| Optimizing Medications for Fall Injury Patients | <p><img src="/Articles/PublishingImages/740%20x%20740/fall_risk.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:300px;height:300px;" />According to the National Council on Aging, an older adult suffering a fall-related injury is seen in an emergency department <a href="https://www.ncoa.org/article/get-the-facts-on-healthy-aging/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Get the Facts on Healthy Aging">every 11 seconds</a>. When patients arrive at a skilled nursing facility after breaking a bone in a fall, the focus is naturally on rehabilitation: physical therapy, pain management, wound care, and getting the patient mobile again. What often doesn’t happen is a careful review of the medications that may have increased their risk of falling in the first place, or a conversation about medications that could help prevent the next fall. This is the gap <a href="https://sites.duke.edu/prism/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">PRISM</a>—or Prevention of Injury in Skilled Nursing Through Optimizing Medications—hopes to close.<br><br>An ongoing study funded by the Patient-Centered Outcomes Research Institute (PCORI) and led by teams at Duke University School of Medicine and Harvard Medical School/Hebrew SeniorLife, PRISM revolves around a simple idea: that the days or weeks a patient spends in a SNF after a fall-related fracture is a rare, underutilized opportunity to rethink their medications. That might mean weaning off medications that increase fall risk, perhaps by causing drowsiness or dizziness; or it might mean adding treatment for osteoporosis, an often-undetected underlying condition that can increase the risk of fracture.<br><br>Forty-two SNFs have volunteered to participate. Working with a PRISM-provided fracture nurse consultant, who reviews medications and makes recommendations to the patient and patient’s care team, these SNFs are helping to answer the question about whether this approach improves patient outcomes. SNFs’ involvement after a simple onboarding process is critical to making this study succeed. <br></p><h2>“A Great Leverage Point”</h2><p>“Skilled nursing facilities are a really great leverage point to reach these patients,” said Cathleen Colón-Emeric, M.D., Professor of Medicine and Chief of the Division of Geriatrics at Duke University and PRISM’s principal investigator. “Sixty percent of these folks spend two weeks or so in post-acute care and in skilled nursing facilities receiving care, and that’s an opportune time to optimize their medications to improve their outcomes.”<br><br>“Taking the time to really think about those medications carefully and talk about them with a patient and family and make the decision to taper some of them is really important but takes a lot of provider time” she added. “We're trying to support the providers in doing that in a more efficient way.”<br><br>At San Francisco Center for Jewish Living, one of the participating SNFs, physician James Deardorff, sees PRISM as a way for SNFs to bring even more value to their patients by initiating needed conversations about appropriate prescribing. “Patients are here for an acute event, and so they’re more likely to be receptive to either de-prescribing or prescribing medications,” he said. “In this case, they’ve had a fracture that might be related to a fall and could be related to a medication adverse effect. I think this is a good time period to have these conversations.”<br><br>“We know that many people have underlying osteoporosis and don't receive treatment,” he added. “A lot of times, the decision to start a medication like a bisphosphonate ends up getting deferred from person to person. If we’re able to start these medications at a skilled nursing facility, it can benefit patients who have recently had a fracture and have an indication for these medications.”<br></p><h2>Treating the Overmedication Epidemic</h2><p>The data behind PRISM tell a sobering story. As a recent CDC fact sheet <a href="https://www.cdc.gov/falls/data-research/facts-stats/?CDC_AAref_Val=https://www.cdc.gov/falls/facts.htm" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Facts About Falls">explains</a>, roughly one million seniors are hospitalized for fall-related injuries every year, with almost 319,000 specifically experiencing hip fractures. Although more than 25% of older adults suffer falls every year, less than half of these falls are reported. Crucially, every fall increases the risk of another: per the CDC, “falling once doubles your chances of falling again.”<br><br>Making matters worse is the fact that many seniors are on a cocktail of medications with under-examined risks. According to a <a href="https://www.wsj.com/health/healthcare/americas-seniors-are-overmedicated-f397bb1d?st=37iWQh&reflink=desktopwebshare_permalink" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="America's Seniors Are Overmedicated">recent analysis</a> by the <em>Wall Street Journal,</em> “one in six seniors enrolled in Medicare’s drug benefit were prescribed eight or more medications at the same time.” Of this group, more than 3.9 million were on 10 or more drugs at the same time, and more than 419,000 were on 15 or more. These medications included sedatives and muscle relaxants that are already considered dangerous for seniors when taken by themselves, let alone in combination with other medications that impact the patient’s central nervous system. <br><br>The rising tide of overmedication is what PRISM aims to address. “Older adults accumulate more and more chronic diseases, they go to lots and lots of different providers for those different diseases,” Colón-Emeric said. “They get prescribed lots of different things focused on those diseases, but nobody’s kind of stepping back and looking at the whole picture or periodically reassessing to say, ‘Hey, is the risk of this medication still worth the benefit that the patient’s getting from it?’ They take, on average, 12 in skilled nursing facilities. Many are taking over 20, and a lot of those interact with each other.”<br><br>“After an injury, a fall, or a fracture, it’s a really important time to do a careful risk-benefit assessment of an older adult’s medications,” she added.<br></p><h2>A Light Touch</h2><p>PRISM is designed to make things as easy as possible for SNFs, adapting to their existing workflows rather than disrupting them. Participating communities designate a “facility champion”—typically a nurse—who serves as a liaison with the program. The champion’s duties are light; other than a short weekly check-in with PRISM, the job mostly involves coordinating paperwork between PRISM staff and the facility’s clinicians. <br><br>“It’s easy and smooth,” attested Sarah Fennimore, champion at Hudson Bay Health and Rehab in Vancouver, Washington. “Our building is between 75 and 80 people, and it probably takes five minutes per person.” Once she was onboarded into the process, she added, the main operational change was explaining to clinicians that a third party would be looking at fracture patients and making recommendations. “I feel like our doctors agree with their recommendations 95% of the time.” <br><br>From there, PRISM’s fracture nurse consultants take the lead. Working remotely with the support of an interprofessional team of geriatricians, osteoporosis specialists, and pharmacists, they review each patient’s chart and develop a “medication optimization plan”—a concise, one-page set of recommendations for the facility’s provider. The consultant reaches out to the patient and family to discuss the plan, relieving the facility of time-consuming conversations. When the patient transitions back to the community, PRISM nurses continue following up with them and their primary care providers, coordinating care and providing additional resources as needed.<br><br>The study compares three evidence-based approaches to medication optimization. Enrolled facilities cycle through all three in a randomized sequence, spending approximately six months on each: one focused on treating osteoporosis, one focused on deprescribing medications that increase fall risk, and one combining both strategies simultaneously. Facilities participate for 18 months, with the study involving minimal cost increases (typically from adding osteoporosis medication) or even cost reductions (from deprescribing existing medications).<br><br>“What we’re really trying to understand is whether focusing on osteoporosis medication management, deprescribing all those fall risk-increasing drugs, or doing both at the same time, results in better outcomes for patients and families,” Colón-Emeric said. “Facilities get all three of those focus areas in random sequence. They’ll get six months focused on osteoporosis, six months of de-prescribing, and six months of both.”<br></p><h2>Putting Patients First</h2><p>As PRISM fracture nurse consultant Rachel Passman-James explained, her role is to put the patient’s needs front and center. “We share our recommendations, but first we hear about what matters most to them so that we can use that to individualize the recommendations,” she said. “Making changes to your medication is a big deal, so there’s no pressure. We follow up with them at one month, so often they talk to their PCP before deciding on changes or just have more time to make a decision.”<br><br>Another important part of her job is ensuring that the program’s workflow is tailored to each facility’s unique profile. “Their needs vary depending on their geography, patient populations, whether they’re in a big city or rural area, if their patients are coming from big teaching hospitals or community hospitals,” she explained. At one Texas facility serving a predominantly Spanish-speaking population, for instance, her team learned to route recommendations through the physician first before speaking with patients. “They are more likely to accept a recommendation if a provider has already agreed on it,” she said. “So normally we come up with a plan, conduct shared-decision making, and then send it to the provider of the facility. But for this facility, I send it to the provider first and make sure they agree, and then I talk to the patients.”<br><br>For Deardorff, the PRISM onboarding process was a fairly simple matter: after identifying the right facility champion, his team and PRISM’s undertook an iterative process of finding the most efficient workflows. “We piloted putting the medication optimization plans in binders for different clinicians to look at, and the nurse champion would follow up with them and see if they have any questions about the recommendations,” he said. “The hard part is communication with clinicians. We’ve had to do repeated reminders around making sure they’re aware of what’s going on, so that when they see these sheets, they’re not like, ‘What is this and why do I need to sign it? Where is this recommendation coming from?’”