| Virtual Care and Wearables to Manage Chronic Disease in Long Term Care | <p><img src="/Articles/PublishingImages/2026/wearable.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:350px;height:350px;" />Long term and post-acute care has always lived at the intersection of medicine, aging, and daily routine. Every resident brings a unique mix of chronic conditions, personal history, and day-to-day needs. Staff balance clinical complexity with daily schedules, and subtle changes often reveal themselves in small ways long before they become obvious problems. In this environment, catching early signs of decline is both essential and difficult.</p><p>In recent years, virtual care and wearable health devices have opened new possibilities by giving clinicians clearer visibility into residents’ health between visits. For the first time, long term care teams can see trends that were previously invisible: shifts in heart rate, nighttime oxygen levels, mobility patterns, and early signals of physiological stress. These insights offer a path toward more proactive and less crisis-driven care.</p><h3>The Chronic Care Reality in Long Term Care</h3><p>Residents in long term care often live with multiple chronic illnesses such as heart failure, COPD, diabetes, dementia, renal disease, and frailty. These conditions rarely worsen in dramatic episodes. Instead, they progress quietly:<br></p><ul><li>A small change in breathing.</li><li>A few disrupted nights of sleep.</li><li>Less movement or activity.</li><li>Slight agitation or confusion.</li><li>Irregular heart rate patterns.</li></ul><p>These are early signs of decline, but they’re easy to miss when daily routines are full. Historically, the industry has relied on intuition, experience, and routine vitals. Those skills remain indispensable, but they alone can’t cover the growing complexity of residents’ needs.</p><p>Wearables and virtual care don’t replace clinical intuition— they extend it.</p><h3>How Wearables Create Continuous Awareness</h3><p>Modern wearables used in long term care settings are not consumer gadgets. They’re lightweight, discreet, and designed for older adults who may not tolerate bulky devices. They can monitor:<br></p><ul><li>Heart rate and variability.</li><li>Oxygen saturation.</li><li>Sleep cycles.</li><li>Respiratory patterns.</li><li>Steps and mobility.</li><li>Gait changes.</li><li>Restlessness or nighttime wandering.</li><li>Indicators of stress or fatigue.</li></ul><p>The true value isn’t a single reading of the trajectory. A resident may look fine at 8 a.m., but the data from the previous night may tell a different story.</p><p>These devices quietly create a baseline for each resident, allowing clinicians to see when someone is deviating from their normal pattern—often days before symptoms appear.</p><h3>Virtual Care Turns Signals Into Meaningful Action</h3><p>Data doesn’t help unless someone is responsible for interpreting it. Virtual care teams, remote nurses, physicians, and advanced practice providers bridge that gap. They monitor trends, review alerts, and coordinate with on-site staff.</p><p>A typical workflow may look like this:<br></p><ol><li>Residents wear a device that passively collects vital data.</li><li>When the data deviates from baseline, an alert is generated.</li><li>A virtual clinician reviews the trend and confirms whether it’s clinically meaningful.</li><li>The virtual team contacts the facility to gather context.</li><li>If needed, a virtual consultation happens the same day.</li><li>Treatment adjustments, medication changes, hydration, breathing exercises, or closer observation are made quickly.</li></ol><p>This process doesn’t disrupt staff routine; it strengthens it. Instead of scrambling during emergencies, teams can address issues while they’re still manageable.</p><h3>Case Example 1: Preventing a Heart Failure Exacerbation</h3><p>A resident with chronic heart failure begins showing a subtle rise in nighttime heart rate and a gradual drop in mobility over three days. Staff hadn’t noticed major symptoms yet.</p><p>A virtual nurse reviewing the data flags the trend and contacts the facility. After a quick assessment, the provider adjusts the resident’s diuretic dose and orders extra monitoring. Within 24 hours, the resident stabilizes, avoiding what could have been a hospitalization.</p><h3>Case Example 2: Early COPD Detection Before an Emergency</h3><p>A resident with COPD experiences small drops in oxygen saturation overnight, still within “safe” ranges but lower than their personal baseline. The wearable catches the change long before the resident feels short of breath.