| How Housekeeping Standardization Strengthens Survey Readiness | <p><strong class="ms-rteThemeForeColor-2-0">ADVERTORIAL</strong></p><p style="text-align:center;"><img src="/Articles/PublishingImages/2026/staples_Healthcare_SupplyCloset_3882.jpg" alt="" style="margin:5px;width:500px;height:333px;" /> </p><p>For long term care and senior living providers, regulatory expectations continue to intensify. Infection prevention standards are more prescriptive, environmental services practices receive heightened scrutiny, and surveyors increasingly assess whether processes are executed consistently across units, shifts, and facilities.</p><p>Amid staffing shortages and rising costs, many organizations struggle to maintain that consistency. One often overlooked factor is how housekeeping and environmental services (EVS) supplies are selected, managed, and used.</p><p>Housekeeping standardization offers a practical way to strengthen survey readiness. By aligning products, purchasing, and workflows across facilities, operators can reduce variation, support staff training, and create more defensible, repeatable practices during survey.</p><h3>Why Variation Creates Compliance Risk</h3><p>Surveyors not only assess whether appropriate supplies are available, but whether staff consistently understand how and when to use them. When multiple brands, formats, or SKUs are in circulation, training becomes more complicated and execution less reliable.</p><p>“When staff know exactly what to use and how to use it, execution becomes more consistent and errors decline,” says Greg Hemmer, a health care facilities solutions expert with Staples Business.</p><p>From a regulatory perspective, standardization reduces the likelihood of improper product use, dilution errors, or substitution during supply shortages. It also supports clearer documentation and consistent protocols, both of which can be critical during survey review.<br></p><h3>Gaining Visibility Across Facilities</h3><p>Another regulatory challenge for multi-site operators is limited visibility into purchasing practices. Without centralized oversight, leadership may struggle to confirm whether approved products are being used or if individual facilities are introducing unapproved alternatives.</p><p>That was the case for Claiborne Senior Living, which owns and operates 17 senior living communities across the Southeast. Each property had historically purchased its own housekeeping and environmental services supplies from various vendors.</p><p>“We needed a clearer picture of what each community was spending and what they were actually buying,” says Molly Crawford, asset manager for Claiborne Senior Living. “Not just from a cost standpoint, but for consistency.”</p><p>Working through its group purchasing organization, HPSI Purchasing Services, Claiborne explored opportunities to standardize purchasing across facilities. Certain vendor partners, including Staples, were identified as resources that could support consistent product selection, site-level quantities, and consolidated reporting.<br></p><h3>Aligning Supplies with Regulatory Expectations</h3><p>Like many long term care leaders, Crawford initially associated Staples primarily with office supplies. What she learned was that Staples supports health care providers across categories including housekeeping, dispensers, furniture, technology, and print, and maintains relationships with major GPOs serving the sector.</p><p>Staples analyzed Claiborne’s historical purchasing data and identified opportunities to reduce variation, consolidate SKUs, and align products across communities. The immediate financial impact was clear.</p><p>“It was an automatic 17 percent savings,” Crawford says. “Across 17 buildings, that’s significant. Small costs really do add up.”</p><p>Equally important, leadership gained confidence that every community had access to the same approved products, helping reduce compliance risk when surveyors assess practices across locations or revisit findings.<br></p><h3>Ensuring Availability Without Disruption</h3><p>Standardization must be paired with reliable access to supplies. Delays or substitutions can disrupt care and undermine compliance, particularly during peak demand or severe weather events.</p><p>“Timing is critical,” Crawford says. “Our business doesn’t stop. We can’t wait days for critical supplies.”</p><p>To minimize risk, Claiborne piloted standardized products at one community before expanding systemwide. The gradual rollout gave teams time to validate product performance, confirm staff adoption, and ensure delivery timelines aligned with operational needs.</p><p>Over time, Claiborne standardized key environmental services components, including towel, tissue, and soap dispensers, as well as gloves, trash liners, wipes, microfiber cloths, and other housekeeping essentials. Using fewer brands and consistent SKUs reduced substitution risk and simplified oversight.