<br><br><span><em><img src="/Articles/PublishingImages/2023/SethSimons.jpg" alt="Steve Manning" class="ms-rtePosition-2" style="margin:5px;width:170px;height:170px;" /></em></span>He added that PRISM’s own resources were helpful in facilitating that process—especially a one-page pocket card explaining the rationale for its recommendations. “The pocket card was super helpful,” he said. “Their website is great in terms of resources for deprescribing, bone health, and dosing recommendations.”<br></p><p><em>Steve Manning is a journalist based in New York City.</em></p><p><span style="font-family:aptos, arial, helvetica, sans-serif;font-size:12pt;"><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">Provider<span class="Apple-converted-space"> </span><em>magazine includes information from a variety of sources, such as contributing experts. The views expressed by external contributors do not necessarily reflect the views of<span class="Apple-converted-space"> </span></em>Provider<em> magazine and AHCA/NCAL.<span class="Apple-converted-space"> </span></em></span><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#96607d;"><em><a href="/About/Pages/Submit-Article.aspx" title="https://www.providermagazine.com/About/Pages/Submit-Article.aspx" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="color:#96607d;margin-top:0px;margin-bottom:0px;">Learn how to submit an article.</a></em></span><br></span></p> | 2026-04-16T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/fall_risk.jpg" style="BORDER:0px solid;" /> | Clinical;Falls | Steve Manning | According to the National Council on Aging, an older adult suffering a fall-related injury is seen in an emergency department every 11 seconds. When patients arrive at a skilled nursing facility after breaking a bone in a fall, the focus is naturally on rehabilitation. |
| Standardize Unit Turnover to Meet Rising Demand | <p><img src="/Articles/PublishingImages/2026/improvement.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:300px;height:300px;" />It's no secret that the Baby Boomers have changed the cultural landscape of the United States since their first arrival following WWII. The generation that caused rapid growth in suburbs and school districts and later in adulthood influenced business and industry, is now an aging population who will once again influence services meant for seniors.</p><p>Boomers today are roughly between the ages of 62 and 80 and are looking to downsize from the homes where they raised their families and move into senior living facilities, where maintenance is handled for them, safety features are adapted specifically for their needs, and a community is at the ready to welcome them in.</p><p>Because of this steady and growing trend, senior living facilities are becoming more popular. <a href="https://www.nic.org/news-press/occupancy-rate-for-senior-living-communities-increased-in-2025-as-construction-stalled/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="NIC research">Research conducted by NIC,</a> shows that a combination of high-demand facilities and limited new construction drove occupancy across all senior living property types in the fourth quarter of 2025. Independent living occupancy was above 90 percent, and assisted living occupancy was 87.7 percent.</p><p>Senior living properties that are able to meet this demand by quickly turning over units and placing new residents in vacant apartments will not only provide excellent customer service in an industry where wait lists can be long, but will also positively impact their bottom line. Quickly filling vacant apartments means less gaps in revenue. </p><h3>Standardization Is Key</h3><p>The key to success is standardization. The ability to turn over units is not just a customer service issue, helping seniors move into their new home more quickly, but also a business issue—the faster senior living communities can turn over vacated units, the better for the bottom line. Facilities managers should focus on standardizing the turnover process to eliminate redundancies. Using a checklist for all unit turns ensures all elements are addressed, eliminates guess-work, and keeps the team working as efficiently as possible. </p><h3>Maintenance</h3><p>As soon as a unit is vacated, the facilities team should conduct a thorough inspection to determine any maintenance that needs to be completed. One technique standardizes property inspections by having the team take a systematic approach by starting at the front door and following the left wall completely around the unit as a way to ensure 100 percent of the property is inspected and all needed repairs are identified. This reduces the need for multiple return trips to the unit.</p><p>Not only does this ensure a thorough sweep of the unit but inspecting units for repair the same way each time helps create an efficient system to identify any potential issue. </p><h3>Safety</h3><p>Every property manager should use a checklist to inspect the safety items needed in each unit to prepare for the next tenant. The facilities team should:<br></p><ul><li>Ensure smoke detectors and carbon monoxide detectors are functioning properly.</li><li>Check that a fire extinguisher is available in the kitchen and still current.