</p><p>A virtual provider evaluates the pattern, conducts a same-day virtual check, and adjusts inhaler use. The resident improves without needing an ER visit.</p><p>These small interventions add up: fewer transfers, fewer acute episodes, and more predictable care.</p><h3>The Benefits for Long Term Care Providers</h3><p><strong>1.    Fewer Avoidable Hospital Transfers.</strong><br>Early intervention can prevent many common causes of hospitalization fluid overload, infection, respiratory decline, dehydration, and medication complications.</p><p><b>2.    More Stable Workflows.<br></b>Instead of reacting to emergencies, staff can address issues earlier when they are easier to manage.</p><p><b>3.    Better Clinical Documentation.<br></b>Continuous data provides objective evidence for care plans, surveys, and family conversations.</p><p><strong>4.    Stronger Family Confidence.</strong><br>Families appreciate knowing their loved ones are monitored throughout the day and night.</p><p><strong>5.    Support for Staffing Challenges.</strong><br>In periods of staffing shortages, virtual monitoring acts as an extra layer of awareness, reducing the burden on on-site teams.</p><h3>Implementation Challenges and How to Avoid Them</h3><p>Long term care facilities must consider several practical factors when adopting wearables:<br></p><ul><li><strong>Choosing the Right Devices:</strong> Devices must be comfortable, durable, and suitable for older adults including those with cognitive impairment.</li><li><strong>Avoiding Alert Fatigue: </strong>Alerts need to be based on changes from each resident’s baseline, not rigid population-level thresholds.</li><li><strong>Training Staff: </strong>Clear roles are essential so staff know when to escalate concerns and when virtual teams will take the lead.</li><li><strong>Electronic Health Record Compatibility:</strong> Not all systems integrate smoothly; sometimes a middleware or dashboard is necessary.</li><li><strong>Resident Tolerance and Privacy: </strong>Consent, comfort, and respectful use remain central.</li></ul><p>These challenges are manageable with thoughtful planning.</p><h3>A New Model for Proactive Care</h3><p>Long term care has always valued early detection, but until recently, the tools weren’t available to consistently support it. Wearables and virtual monitoring allow teams to shift from a reactive model responding to visible symptoms to a proactive one where subtle changes trigger early action.</p><p>This isn’t about replacing people. It’s about giving clinicians the information they need but didn’t have access to. It allows nurses to intervene earlier. It helps residents stay stable in the place they call home. It reduces stress for staff and supports better clinical outcomes without adding to their daily workload.</p><p><img src="/Articles/PublishingImages/2026/Vaishnavi-Gadve.jpg" alt="Vaishnavi Gadve" class="ms-rtePosition-2" style="margin:5px;" />As chronic disease becomes more complex and resident needs continue to grow, facilities need tools that help them stay ahead, rather than catching up. Virtual care and wearables are not a luxury; they are becoming a foundational part of modern long term care. They help the industry move toward a future where fewer problems escalate, fewer residents experience preventable decline, and more care is delivered before and not after crisis strikes.<br><br><em>Vaishnavi Gadve is a research-driven health care engineer specializing in advanced language models and data-driven clinical decision systems. She works across the full lifecycle of digital health solutions building scalable pipelines, designing intelligent prototypes, and applying predictive modeling to solve real problems in care delivery. She can be contacted at <a href="mailto:vaishnavigadve143@gmail.com" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">vaishnavigadve143@gmail.com</a>.</em></p><p><em><br></em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;"></span></em></p><p><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">Provider<span class="Apple-converted-space"> </span><em>magazine includes information from a variety of sources, such as contributing experts. The views expressed by external contributors do not necessarily reflect the views of</em><span class="Apple-converted-space"> </span><em>Provider</em><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;"><span style="text-decoration:underline;"><a href="/About/Pages/Submit-Article.aspx" title="https://www.providermagazine.com/About/Pages/Submit-Article.aspx" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="color:#96607d;margin-top:0px;margin-bottom:0px;"><em>Learn how to submit an article.</em></a></span></span><br></p> | 2026-01-06T05:00:00Z | <img alt="" src="/Articles/PublishingImages/2026/wearable.jpg" style="BORDER:0px solid;" /> | Caregiving;Technology | Vaishnavi Gadve | In recent years, virtual care and wearable health devices have opened new possibilities by giving clinicians clearer visibility into residents’ health between visits. |