<br></p><h3>Simplifying Training and Reinforcing Execution</h3><p>One of the most tangible compliance benefits of standardization has been its effect on staff training. When products are consistent, onboarding becomes less complex, and procedures can be reinforced uniformly across communities.</p><p>“When we implement change, we focus on sustainability,” Crawford says. “Success isn’t tied to any one person. Standardization creates consistency and makes training easier across our communities.”</p><p>This consistency helps staff confidently explain processes during survey, supports more uniform execution across shifts, and reduces variation that could otherwise prompt surveyor concern.<br></p><h3>Reducing Administrative Burden on On-Site Leaders</h3><p>Before standardization, on-site leaders spent time researching products, comparing prices, managing vendors, and reconciling invoices, time that could be spent supporting staff or maintaining regulatory readiness.</p><p>“That’s the hidden labor cost,” Hemmer explains. “Time spent scouring the internet for products instead of focusing on the community.”</p><p>By consolidating purchasing on a single platform, Claiborne reduced administrative tasks for department heads and simplified budgeting. Managers no longer needed to make product decisions or manage multiple suppliers.</p><p>“All they have to worry about is staying within their budget,” Crawford says.<br></p><h3>Building a More Survey-Resilient Organization</h3><p>Today, Claiborne has clearer visibility into spending, product usage, and cash flow across all 17 communities. That visibility helps leadership identify risks, reinforce standard practices, and plan with greater confidence.</p><p>“Because we know our average spend and manage it consistently,” Crawford says, “we’re better able to spot inefficiencies, reduce risk, and make informed decisions as we grow.”</p><p>For long term care providers navigating evolving regulatory expectations, housekeeping standardization is not simply an efficiency initiative. It is a foundational strategy that supports infection prevention, staff execution, training, and survey readiness, while also reducing complexity and controlling costs.<br><br>To learn more about how standardized purchasing supports regulatory readiness and operational consistency in senior living and long term care, contact Greg Hemmer at <a href="mailto:Gregory.Hemmer@Staples.com" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="email Greg">Gregory.Hemmer@Staples.com</a> or visit <a href="https://www.staplesadvantage.com/learn/industries-served/healthcare/senior-living?cid=bnr:tp:tp:sb:mf:t:sl:cc:na:sl:na:na:ahca:ca&utc=LFKYXG" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">staplesbusiness.com/seniorliving</a>.<br><br></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<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;"><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;"><em><span style="text-decoration:underline;">Learn how to submit an article.</span></em></a></span><br></p> | 2026-05-12T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/staples_supply.jpg" style="BORDER:0px solid;" /> | Management;Survey and Certification | | Housekeeping standardization offers a practical way to strengthen survey readiness. By aligning products, purchasing, and workflows across facilities, operators can reduce variation, support staff training, and create more defensible, repeatable practices during survey. |
| How AI Supports Clinical Decision-Making in Long Term Care | <p style="text-align:center;"><img src="/Articles/PublishingImages/2026/AI%20dr.jpg" alt="" style="margin:5px;width:500px;height:317px;" /><br></p><p>In long term and post-acute care, the past decade has focused heavily on improving visibility into resident health. Remote patient monitoring, electronic health records, and connected devices have made it easier to track vital signs, detect changes, and generate alerts. Yet despite this progress, a persistent challenge remains: turning data into timely, confident clinical decisions.</p><p>For many clinical leaders, the challenge is no longer insufficient information, but rather the overwhelming volume of data.</p><p>Directors of nursing, attending physicians, and care teams often manage numerous alerts, documentation requirements, and competing priorities during each shift. This environment contributes to what some industry observers call “clinical decision fatigue,” where the volume of inputs makes it more difficult to determine the appropriate course of action.</p><p>A new class of tools, known as AI clinical co-pilots, is beginning to address this gap.