</li><li>Ensure all appliances are working. </li><li>Test unit’s intercom system to ensure next resident can reach out in an emergency.</li><li>Confirm non-slip surfaces are still in place and functional.</li><li>Make sure grab bars in bathrooms and other key areas are secure.</li></ul><h3>Aesthetics</h3><p>It is important that facilities managers remember that their teams aren’t just turning over a unit for the next resident—they are preparing a property that will become someone’s home. The look and feel of the space are important factors that drive demand for senior living properties. Baby boomers don’t want to leave their long-term residences for sub-par apartments. Small details like the quality of the carpet and the look and feel of the kitchens and bathrooms make large impacts on future residents.</p><p>It is not unusual to need to replace carpeting and other flooring between tenants. It is important to choose durable materials that are quickly available and easy to install. High-quality vinyl flooring and stain resistant surfaces extend the lifespan within the unit. One of the most common refreshes in unit turns is repainting. It is one of the easiest ways to give a space a total facelift, making the unit look fresh, new, and ready to become a home. </p><h3>Leaning on Technology for Efficiency </h3><p>Facility managers work with many vendors to quickly turn over units. Today, it is becoming more common for service vendors to leverage technology to automate the administrative tasks associated with the job—pricing, scope of work and contracts can all be managed using automation.</p><p>Working with technology enabled vendors, like plumbing, electrical, flooring installation, or paint contractors with easy-to-use apps for booking, helps streamline workflows and ensure units can be quickly turned over for the next occupant.</p><p>Here is how it can work for painting vendors: the facilities manager works with the painting contractor to enter the schematics for each unit into the automated system. Pricing for the standard scope is agreed for each unit type, based on layout, number of bedrooms, and detail work that might be an add-on or vary by unit. When it comes time for one or more units to be painted, the facilities manager simply selects the location, the scope of work needing to be painted, and date for completion.</p><p>The system instantly alerts the paint contractor’s project manager, contracts are auto-generated, and a crew is scheduled and can be onsite within days—often as fast as within 24 hours.  Working with service vendors that use technology to automate the administration of paperwork, estimates, work orders, and contracts means that units can be quickly repaired, refreshed, and maintained in a streamlined manor that ensures the next tenant is able to move in quickly. </p><h3>The Bottom Line</h3><p><img src="/Articles/PublishingImages/2026/Richard%20Kilgannon.jpg" alt="Richard Kilgannon" class="ms-rtePosition-2" style="margin:5px;width:175px;height:175px;" />Baby Boomers are driving demand for senior living facilities. The locations that offer a luxurious ambiance will be highest in demand, with potentially long wait lists. Facilities managers can have lasting impact on the property’s bottom line by quickly and efficiently turning over units between residents. Using standardized processes and checklists will ensure streamlined maintenance, safety, and ambiance management. Partnering with vendors that have invested in technology to streamline the administrative side of work orders will ensure that units are turned quickly and ready to become home for the next resident. <br><br><em>Rich Kilgannon is the president and CEO of Arch Painting.</em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;"><br></span></em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">Provider<span class="Apple-converted-space"> </span><em>magazine includes information from a variety of sources, such as contributing experts. The views expressed by external contributors do not necessarily reflect the views of<span class="Apple-converted-space"> </span></em>Provider<em> magazine and AHCA/NCAL.<span class="Apple-converted-space"> </span></em></span><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#96607d;"><em><span style="text-decoration:underline;"><a href="/About/Pages/Submit-Article.aspx" title="Submit an article" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="color:#96607d;margin-top:0px;margin-bottom:0px;">Learn how to submit an article.</a></span></em></span><br></em></p> | 2026-04-07T04:00:00Z | <img alt="" src="/Articles/PublishingImages/2026/improvement.jpg" style="BORDER:0px solid;" /> | Caregiving | Richard Kilgannon | Senior living properties that are able to meet this demand by quickly turning over units and placing new residents in vacant apartments will not only provide excellent customer service in an industry where wait lists can be long, but will also positively impact their bottom line. |