| Top 5 ProviderTV Videos of 2025 | <p><img src="/Video-Resources/ProviderTV/PublishingImages/ProviderTV-03.png" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:140px;" />As we close out 2025, we're looking back at the videos that captured our attention, sparked conversation, and racked up the most views this year. From value-based care to technology to rationalizing regulations, these five videos rose to the top. Whether you watched them all or if you missed one, now is the perfect time to watch (or re-watch!) these videos to stay on top of the important topics of 2025.<br></p><p>
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</p><table cellspacing="0" class="ms-rteTable-2" style="width:75%;height:1383px;"><tbody><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2" style="width:5%;"><h1>
1.</h1></td><td class="ms-rteTableOddCol-2" style="width:33.3333%;text-align:center;"><a href="https://www.youtube.com/watch?v=geQC5cD7MCQ" title="Scott Rifkin" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><br><img src="/Articles/PublishingImages/2025/ScottRifkin.jpg" class="ms-rtePosition-5" alt="" style="margin:5px;width:200px;height:200px;" /></a></td><td class="ms-rteTableEvenCol-2" style="width:33%;"><h1><a href="https://www.youtube.com/watch?v=geQC5cD7MCQ" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Better Outcomes Through Value-Based Care with Dr. Scott Rifkin</a></h1></td></tr><tr class="ms-rteTableOddRow-2"><td class="ms-rteTableEvenCol-2" style="width:5%;"><h1>
2.</h1></td><td class="ms-rteTableOddCol-2" style="text-align:center;"><br><a href="https://www.youtube.com/watch?v=xZEGQ9IzzWM" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><img src="/Articles/PublishingImages/2025/PCC.jpg" alt="" style="margin:5px;width:200px;height:200px;" /></a><br></td><td class="ms-rteTableEvenCol-2" style="width:33%;"><h1><a href="https://www.youtube.com/watch?v=xZEGQ9IzzWM" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Using Technology to Navigate Changing Regulations</a><br></h1></td></tr><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2" style="width:5%;"><h1>
3.</h1></td><td class="ms-rteTableOddCol-2" style="text-align:center;"><a href="https://www.youtube.com/watch?v=7T-M4D7XQk4" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><br><img src="/Articles/PublishingImages/2025/HollyHarmon.jpg" alt="" style="margin:5px;width:200px;height:200px;" /></a></td><td class="ms-rteTableEvenCol-2" style="width:33%;"><h1><a href="https://www.youtube.com/watch?v=7T-M4D7XQk4" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Rationalizing Regulations with Holly Harmon</a></h1></td></tr><tr class="ms-rteTableOddRow-2"><td class="ms-rteTableEvenCol-2" style="width:5%;"><h1>
4.</h1></td><td class="ms-rteTableOddCol-2" style="text-align:center;"><a href="https://www.youtube.com/watch?v=8xb9GmJScvQ" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><br><img src="/Articles/PublishingImages/2025/NickTrankito.jpg" alt="" style="margin:5px;width:200px;height:200px;" /></a></td><td class="ms-rteTableEvenCol-2" style="width:33%;"><h1><a href="https://www.youtube.com/watch?v=8xb9GmJScvQ" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Forming a Collaborative Partnership with Nick Trankito</a></h1></td></tr><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2" style="width:5%;"><h1>
5.</h1></td><td class="ms-rteTableOddCol-2" style="text-align:center;"><a href="https://www.youtube.com/watch?v=8hLlin5u7XI" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><br><img src="/Articles/PublishingImages/2025/SamVosloo.jpg" alt="" style="margin:5px;width:200px;height:200px;" /></a><br></td><td class="ms-rteTableEvenCol-2" style="width:33%;"><h1><a href="https://www.youtube.com/watch?v=8hLlin5u7XI" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Defining Value-Based Care Success with Samantha Vosloo</a></h1></td></tr></tbody></table> | 2025-12-30T05:00:00Z | <img alt="" height="514" src="/Video-Resources/ProviderTV/PublishingImages/ProviderTV-03.png" width="740" style="BORDER:0px solid;" /> | Caregiving;Management | | Whether you watched them all or if you missed one, now is the perfect time to watch (or re-watch!) these videos to stay on top of the important topics of 2025. |
