| 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. |
| The Digital Front Door | <p style="text-align:center;"><span><img src="/Articles/PublishingImages/2026/digital-516718288.png" alt="" style="margin:5px;" /></span> </p><p><span style="color:#555555;"></span><span style="color:#555555;">Providers are spending real money to keep pace: new electronic health records modules, staffing platforms, survey-readiness tools, census dashboards. All of it aimed at the machinery inside the building. Meanwhile, the most consequential impression a prospective resident forms happens somewhere no one on the org chart is watching, and it happens before your admissions team ever hears the phone ring.</span></p><p>When a daughter is deciding where to place her mother, she rarely tours four buildings cold. She searches for them. She reads the reviews, studies the photos, and decides who is even worth a call. In health care more broadly, 84 percent of patients now examine online reviews before booking care, and more than half read at least six reviews before they act. Your website and your Google listing are the first tour now. The walk-through is the second date, and plenty of families never grant one.</p><p>Here is the encouraging part: this is one of the rare advantages still sitting unclaimed. So few operators have truly taken ownership of their digital presence that the building which does take charge stands out right away. No capital project, no construction, no new line item required.</p><p>Turnover is part of why the door is open. With administrator turnover above 22 percent in 2025 and certified nurse aide turnover above 42 percent, per data compiled for the American Health Care Association, digital platforms often go unassigned simply because no one has been named to own them. Claiming that role pays off quickly. The operator who knows when a review comes in, when it was last answered, and who is posting in the building’s name controls the first impression every family forms and does it faster and more affordably than almost any other census lever. So if you have not gotten your digital presence under control, now is the time. With benefits this clear, and with your online presence serving as the real front door to your building, there is no reason to wait.<br><br><strong>Three Questions to Audit Yourself </strong><br>You do not need an agency or a budget line to find out where you stand. You need to answer three questions honestly.</p><ol><li><strong>When did someone last respond to a review on your Google, Yelp, or Facebook page?</strong> Every review is a chance to show families who you are. Roughly 45 percent of patients say they value providers who respond to reviews, and 41 percent say a response raises their trust. Even a critical review becomes an opportunity: a calm, specific reply often persuades the reader more than the original complaint and signals a team that listens. Buildings that respond consistently turn their review pages into one of their most persuasive tools for admissions.</li><li><strong>Do the photos on your website reflect the care happening in the building today?</strong> Families are remarkably good at spotting stock photography and a lobby that was last redecorated a decade ago. They are searching in a fog: in one 2025 survey of family caregivers, 88 percent said families need more guidance navigating the search, and 41 percent were not even sure what they were looking for. Authentic, current photos are a signal in that fog. Dated or generic ones tell a story you did not intend to tell.</li><li><strong>Is your team trained to post in a way that is both compelling and HIPAA-compliant?</strong> This is the question that gives many teams pause, and for good reason. In 2025, a Delaware nursing home operator agreed to pay $182,000 after posting resident success stories, photos, and diagnoses to its website and social media without written authorization. Federal regulators found roughly 150 residents affected and required a privacy officer, annual audits, and social-media-specific HIPAA training. The encouraging takeaway is that a little training changes everything: with a simple consent process in place, the instinct to show the warmth of real care becomes one of your strongest assets.</li></ol><p><strong>Compelling and Compliant Is Not a Contrad</strong><strong>iction</strong><br>The encouraging part is that one simple move solves for both risks at once: an owned, trained process. When a single person is accountable for the platforms, a consent workflow is understood, and a steady cadence treats the digital front door as a real operational responsibility, the two things operators worry about most both fall away. It is not a marketing budget. It is a decision, and it is one you can make this quarter.</p><p>I have watched this play out on both sides. One executive director called me directly to say his building had lost several prospective admissions in a matter of weeks, and he put the blame squarely on a cluster of unanswered negative reviews and a neglected online presence. Another facility moved the opposite direction: after its team was trained to respond and engage online, census climbed within the month. The difference was not budget or building quality. It was ownership.</p><p>Owning your digital front door does not require a marketing department. It requires naming one person accountable for every review platform, giving them a standing weekly slot to respond, and putting a simple consent checklist in the hands of anyone who might photograph a resident. That is a policy decision, not a budget line. It is one an administrator can make this week.