| Senior Living Trends for 2026 and Beyond | <p><img src="/Articles/PublishingImages/2026/dr-meeting.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:430px;height:286px;" />For years, the senior living industry referred to the silver tsunami as a distant force approaching the horizon. In 2026, that wave is no longer theoretical. The oldest Baby Boomers are now in their seventies, and the next cohort is approaching retirement with longer life expectancies, strong consumer expectations, and a clear vision for how they want to live.</p><p>Through conversations and research, we’ve noticed that senior living providers are shifting from cautious observation to decisive action. Across the country, organizations are moving away from a “wait and see” approach and are instead acting on strategic initiatives that strengthen market position, modernize assets, and align communities with the preferences of a new generation of residents.</p><h3>A Return to Data-Driven Decision Making</h3><p>A renewed emphasis on market intelligence is shaping investment decisions. After several years of capital restraint, providers are commissioning market studies and reassessing competitive positioning to understand future demand more clearly. Many now recognize that existing facilities may not meet the expectations of younger Boomers, whose housing, travel, and lifestyle choices have long been defined by customization and quality.</p><p>Property evaluations increasingly determine whether communities can be repositioned through renovation or expansion, or whether full redevelopment is necessary. Rather than delaying decisions, providers are using data to clarify risk, prioritize investments, and plan for long-term viability.<br></p><h3>Independent Living Takes Center Stage</h3><p>The market continues to tilt toward independent living. While higher-acuity services remain essential, Boomers are delaying entry into senior living until they desire lifestyle benefits rather than care support. This shift is intensifying demand for detached living options, particularly for middle-income seniors who currently remain underserved.</p><p>In higher-end markets, providers are investing in Active Adult Plus models that resemble resort-style communities while incorporating infrastructure to layer in home health services as residents age. At the same time, organizations are exploring creative development strategies that make middle-market housing financially feasible without sacrificing quality or dignity.<br></p><h3><img src="/Articles/PublishingImages/2026/Arlington-12%20copy.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:450px;height:300px;" />Rising Expectations: Amenities as Lifestyle</h3><p>The incoming generation is not simply seeking housing; they are selecting a lifestyle. Communities designed for 2026 increasingly reflect hospitality driven environments rather than institutional models. Multiple dining venues, demonstration kitchens, wine storage, and high-quality recreational amenities are becoming standard features rather than premium upgrades.</p><p>Wellness has taken center stage. Traditional rehab gyms are giving way to holistic wellness centers that include hydrotherapy, yoga studios, strength training spaces, and outdoor meditation areas. These environments support vitality and well-being while reinforcing a lifestyle centered on health rather than physical decline.<br></p><h3>The Shift Toward Micro-Campuses</h3><p>Development patterns are evolving. New construction is trending away from isolated, sprawling campuses and toward integrated micro-campuses located within walkable urban or suburban town centers. Residents increasingly want to remain connected to the cultural energy and intergenerational activity they have long enjoyed.</p><p>Proximity to restaurants, arts venues, parks, and retail creates continuity rather than separation from community life. Partnerships with universities and cultural institutions are also expanding, offering access to lectures, performances, and lifelong learning opportunities that reinforce intellectual engagement and social connection.<br></p><h3>Renovation Over Replacement</h3><p>Economic pressures continue to shape development strategies. With interest rates and labor costs remaining elevated, renovations currently outpace new construction. Many providers are investing in targeted upgrades to lobbies, dining spaces, and common areas to modernize aesthetics and reposition their brand.</p><p><img src="/Articles/PublishingImages/2026/Skaalen%20CBRF%20main%20dining%203.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:450px;height:300px;" />However, superficial updates are no longer sufficient. Renovations must reflect fundamental lifestyle expectations, including larger residences, flexible living spaces, and integrated smart-home features that support independence and convenience.</p><h3>Mergers, Acquisitions, and Strategic Scale</h3><p>Mergers and acquisitions are on the rise, but the emphasis has shifted toward quality rather than scale. Buyers are pursuing Class A properties and assets with strong value-add potential instead of distressed portfolios.</p><p>At the same time, smaller single-site nonprofit providers are increasingly affiliating with larger regional systems to gain access to capital and operational resources needed for modernization. This consolidation allows organizations to invest in infrastructure improvements and remain competitive in an evolving marketplace.</p><h3>Designing for the Workforce</h3><p>Workforce challenges are influencing design in new ways as well. In a tight labor market, the physical environment has become a recruitment and retention tool. New projects prioritize back-of-house functionality and aesthetics, incorporating ergonomic workspaces, efficient layouts that reduce caregiver fatigue, and staff break areas with natural light and outdoor access.