| Looking Back: Top 10 Provider Articles of 2025 | <p style="text-align:center;"><img src="/Articles/PublishingImages/740%20x%20740/top10.jpg" alt="Top 10" class="ms-rtePosition-4 ms-rteImage-0" style="margin:5px;width:400px;height:400px;" /></p><p>As we close the books on 2025, the long term care landscape continues to evolve at a remarkable pace. This year brought both challenges and breakthroughs, from technological innovations transforming dementia care to pressing policy debates that will shape the future of our industry.</p><p>These top 10 articles represent more than just popular content—they reflect the questions you're asking, the challenges you're facing, and the future you're building. <br></p><table cellspacing="0" class="ms-rteTable-2" style="width:100%;height:2871px;"><tbody><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2" style="width:10%;"><h1>1.<br></h1></td><td class="ms-rteTableOddCol-2" style="width:25%;"><img src="/Articles/PublishingImages/2025/AI_memory.jpg" alt="" style="margin:5px;width:200px;" /><br></td><td class="ms-rteTableEvenCol-2" style="width:65%;">
<h2><a href="/Articles/Pages/The-Promise-of-AI-Companions-in-Memory-Care.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">The Promise of AI Companions in Memory Care</a><br></h2><p>
<span style="color:#555555;">AI continues to redefine health care, offering tools that address complex challenges with precision and scalability. Among its most promising applications is the use of AI companions in memory care.   </span><br></p></td></tr><tr class="ms-rteTableOddRow-2"><td class="ms-rteTableEvenCol-2"><h1>2.</h1></td><td class="ms-rteTableOddCol-2"><img src="/Articles/PublishingImages/740%20x%20740/nurse_patient.jpg" alt="" style="margin:5px;width:200px;height:200px;" /></td><td class="ms-rteTableEvenCol-2"><h2><a href="/Articles/Pages/Long%20Term%20Care%202025%20Trends%20and%20Outlook.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Long Term Care 2025 Trends and Outlook</a><br></h2><p>
<span style="color:#555555;">The evolving industry looks to technology, training, wellness, and better communication to meet residents’ needs.</span><br></p></td></tr><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2"><h1>3.</h1></td><td class="ms-rteTableOddCol-2"><img src="/Articles/PublishingImages/2025/SkaalenCBRF-1.jpg" alt="" style="margin:5px;width:200px;height:200px;" /></td><td class="ms-rteTableEvenCol-2"><h2><a href="/Articles/Pages/5-Steps-to-Reconfigure-Skilled-Nursing-Facilities-to-Assisted-Living-Facilities.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">5 Steps to Reconfigure Skilled Nursing Facilities to Assisted Living Facilities</a><br></h2><p>
<span style="color:#555555;">As providers grapple with new demands, one strategy gaining traction is the reconfiguration of skilled nursing facilities into spaces with less intensive staffing needs, such as assisted living facilities.  </span><br></p></td></tr><tr class="ms-rteTableOddRow-2"><td class="ms-rteTableEvenCol-2"><h1>4.</h1></td><td class="ms-rteTableOddCol-2"><img src="/Articles/PublishingImages/2025/music-therapy.jpg" alt="Bridgetown Music showing “Music with Alexis” " style="margin:5px;width:200px;height:200px;" /></td><td class="ms-rteTableEvenCol-2"><h2><a href="/Articles/Pages/Advancing-Music-Therapy-Approaches-in-Dementia-Care.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Advancing Music Therapy Approaches in Dementia Care</a><br></h2><p>
<span style="color:#555555;">As senior living communities continue to seek meaningful ways to support their residents, both individualized music therapy and structured group-based </span><span style="color:#555555;">programs offer complementary solutions.  </span><br></p></td></tr><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2"><h1>5.</h1></td><td class="ms-rteTableOddCol-2"><img src="/Articles/PublishingImages/740%20x%20740/Spring25.jpg" alt="Spring 2025 issue" style="margin:5px;width:200px;height:200px;" /></td><td class="ms-rteTableEvenCol-2"><h2><a href="/Issues/2025/Spring/Pages/default.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Spring 2025 Issue of
<em>Provider</em></a></h2><p>
<span style="color:#555555;">When it seems that everything is changin</span><span style="color:#555555;">g—new regulations, different guidelines, unknown timetables—we naturally search for something that isn’t shifting. In the long term care sector, one thing that doesn’t change is our focus on delivering the highest quality of care for our residents.</span><br><br></p></td></tr><tr class="ms-rteTableOddRow-2"><td class="ms-rteTableEvenCol-2" rowspan="1"><h1>6.<br></h1></td><td class="ms-rteTableOddCol-2" rowspan="1"><img src="/Articles/PublishingImages/2025/nurse_paperwork.jpg" alt="" style="margin:5px;width:200px;height:200px;" /></td><td class="ms-rteTableEvenCol-2" rowspan="1"><h2><a href="/Articles/Pages/How-to-Structure-Your-Compliance-Program.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">How to Structure Your Compliance Program</a><br></h2><p>