</p><p>The digital front door is not marketing fluff, and it is not below an operator’s pay grade. It is the first clinical impression a family forms, made before anyone in your building has a chance to make a better one. Answer the three questions. If you do not like what you find, you have just located the least expensive census intervention available to you.<br><img src="/Articles/PublishingImages/2026/Brittney-Davis.jpg" alt="Brittney Davis" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" /><br><em>Brittney Davis is the founder and president of PJR Team and has spent more than a decade focused on the digital presence of skilled nursing, assisted living, home health, and senior living organizations. She can be reached at bdavis@pjrteam.com or at PJRTeam.com.</em></p><p>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><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"><em>Learn how to submit an article.</em></a><br></p> | 2026-07-30T04:00:00Z | <img alt="" src="/Articles/PublishingImages/2026/digital.jpg" style="BORDER:0px solid;" /> | Technology | Brittney Davis | The digital front door is not marketing fluff, and it is not below an operator’s pay grade. It is the first clinical impression a family forms, made before anyone in your building has a chance to make a better one. |
| Higher Air Quality Brings Better Financial Performance | <p style="text-align:center;"><img src="/Articles/PublishingImages/2026/air%20quality-1138823699.jpg" alt="air quality" style="margin:5px;width:482px;" /></p><p>Most long term care (LTC) administrators have optimized staffing, supply chains, and clinical resource allocation. But until recently, few fully appreciated the importance of indoor air quality not just for patient health, but for the facility’s financial well-being.</p><p>Historically, airborne disease transmission in LTC facilities has been treated as an uncontrollable background variable. However, scientific literature increasingly points to airborne transmission as a documented, persistent driver of infections in LTC facilities. A recently published peer-reviewed study in the <em>Journal of the American Medical Directors Association</em> offers clinical evidence that facilities can reduce infection incidence by nearly 50 percent through an approach known as continuous active air disinfection.</p><p>The upshot for LTC leaders is clear. No longer restricted to specialized sterile environments like operating theaters, continuous air disinfection is now a practical tool that can reduce the medical, operational, and financial burdens of airborne infections in LTC facilities.<br></p><h3>What Airborne Infections Cost Your Facility</h3><p>One direct way airborne infections cost LTC facilities is through the Skilled Nursing Facility Value-Based Purchasing (VBP) program. The VBP program withholds 2 percent of all Medicare Part A payments to create a pool of funds that it redistributes to facilities based on their scores on various measures.</p><p>Each fiscal year, facilities receive a payment adjustment ranging from a 1.5 percent increase to a 2 percent cut based on, among other measures, their rehospitalization rates in the previous year. This means an airborne infection-driven hospitalization in an LTC facility is not just a clinical event. It also feeds directly into a scored, payment-adjusted federal quality measure.</p><p>It is not just patient infections LTC facilities worry about. Airborne disease transmission can also contribute to staffing strains. When nursing staff are absent due to respiratory infections, LTC facilities are often forced to bring in agency staff at premium rates, which contributes to cost pressures. The relative cost of contract nursing staff has also ballooned since the COVID-19 pandemic. The Department of Health and Human Services <a href="https://aspe.hhs.gov/sites/default/files/documents/0efd4ee9d0d0e9e67c5442141053d71c/contract-staff-nhs-high-after-covid.pdf?utm_source=copilot.com" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="The Use of Contract Staff in Nursing Homes Remains High After the COVID-19 Pandemic">reports</a> in a recent issue brief that labor costs were 75 percent higher for contract nursing staff than for permanentemployees in 2021.</p><p>Infections are also a financial risk to LTC facilities in the form of occupancy and retention. Outbreak-driven cohort restrictions can interrupt admissions and force bed-holds. Meanwhile, well-publicized outbreaks can erode family confidence and interrupt the referral pipeline. Infection-related quality measures are also a component of a facility’s CMS Star Rating.</p><p>There is also the cost of the response itself. Following updated ventilation guidance after 2020, many facilities increased airflow and fresh air intake to dilute airborne pathogens. The intent was sound, but the approach carries an ongoing operational burden. Conditioning more outside air raises energy costs and accelerates wear on HVAC equipment, and adding higher-efficiency filtration on top increases the strain further, since denser filter media restricts airflow and forces the system to work harder for a partial result. Facilities can find themselves paying more on both ends and still managing infection risk only indirectly.