</p><p>Some communities are introducing amenities such as on-site childcare, flexible scheduling support areas, and staff wellness spaces. When the built environment supports employee well-being and efficiency, providers gain a meaningful advantage in attracting and retaining talent.</p><h3>Technology as Invisible Infrastructure</h3><p>Boomers entering senior living in 2026 are the most technologically fluent generation to date, and seamless connectivity is now a baseline expectation. High-speed Wi-Fi throughout a campus is essential infrastructure.<br>Communities are also integrating unobtrusive technologies such as AI-driven fall detection, passive health monitoring, smart-home controls, and circadian rhythm lighting systems. These innovations enhance safety and comfort while remaining largely invisible, allowing environments to feel residential rather than clinical.</p><h3>Meeting the Moment</h3><p>Taken together, these trends signal a decisive shift in industry posture. The senior living sector is moving from defensive positioning toward proactive growth and reinvention. While new construction remains expensive, the increase in property evaluations and renovation initiatives indicates that providers are no longer ignoring aging facilities or outdated models.</p><p><span><span><img src="/Articles/PublishingImages/2026/Mike-Edwin.jpg" alt="Mike Edwin" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" /></span></span>The resident emerging in 2026 does not view senior living as a last resort. Instead, it is a carefully chosen lifestyle emphasizing independence, wellness, connectivity, and meaningful engagement. Communities that align with these expectations will not merely absorb the coming wave of demand; they will help influence and define the future of aging.</p><p>The silver tsunami is no longer approaching. It has arrived. The defining question for providers now is whether they are prepared to meet this moment with environments, services, and strategies designed for a generation that is redefining what it means to be a senior adult in America.<br><br><span><em><img src="/Articles/PublishingImages/2026/Julie-Heiberger.jpg" alt="Julie Heiberger" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" /></em></span><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></p><p><em>Julie Heiberger is a senior project architect and the senior living market leader for Hoffman Planning, Design & Construction, Inc. She is 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. She 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><br></p> | 2026-03-31T04:00:00Z | <img alt="" src="/Articles/PublishingImages/2026/dr-meeting.jpg" style="BORDER:0px solid;" /> | Management;Caregiving | Mike Edwin and Julie Heiberger | Across the country, organizations are moving away from a “wait and see” approach and are instead acting on strategic initiatives that strengthen market position, modernize assets, and align communities with the preferences of a new generation of residents. |
| Balancing Building Access with Safety and Security | <p><img src="/Articles/PublishingImages/2026/nurse_security.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:400px;height:400px;" />Senior living facilities need to blend residential comfort, medical readiness, hospitality, and security into a single integrated ecosystem designed around the well-being of older adults. As these communities continue to evolve—from traditional assisted-living homes to sprawling, campus-style continuing care retirement communities—their operational demands have become increasingly complex.</p><p>At the heart of these complexities lies the need for reliable, intuitive, and integrated access control systems. These systems must balance safety and security with accessibility, and regulatory compliance with an atmosphere that still feels like home. Understanding the intricacies of senior living means recognizing the delicate interplay between human needs and the technologies that support them, particularly in controlling who can move where, when, and under what conditions.</p><h3>Diverse Access Needs</h3><p>One of the foundational challenges in senior living is the diversity of resident needs. A single facility may include independent-living apartments, assisted-living units, and memory care wings. Each of these environments comes with its own risk factors and considerations for freedom of movement. Residents in independent living expect near-total autonomy, often with minimal restrictions, whereas memory care residents require more structured mobility boundaries to mitigate risks such as wandering or elopement.</p><p>Integrated access control systems must therefore be capable of granular zoning, where doors, elevators, and outdoor spaces can enforce customized permissions based on the cognitive, physical, and medical profiles of individual residents. In addition to resident access, safe access and permissions can be granted for back-of-house offices, including administrative office spaces, medical and storage closets, and recordkeeping areas.</p><p style="text-align:left;">At the same time, senior living facilities are dynamic environments that welcome not just residents but families, caregivers, contractors, medical personnel, volunteers, delivery services, and third-party providers. This constant flow introduces unique security challenges. Facilities must track and manage a variety of credentials without inhibiting community engagement. Integrated, modern access control solutions, therefore, rely on cloud-based credentialing, visitor management software, and time-bound access credentials to streamline entry while maintaining auditability.