<span style="color:#555555;">It is important that an organization have a formal compliance program as proactive and preventive; a structure to address issues; and as a mitigating factor should compliance violations be identified by regulatory agencies.  </span><br></p></td></tr><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2" rowspan="1"><h1>7.</h1></td><td class="ms-rteTableOddCol-2" rowspan="1"><img src="/Articles/PublishingImages/740%20x%20740/medications_4.jpg" alt="" style="margin:5px;width:200px;height:200px;" /></td><td class="ms-rteTableEvenCol-2" rowspan="1"><h2><a href="/Articles/Pages/Polypharmacy-Is-a-Problem-in-Senior-Care.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Polypharmacy Is a Problem in Senior Care</a><br></h2><p>
<span style="color:#555555;">Addressing polypharmacy is not just a medical issue; it's a critical aspect of providing holistic, patient-centered care that respects the complexities of aging. </span><br></p></td></tr><tr class="ms-rteTableOddRow-2"><td class="ms-rteTableEvenCol-2" rowspan="1"><h1>8.</h1></td><td class="ms-rteTableOddCol-2" rowspan="1"><img src="/Articles/PublishingImages/2025/data-funnel.jpg" alt="data funnel" style="margin:5px;width:200px;height:200px;" /></td><td class="ms-rteTableEvenCol-2" rowspan="1"><h2><a href="/Articles/Pages/Improving-Section-GG-Accuracy-Through-QAPI.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Improving Section GG Accuracy Through QAPI</a><br></h2><p>
<span style="color:#555555;">Common issues are incomplete or missing observations, inconsistent input across disciplines, or the lack of an interdisciplinary effort to determine usual performance. The QAPI process is an effective method for facility teams to identify and address the root causes of these issues. </span><br></p></td></tr><tr class="ms-rteTableEvenRow-2"><td class="ms-rteTableEvenCol-2" rowspan="1"><h1>9.</h1></td><td class="ms-rteTableOddCol-2" rowspan="1"><img src="/Articles/PublishingImages/740%20x%20740/Medicaid.jpg" alt="" style="margin:5px;width:200px;height:200px;" /></td><td class="ms-rteTableEvenCol-2" rowspan="1"><h2><a href="/Articles/Pages/Medicaid-Cuts-Would-Devastate-Providers-Serving-ID-DD-Populations.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Medicaid Cuts Would Devastate Providers Serving ID/DD Populations</a><br></h2><p>
<span style="color:#555555;">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.</span><br></p></td></tr><tr class="ms-rteTableOddRow-2"><td class="ms-rteTableEvenCol-2" rowspan="1"><h1>10.</h1></td><td class="ms-rteTableOddCol-2" rowspan="1"><img src="/Articles/PublishingImages/740%20x%20740/nurse_patient4.jpg" alt="nurse with patient" style="margin:5px;width:200px;height:200px;" /><br></td><td class="ms-rteTableEvenCol-2" rowspan="1"><h2><a href="/Articles/Pages/Modern-Care-for-a-Modern-World.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083">Modern Care for a Modern World</a><br></h2><p>
<span style="color:#555555;">In the current health care environment, a skilled nursing facility needs the most advanced technology available. </span><br></p></td></tr></tbody></table><p>
<br>
</p> | 2025-12-23T05:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/top10.jpg" style="BORDER:0px solid;" /> | Caregiving;Management | | These top 10 articles represent more than just popular content—they reflect the questions you're asking, the challenges you're facing, and the future you're building. |
| The Complexities of Assisted Living Fire Evacuation Planning | <p style="text-align:center;"><img src="/Articles/PublishingImages/2025/189661849_fire.png" class="ms-rtePosition-3" alt="" style="margin:5px;width:400px;height:233px;" /></p><p>The popularity of assisted living communities continues to grow as aging individuals look to simplify their lives while receiving limited support and maintaining much of their independence. Residents in assisted living communities can benefit from custodial or personal care services including prepared meals, transportation, and basic medical assistance while shedding the challenges associated with managing their own home and property as they transition toward needing additional care.