<br></p><h3>What the Study Say</h3><p>Recognizing that airborne transmission is an important driver of health care-associated infections, a team led by Israeli epidemiologist Itamar Grotto conducted a controlled study into the impact of continuous air disinfection at the Golden Care Geriatric Center in Ness Ziona, Israel.</p><p>In their research letter to <em>JAMDA</em>, <a href="https://www.jamda.com/article/S1525-8610%2826%2900038-1/abstract" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Continuous Hydroxyl Radical Air Disinfection and Infection Outcomes in a Geriatric Long-Term Care Department: A Prospective Coho">“Continuous Hydroxyl Radical Air Disinfection and Infection Outcomes in a Geriatric Long Term Care Department: A Prospective Cohort Study,”</a> the authors describe how they evaluated 242 resident-years across two comparable LTC units for two consecutive years. Residents who were present in both years count as two resident years.</p><p>At the start of Year 2, induct-mounted hydroxyl radical generators, which disperse hydroxyls radicals that replicate the effects of the sun’s ultraviolet energy and sanitize indoor air, were installed in the intervention unit and operated continuously throughout the year. The control unit received standard care with no additional air disinfection.</p><p>The results show a dramatic 48 percent reduction in respiratory infections in the intervention group during Year 2.</p><p>Infection incidence in the intervention unit decreased from 1.88 to 0.98 events per resident-year, while remaining unchanged in the control unit (1.61 to 1.57).</p><p>Overall infections declined from 51.6 to 26.8 per 10,000 resident days in the treated unit, compared to minimal change in the control unit.</p><p>Hospitalization rates between the two units remained comparable, indicating that the primary benefit was reducing infection burden within the facility.<br></p><h3>Doing the Math</h3><p>While the reduction in infections with continuous air disinfection is measurable, existing studies do not discuss the potential economic impact. The cost per infection varies widely from facility to facility, and so will the return on investment.</p><p>Nevertheless, administrators can estimate the potential savings by leveraging this simple framework.<br></p><ol><li>Take your facility’s current annual infection event rate or use the study’s pre-intervention benchmark of 1.88 events per resident-year as a reference.</li><li>Apply a conservative 40 percent reduction scenario, which is below the study’s observed 48 percent.</li><li>Multiply avoided events by your facility’s estimated cost per infection event. These costs may include staffing up with agency nurses, lost bed space due to quarantines, and the VBP payment exposure related to health care-associated infections that require hospitalization.</li><li>Compare these savings against device installation and operating costs. These vary widely by facility size, layout, and vendor. Factors such as installation, maintenance, and energy costs can make or break the ROI. Legitimate vendors will have robust figures ready to present during the ROI conversation. Administrators should always request a transparent cost breakdown from any vendor they speak to.</li></ol><h3>What Operators Can Do Now</h3><p>Being just one study, the <em>JAMDA</em> study has its limitations. The authors acknowledge the limited, single-center implementation and potential variations between care units, as well as reliance on electronic medical records, as potential confounding factors. But it contributes to a growing body of research that highlights the impact of indoor air quality on resident health. The <em>JAMDA</em> paper itself cites a systematic review showing that air filtration and decontamination can reduce respiratory infections in congregate care environments.</p><p>Some administrators worry that installing new air filtration appliances will be intrusive. But one of the best parts about continuous air disinfection is that it operates completely autonomously. Once installed, it does not require vacancy periods, staff compliance, or behavior changes from patients. Furthermore, induct hydroxyl radical generators like those used in the <em>JAMDA</em> study operate out of the way of patients and staff, keeping critical floor space clear.</p><p>LTC administrators tend to be cautious, and rightly so. To ease into the continuous air disinfection conversation, administrators can take these three practical steps.<br></p><ol><li><strong>Audit your infection data.</strong> Before any conversations with vendors, pull your infection event logs and hospitalization transfer rates so you know your baseline.</li><li><strong>Ask the right vendor questions.</strong> Is the system designed for continuous operation in occupied spaces? What purification technology does it use? Is there peer-reviewed, LTC-specific evidence for it? What is the installation, maintenance, and ongoing monitoring requirements?</li><li><strong>Consider a phased pilot. </strong>The <em>JAMDA</em> study validated the efficacy of continuous air disinfection at the unit level. A pilot in one wing would generate internal data before committing to a facility-wide upgrade.</li></ol><h3>No Going Back</h3><p>Air quality is no longer just an infection control issue. It is a financial performance issue, a workforce stability issue, and a regulatory risk issue. Administrators now have peer-reviewed, real-world evidence that continuous air disinfection in LTC facilities correlates with a clinically and operationally meaningful reduction in infection burden.