</p><h2>The Shift from Data Collection to Decision Support</h2><p>Traditional health care technology systems in long term care have largely focused on documentation and monitoring. These systems primarily answer descriptive questions such as what is happening with a resident at a given time and how their condition compares to baseline.</p><p>AI co-pilots move a step further by addressing a more complex question: what should be done next?</p><p>Rather than simply generating alerts for abnormal vitals, these systems integrate multiple data sources, including vital signs, medication records, and historical trends, to produce prioritized, actionable insights. For example, instead of separate alerts for elevated heart rate, reduced mobility, and missed medications, an AI system may identify a combined pattern suggestive of early clinical deterioration and recommend escalation.</p><p>This shift from fragmented alerts to synthesized recommendations has the potential to reshape how clinical leadership operates in long term care.</p><p>To understand this evolution, it is useful to distinguish between technologies that collect clinical data and those that support clinical decisions. Wearables fall into the first category, continuously capturing physiological data such as heart rate, oxygen saturation, temperature, activity, and sleep patterns, and triggering alerts when thresholds are exceeded.</p><p>As data becomes more continuous and complex, the challenge in long term care is no longer data availability but interpretation. AI clinical co-pilots address this gap by synthesizing inputs from electronic health records, wearable devices, and clinical history to generate contextual insights. In this model, wearables expand monitoring capability, while AI co-pilots translate data into actionable clinical decisions.</p><h2>Emerging Use Cases in Long Term Care</h2><p>While still evolving, several practical applications of AI-driven decision support are gaining traction in skilled nursing and assisted living environments.<strong><br></strong></p><p><strong>1.    Early Identification of Clinical Deterioration</strong><br>Subtle changes in condition often precede hospitalizations. AI models can analyze longitudinal data to detect patterns that may not be immediately visible to staff, enabling earlier intervention. In some cases, this supports proactive treatment within the facility and may reduce avoidable hospital transfers.</p><p><strong>2.    Medication Optimization and Risk Flagging</strong><br>Polypharmacy remains a significant challenge in long term care. Decision-support tools can highlight potential drug interactions, duplications, or adherence concerns, enabling clinicians to review regimens more efficiently.</p><p><strong>3.    Fall Risk Prioritization</strong><br>Rather than relying only on periodic assessments, AI systems can continuously evaluate fall risk using mobility patterns, prior incidents, and environmental factors. This enables care teams to focus preventive resources where they are most needed.</p><p><strong>4.    Workflow Prioritization for Care Teams</strong><br>By ranking alerts by severity and likelihood of adverse outcomes, AI co-pilots help reduce noise and ensure the most critical issues are addressed first.</p><h2>Implications for Clinical Leadership</h2><p>The introduction of AI co-pilots is not simply a technology upgrade; it represents a shift in how clinical decisions are supported and governed.</p><p><strong>1.    Improved Consistency in Care Delivery</strong><br>Decision-support systems can help standardize responses to common clinical scenarios, reducing variability across shifts and staff members.</p><p><strong>2.    Enhanced Capacity in a Constrained Workforce</strong><br>Due to continuous workforce shortages, facilities may still run with a bare minimum of clinical staff. AI tools can serve as an enabler, boosting the performance of less experienced staff by helping them not only identify but also respond to complex conditions.</p><p><strong>3.    Focus on High-Value Clinical Judgment</strong><br>By automating routine analysis and prioritization, clinicians may be able to spend more time on direct resident care and complex decision-making that requires human expertise.</p><h2>The Risks: Avoiding “Alert Fatigue 2.0”</h2><p>Despite the promise, AI-driven decision support is not without challenges. If not implemented thoughtfully, these tools risk recreating the very problems they are meant to solve.</p><p><strong>1.    Over-Reliance on Technology</strong><br>There is a risk that staff may defer too readily to algorithmic recommendations, failing to apply clinical judgment. Clear guidelines are needed to define how AI outputs should be used in decision-making.</p><p><strong>2.    