while undermining efforts to recruit and retain much-needed stay in care facilities.</p><p>Medicaid is a lifeline for individuals with intellectual disabilities, especially those children and adults receiving 24-hour specialized care in ICFs/IIDs,” said Jamie L. Anthony, LSW, executive director, Developmental Options, a small non-profit organization located in Southeastern Idaho.</p><p>“ICFs provide essential access to health care, support services, and community resources, ensuring the individuals served receive necessary care and support to lead fulfilling lives and promote their independence and social inclusion,” Anthony said. “Without Medicaid, many would face significant barriers to essential services, limiting their opportunities for growth and well-being.”</p><h3>Forced to Reduce Services</h3><p>“The ICF industry has been plagued with funding challenges for over a decade, doing more with less, resulting in a significant decline in facilities nationwide,” Anthony said. “ICF providers rely upon Medicaid dollars for operation, allowing the industry to continue to survive for those individuals who benefit from the high-quality, individualized care plans and services.”</p><p>Anthony added, “Without Medicaid, or with significant cuts to Medicaid, they could face closure or be forced to reduce services. This would leave individuals with intellectual and developmental disabilities without access to critical care, potentially leading to institutionalization, neglect, or a lack of proper support in the community. Families may struggle to find alternative care options, and the overall quality of care could diminish.”</p><p>“We have reached a point where there are no further expense areas to reduce without significantly impacting essential services or operations, said Anthony. “Every line item has been carefully evaluated, and additional cuts would compromise the program’s core functions, quality of service, or overall sustainability. At this stage, the budget is already operating at minimal levels, and any additional reductions would harm the provider's ability to meet its goals.”</p><h3>Hiring Challenges Are Persistent</h3><p>Debbie Jenkins, advocacy director, Ohio Health Care Association, said that for a long time, ICF members have struggled to attract and retain the direct support professionals (DSPs), nurses, and other staff needed to care for their residents.</p><p>“For several years, they had to turn away people needing services because they couldn’t find enough staff to care for them,” Jenkins said.</p><p>In July 2023, the Ohio legislature passed HB 33, which invested significantly in ICF services to help increase wages. “This investment has stabilized most of our ICF providers' workforces,” Jenkins said. She said that during the past year and a half, her members told her that they have been able to adequately staff their current residents and take on a few new residents.</p><p>“However, challenges remain for serving people with significant needs requiring higher staffing ratios,” Jenkins said. “If Medicaid reimbursement for services is cut, any progress made in Ohio in the past year and a half would be lost. Providers would not be able to continue supporting their current wages, much less keep up with any future inflation.”</p><p>Additionally, Ohio has a pending provision in its budget bill that would eliminate the expansion population if the FMAP is reduced from the current 90 percent. </p><p>“Our rates do not cover these employees' full health insurance costs,” Jenkins said. Many DSPs are on Medicaid through the expansion population eligibility. If that goes away, we anticipate some DSPs will leave ICFs to find employment that includes health insurance benefits. These cuts would devastate the ICF workforce and leave many residents without care.”</p><h3>Wages a Key Determinant for Care</h3><p>Developmental Options has been actively working to raise wages for direct support staff to close the gap on open positions and attract reliable, dedicated caregivers. </p><p>“These efforts are critical to ensuring individuals receive the high-quality care they need,” Anthony said. “However, the uncertainty surrounding Medicaid funding has slowed this progress. Without stable and predictable funding, making the necessary wage adjustments and retaining staff is difficult, ultimately hindering the ability to fill positions and maintain consistent care for those who rely on these services.”</p><h3>Technology a Possible Solution</h3><p>Anthony said that better use of technology, such as artificial intelligence, could help to solve some of the funding and hiring gaps.</p><p>“It is important for our company and the industry to look for ways in which technology and AI can help us achieve more with fewer resources, allowing us to meet the regulations’ intent while maintaining high-quality programs,” Anthony said. “For example, finding software solutions that automate routine workflows reduce the time staff spends documenting while capturing critical data and allow agencies to make data-driven decisions can help improve compliance without adding staff.”</p><p><span><img src="/PublishingImages/Headshots/PaulBergeron.jpg" alt="Paul Bergeron" class="ms-rtePosition-2" style="margin:5px;width:140px;height:140px;" /></span>“However, a hurdle regarding software solutions is that many systems only focus on a single function (billing or scheduling, for example) and don't truly integrate tools and solutions that align with the ICF/IID regulations or program structure,” said Anthony.</p><p><em>Paul Bergeron is a freelance writer based in Herndon, VA.</em><br></p> | 2025-04-22T04:00:00Z | <img alt="" height="740" src="/Articles/PublishingImages/2025/Medicaid.jpg" width="740" style="BORDER:0px solid;" /> | Policy | Paul Bergeron | Despite being the backbone of ID/DD care, Medicaid reimbursement rates often fall short of covering the actual cost of care, regardless of any future cuts. This underfunding has led to longer waitlists for home and community-based services programs, facility closures, and reduced access to timely, essential support that individuals desperately need. |