</p><p><span><em><img src="/Articles/PublishingImages/2026/MahyarKhosravi.jpg" alt="Mahyar Khosravi" class="ms-rtePosition-1" style="margin:5px;" /></em></span>Air quality is emerging as a strategic lever for LTC facilities to potentially improve their cost structure and staffing stability. Administrators owe it to their facility’s patients and staff to start a conversation about this promising new direction for infectious disease control in LTC settings.<br><br><em>Mahyar Khosravi, P.Eng., is the chief executive officer and a member of the board at <a href="https://pyure.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Pyure Company, Inc.">Pyure Company, Inc.</a> Mahyar brings over two decades of experience in strategy, technology, and operations and holds a Bachelor of Science in Computer Engineering from the University of Calgary.</em></p><p><em><br></em></p><p><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></p> | 2026-07-23T04:00:00Z | <img alt="air quality" src="/Articles/PublishingImages/2026/air-quality.jpg" style="BORDER:0px solid;" /> | Quality;Caregiving | Mahyar Khosravi | Airborne disease transmission in LTC facilities has been treated as an uncontrollable background variable. However, scientific literature increasingly points to airborne transmission as a documented, persistent driver of infections in LTC facilities. |
| Proactive Decisions about Expanding Services | <p style="text-align:center;"><img src="/Articles/PublishingImages/2026/expanding-services_207Primrose.jpg" class="ms-rtePosition-4" alt="" style="margin:5px;" /></p><p>Service expansion has become one of the most important strategic conversations in senior living and post-acute care. As resident expectations shift, acuity rises, and market pressures intensify, providers are being asked to do more with the campuses they already own.<br><br>In many cases, the opportunity is not to build new, but to rethink what already exists. Underused spaces, outdated layouts, and legacy service models can often be repositioned to support new care lines, stronger resident experiences, and better long-term performance.<br><br>The challenge is knowing which opportunities are worth pursuing. That requires a disciplined look at market realities, resident needs, operational readiness, and the physical environment itself.<br></p><h3>Begin with Market Demand</h3><p>Any decision to expand services should begin with understanding what the market needs. A market demand study can reveal key trends in demographics, referral patterns, competitor offerings, and unmet or unclear resident expectations.<img src="/Articles/PublishingImages/2026/expanding-services_125Hoff17.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:500px;height:320px;" /><br></p><p>Your market demand study will help answer practical questions. Is there rising demand for memory care? Are more consumers seeking lower-cost alternatives to skilled nursing? Is there growing interest in short-term rehabilitation, enhanced assisted living, or hospitality-based amenities?<br><br>In most cases, formal analysis is reinforced by internal indicators such as wait lists, repeated requests from families, or referral relationships that point to consistent and/or unmet demand. When providers ground expansion decisions in measurable need rather than assumptions, they reduce risk and improve the odds that your business strategy will succeed.<br></p><h3>Look Beyond the Wait List</h3><p>Resident need is not identical to market demand, and that distinction matters. A campus may be known for one care model, yet its resident population may increasingly require something different as people age in place and stay on campus longer.<br><br>Communities built around independent living may find growing need for assisted living, memory support, or more flexible post-acute options. Some organizations are also discovering that reducing traditional skilled care beds and transitioning certain areas to lower-acuity residential models can better match family expectations and resident independence goals.<br><br>This type of repositioning can also create environments that feel less institutional and more like home. A careful review of resident profiles, family feedback, care transitions, discharge patterns, and unmet requests can reveal whether the current service mix still fits the people being served.<br></p><h3>Test Operational Readiness</h3><p>Even when a market opportunity is clear, expansion only succeeds if the organization can support it operationally. Adding a new care line requires more than renovating a wing or updating finishes.<br><br>It may involve new staffing models, different clinical workflows, regulatory requirements, training expectations, technology needs, and revised programming. Leaders should ask whether the organization can recruit and retain the right team and whether current systems can support the added complexity.<br><br>Not every market gap should be pursued. In some cases, a modest enhancement such as a bistro, a wellness amenity, or a short-term stay offering may create value without overextending staffing or operations.<br></p><h3>Study the Building’s Potential</h3><p>The physical environment has a direct impact on whether a service expansion can succeed. Existing buildings must be evaluated for code compliance, life safety requirements, circulation, lighting, privacy, and the ability to support the intended level of care.