</p><p style="text-align:left;">For example, a visiting nurse may receive a credential valid only for specific hours and areas. In contrast, family members may be granted privileges suited to their loved ones’ locations and care plans. This approach reduces administrative time and effort associated with traditional sign-in logs while providing real-time oversight and data analytics that support compliance and operational efficiency.</p><p>Emergency preparedness also plays a vital role in the design of access control systems in senior living. Access control must integrate with life-safety systems so that doors unlock or lock in accordance with the emergency scenario. </p><h3>Human-Centered Access</h3><p>Equally important is the human-centric aspect of system design. Residents in senior care communities often experience mobility impairments, vision limitations, or cognitive challenges that make traditional mechanical keys impractical. Access points must be intuitive, physically accessible, and often hands-free. Mobile-friendly technologies, facial identification systems, and automated doors help remove barriers and maintain residents’ independence.</p><p style="text-align:center;"><span><img src="/Articles/PublishingImages/2026/Rooney2.jpg" class="ms-rtePosition-4" alt="" style="margin:5px;width:799px;" /></span> </p><p style="text-align:left;">Change can be hard, especially for seniors. They become used to a particular process or behavior patterns. When implementing new technologies and solutions, significant consideration must be given to the existing processes and to technologies that residents feel comfortable using. For example, many seniors may not use a smartphone; they may still use a flip phone or feel uncomfortable with either. If a facility decides to implement a visitor-entry system that requires telephone approval or authorization from a resident, the new system must support both digital and analog communications.</p><p>For example, when the existing door hardware at some senior public housing facilities began failing, the housing complex sought to modernize the facilities' security by integrating advanced systems that would also accommodate residents' preferences. The selected solution needed to support card access security, audio and video intercom communication, cloud-based management, and residents' ability to answer door calls via landline or cellular phones via updated IP-based door stations.</p><p>Each resident was provided with a rights-managed key fob, an app for the video intercom, and a telephone intercom with caller ID identifying the intercom as “Front Door.” From their phones or intercoms, residents could temporarily unlock the front door to let guests inside. Additionally, resident-approved family members can be granted mobile keys through a cloud-based access control system and the video intercom app to access the building and the apartment door. Ongoing operating costs were reduced by eliminating nine dedicated PSTN phone lines, and each building now has a future-proof, low-maintenance, easy-to-use door security system.</p><h3>Analytics and Maintenance</h3><p>From a management perspective, data and analytics are increasingly valuable. Cloud-based platforms provide administrators with detailed reports on door events, staff movements, resident patterns, and system health. These insights can inform staffing decisions, maintenance planning, risk assessments, compliance audits, and even clinical strategies.</p><p>Finally, the implementation and ongoing maintenance of access control systems must account for the realities of senior living budgets, regulatory scrutiny, and staffing capabilities. Systems should be scalable as the community grows, easy for staff to administer, and backed by strong vendor support. Training is a continuous necessity, especially in settings with frequent staff changes. The most successful implementations are those where the technology fades into the background, supporting safety and efficiency without diminishing the warmth and sense of community that residents expect from their home.</p><p><img src="/Articles/PublishingImages/2026/Michael-Rooney.jpg" alt="Michael Rooney" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" />The intricacies of access control in senior living facilities extend far beyond locking and unlocking doors. They encompass a careful blending of safety, autonomy, compliance, clinical support, operational efficiency, and resident experience. The best systems acknowledge the nuanced needs of aging populations and the professionals who care for them, creating environments where technology quietly supports dignity, independence, and well-being.</p><p><em>Michael Rooney is the director of business development multifamily for ASSA ABLOY with over 20 years of experience in the access control and contract hardware distribution industries.</em></p><h4><span class="ms-rteFontSize-1" style="font-family:aptos, sans-serif;color:#212121;">Provider<span class="Apple-converted-space ms-rteFontSize-1"> </span><em>magazine includes information from a variety of sources, such as contributing experts. 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