</p><p>The tragic fatal fire that occurred on July 13, 2025, at the Gabriel House assisted living community in Fall River, Mass., has reignited a critical and complex conversation around assisted living fire evacuation planning—specifically, how well communities understand their unique fire protection features, evolving resident capabilities, staffing availability, and ongoing training and drills. </p><h3>Fire Protection Challenges</h3><p>One of the primary challenges stems from overlapping regulatory frameworks. Fire and life safety requirements are governed by individual state building codes (often based upon the International Building Code), the Life Safety Code (NFPA 101), and various state-specific licensure rules. Each of these codes and regulations approach assisted living occupancies differently, affecting criteria for construction, egress, fire protection systems, and even staffing. Communities are often caught between conflicting or inconsistent standards, especially when states adopt different versions or impose unique amendments.</p><p>This risk may also be impacted by building design features. Some communities incorporate smoke barrier wall assemblies that allow for horizontal evacuation, moving residents to a protected area on the same floor without leaving the building. While others rely on full evacuation to the exterior every time a fire alarm activates. This distinction affects evacuation planning and may create challenges, especially during nighttime hours or in inclement weather.</p><p>Another critical variable is the sprinkler system. Communities equipped with systems fully compliant with NFPA 13 provide comprehensive sprinkler coverage, whereas those meeting NFPA 13R, a residential standard, may omit sprinklers in certain areas, including attics, concealed combustible spaces, exterior overhangs, small closets, and bathrooms. </p><h3>Resident Capabilities and Staffing Availability</h3><p>Adding to this complexity is the assisted living model itself. It’s common for residents who are mobile and capable of self-preservation upon move in to later experience a gradual decline in mobility and/or cognition. Yet, the community’s original design and classification may not change to reflect these evolving realities, leading to a growing gap between code assumptions and actual risk.</p><p>Staffing levels also vary from one assisted living community to another, particularly overnight, when fewer staff members are available to initiate a community’s fire response procedures and provide direction and assistance to residents. Support and guidance are particularly important for residents who may have mobility or cognitive impairment. </p><h3>Evacuation Response Plan</h3><p>All of these factors play a role in determining a community’s fire and evacuation response plan, and specifically its ability to defend in-place, relocate within the building (progressive evacuation), or execute a complete building evacuation. Codes and regulations aside, the following factors must be addressed to consider options other than full building evacuation.<br></p><ul><li><strong>Building Compartmentation with Smoke Barriers: </strong>Similar to a health care facility, smoke barrier walls must be in place to divide each floor into two or more compartments. Smoke barrier walls are designed to be continuous from floor to floor and outside wall to outside wall with any penetrations sealed to limit the passage of smoke. Smoke barrier walls minimize the ability for smoke to travel to adjacent portions of the building, allowing for the horizontal relocation of occupants to unaffected portions of the same floor. </li><li><strong>Comprehensive Sprinkler Coverage:</strong> A sprinkler system designed and in compliance with NFPA 13 will provide complete and comprehensive sprinkler protection throughout the building. Buildings with NFPA 13R systems are permitted to omit sprinklers in attic spaces. This can allow a fire to spread through the attic, requiring full evacuation of the building without delay. </li><li><strong>Early Fire Detection:</strong> Smoke detectors installed throughout building common areas can provide early notification to building staff, residents, and the local fire department to enable quicker execution of a building fire response plan.</li><li><strong>Staffing:</strong> If residents are directed to remain in the building, whether in their apartments or another interior location, trained staff must be available at all times to respond to the fire/alarm area and provide direction to residents. If there are times when staff are not on-site and available for that role, the expectation is that residents will evacuate the building under their own power, remaining at an assembly location until otherwise directed by fire department personnel. </li></ul><h3>Staff and Resident Training </h3><p>The success of any fire safety program, regardless of the type of evacuation, relies on an effective staff training and testing program. Periodic staff training on the community fire response plan, including specific roles and responsibilities, is critical. While training can be presented through various mechanisms, in-person training that includes building familiarization, an overview of evacuation routes, familiarization with the fire alarm system, and highlighting the location of smoke barrier walls is a comprehensive training program. In-person training also allows for real-time questions and answers.