<br><br>Physical feasibility is about more than compliance alone. It is also about creating spaces that support dignity, safety, staff efficiency, and quality of life while still feeling homelike.<br><br><img src="/Articles/PublishingImages/2026/expanding-services_Skaalen-CBRF-res-room-5.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:500px;height:334px;" />A strong example is the renovation of Magnolia Gardens at Skaalen Retirement Services, a specialized, memory care community-based residential facility on the Skaalen Retirement Services campus in Stoughton, Wisconsin. In this case, an outdated skilled care setting was transformed into a 16-unit community-based residential facility. Double rooms were converted into private rooms with full baths. Lighting and access control were improved, and walls were opened to bring more daylight into interior spaces.<br><br>The renovation also introduced centralized staff areas, a full cooking and serving kitchen, a bathing spa, laundry space, and dual-purpose cabinetry. In order to achieve the desired vision, an analysis of code required changes and how to accomplish them was critical to getting the project approved for the new license. The project shows how understanding building licensing requirements can result in thoughtful solutions that are realistic to existing conditions; it can reposition a building for a different, more relevant care model.<br><br>Existing conditions may limit the possibilities for re-purposing spaces—it is better to understand this up front as you begin planning to avoid headaches down the road.<br></p><h3>Build the Strategy Across Disciplines</h3><p>The most effective expansion efforts are rarely led by one department alone. They come from collaboration among leadership, nursing, facilities, operations, and frontline staff who understand how residents actually experience the campus.<br><br>In the Magnolia Gardens project, staff from multiple departments contributed insight that helped the design respond to real and honest irritations, unmet workflow needs, and challenges to serving residents well. That kind of input is not a nicety; it is a practical way to reduce risk and improve implementation which leads to a healthy business model and ultimately a better bottom line.<br><br>When organizations engage stakeholders early, they are more likely to identify hidden barriers, avoid costly redesigns, and create solutions that work in daily practice rather than only on paper. That is often the difference between a compelling concept and an executable strategy. Deliberate and careful planning can pay dividends for the owners and for the residents. Upfront planning is one of the most important indicators of future success. <br></p><h3>Turning Capacity Into Capability</h3><p>Service expansion should never be a reactive move based on empty square footage or competitive pressure. The strongest strategies emerge when leaders evaluate market demand, resident need, operational readiness, and physical feasibility together. When those factors align, campuses can evolve in ways that are strategic, financially sound, and mission aligned.<br><br><em>Jon Rynish is a senior project architect with with <a href="https://www.hoffman.net/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Hoffman Planning, Design & Construction, Inc.</a> and a Leadership in Energy and Environmental Design (LEED) accredited professional. He can be reached at <a href="mailto:jrynish@hoffman.net" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">jrynish@hoffman.net.</a></em><br><br><em>Mike Edwin is a senior consultant – senior living and religious markets with Hoffman Planning, Design & Construction, Inc. He can be reached at <a href="mailto:medwin@hoffman.net" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">medwin@hoffman.net. </a></em><br><br><em>Julie Heiberger is a senior project architect and the senior living market leader for with Hoffman Planning, Design & Construction, Inc. A member of the American Institute of Architects, the National Council of Architectural Review Boards, and the Board of Directors of the Society for the Advancement of Gerontological Environments, Julie can be reached at <a href="mailto:jheiberger@hoffman.net" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">jheiberger@hoffman.net</a>.</em></p><p style="text-align:center;"><em><img src="/Articles/PublishingImages/2026/Jon-Rynish.jpg" alt="Jon Rynish" style="margin:5px;" />     <img src="/Articles/PublishingImages/2026/Mike-Edwin.jpg" alt="Mike Edwin" style="margin:5px;" />     <img src="/Articles/PublishingImages/2026/Julie-Heiberger.jpg" alt="Julie Heiberger" style="margin:5px;" /></em></p><p style="text-align:center;"><em><br></em></p><p style="text-align:left;"><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 </em>Provider<em> 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="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;"><span style="text-decoration:underline;"><em>Learn how to submit an article.</em></span></a></span><br></p> | 2026-06-18T04:00:00Z | <img alt="" src="/Articles/PublishingImages/2026/Hoffman.jpg" style="BORDER:0px solid;" /> | Management | Jon Rynish, Mike Edwin, and Julie Heiberger | Service expansion has become one of the most important strategic conversations in senior living and post-acute care. As resident expectations shift, acuity rises, and market pressures intensify, providers are being asked to do more with the campuses they already own. |