</p><p>In similar fashion, residents should receive training upon admission and then at predetermined frequencies thereafter that clarifies their role and appropriate response during a fire or upon hearing the fire alarm. This includes instruction on whether they should remain in place while waiting for further direction or if they should automatically commence evacuation upon activation of the fire alarm system.</p><p>Education on the functionality of the fire alarm system is particularly important for assisted living residents. Apartment smoke detectors may only sound locally upon activation, therefore requiring the building-wide fire alarm to be activated manually. The systems in place and resulting response may be very different from what residents were familiar with in their previous residential settings.</p><p>Training is specifically identified as a lesson learned in the Gabriel House Fire After Action Report, prepared by the Fall River Fire Department and released on October 21, 2025. The report states that, “staff and residents must be trained in shelter-in-place and compartmentalization strategies, including maintaining closed doors and using designated refuge areas, while also recognizing when conditions require prompt evacuation to triage or transport points. While shelter-in-place was not feasible at Gabriel House, it should be strongly considered whenever appropriate.”</p><p>Fire drills are an excellent way to both test and educate. Fire drills test staff and resident knowledge, validate the effectiveness of procedures, verify resident evacuation capability, and provide an opportunity to learn through actions. An effective fire drill program will incorporate all aspects of the community fire procedure, including activation of the alarm, containment of the fire and smoke, implementation of the appropriate evacuation strategy, communications, and accountability. Fire drills are best conducted on different days and at different times. Most states have detailed requirements related to fire drills.</p><p>Coordination and collaboration with the local fire department is essential to ensure positive fire outcomes. It is critical that fire department personnel are familiar with the building, the fire safety plan, and resident capabilities. These factors will affect their pre-planning efforts and help establish proper expectations when they respond to the community, minimizing surprises.</p><p><span><em><img src="/Articles/PublishingImages/2025/DaveHood.jpg" alt="Dave Hood" class="ms-rtePosition-1" style="margin:5px;" /></em></span>Ultimately, assisted living communities require a customized fire safety and evacuation planning approach that complies with applicable codes. Additionally, an assessment of the building design, staffing patterns, and fire protection features should be coupled with an ongoing risk assessment that considers the changing capabilities and needs of the residents. While the analysis required to properly develop emergency procedures can be complicated, the product should be a clear and concise set of fire and evacuation procedures tailored to the building and its occupants. By ensuring proper procedures are in place, assisted living communities can better protect both their residents and staff, ensuring safety remains at the heart of care. <br><br><em>David Hood is a technical fellow at Jensen Hughes and a past Chairman of the National Fire Protection Association (NFPA) Health Care Section Executive Board. He currently serves as the Chair of the Health Care Section Education Committee. Hood also has fire service experience at the Company Officer level in Prince George’s County, MD, and Monroe County, NY, and previously served as the Fire Chief in Honeoye Falls, NY.</em></p><p><em><br></em></p><p><em><span style="font-style:normal;font-weight:400;letter-spacing:normal;text-align:start;text-indent:0px;text-transform:none;white-space:normal;word-spacing:0px;text-decoration:none;font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">Provider<span class="Apple-converted-space"> </span><em>magazine includes information from a variety of sources, such as contributing experts. 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