Data Quality Limitations</strong><br>AI systems are only as reliable as the data they analyze. Inconsistent documentation or incomplete data can lead to inaccurate recommendations.</p><p><strong>3.    Workflow Disruption</strong><br>Introducing new tools into already complex workflows can create friction if systems are not well integrated or aligned with staff routines.</p><p><strong>4.    Accountability and Governance</strong><br>Questions of responsibility, particularly when AI recommendations influence clinical outcomes, must be addressed through clear governance structures.</p><h2>What Should Clinical Leaders Do Next?</h2><p>As AI co-pilots move from concept to implementation, clinical leaders in long term care face a critical question: How to engage with this technology in a way that enhances care without introducing new risks?</p><p>Several practical steps are emerging as best practices:</p><p><strong>1.    Start with Targeted Use Cases</strong><br>Instead of deploying broad, facility-wide solutions, organizations may benefit from focusing on specific challenges such as reducing hospital readmissions or improving fall prevention.</p><p><strong>2.    Evaluate Integration with Existing Systems</strong><br>Seamless integration with electronic health records and workflow tools is essential to prevent added complexity.</p><p><strong>3.    Invest in Staff Training and Adoption</strong><br>Technology alone is insufficient. Staff must understand how to interpret and act on AI-generated insights.</p><p><strong>4.    Establish Clear Governance Frameworks</strong><br>Policies should define when and how AI recommendations are used, and how outcomes are monitored.</p><p><strong>5.    Measure Impact Rigorously</strong><br>Clinical, operational, and financial outcomes should be tracked to assess whether AI tools are delivering meaningful value.</p><h2>Looking Ahead</h2><p>The long term care industry has already invested significantly in monitoring and data collection. The next phase of transformation will likely focus on making that data actionable.</p><p>AI clinical co-pilots represent one possible path forward, shifting the role of technology from passive observer to active participant in care delivery. For clinical leaders, the opportunity lies not in replacing human judgment but in augmenting it.</p><p>As the sector continues to navigate workforce constraints, rising acuity, and increasing regulatory pressure, the ability to make faster, more informed decisions may become a defining factor for both quality outcomes and operational sustainability.<br><br><em><img src="/Articles/PublishingImages/2026/Vaishnavi-Gadve.jpg" alt="Vaishnavi Gadve" class="ms-rtePosition-2" style="margin:5px;" />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 vaishnavigadve143@gmail.com.</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;"><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;"><em><span style="text-decoration:underline;">Learn how to submit an article.</span></em></a></span><br></em></p> | 2026-05-07T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/AI-dr.jpg" style="BORDER:0px solid;" /> | Technology | Vaishnavi Gadve | Remote patient monitoring, electronic health records, and connected devices have made it easier to track vital signs, detect changes, and generate alerts. Yet despite this progress, a persistent challenge remains: turning data into timely, confident clinical decisions. A new class of tools, known as AI clinical co-pilots, is beginning to address this gap. |
| Conversations You Need to Have to Develop People | <p><img src="/Articles/PublishingImages/740%20x%20740/dr_staff.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:300px;height:213px;" />You've just finished another one-on-one with one of your strongest department heads or charge nurses. You reviewed staffing ratios for the week, talked through a resident care concern, and confirmed priorities before the next survey window. Twenty minutes, clear action items, everyone knows what to do next.</p><p>They leave. You get back to the floor. Another productive meeting complete.</p><p>But here's what didn't happen: You didn't ask what energizes them about their work right now. You didn't ask what's wearing them down. You didn't ask what they're proud of this month—or where they want to go in their long term care career. You managed the operation. You didn't develop the person.</p><p>And six months from now, when they tell you they're leaving for another facility, the acute care side, or a different field entirely, you'll be genuinely surprised. It's one of the most consistent patterns in long term and post-acute care leadership today—and one of the most preventable.</p><p>Sound familiar?</p><h3>Managing the Building vs. Developing People</h3><p>Most skilled nursing and assisted living leaders are skilled at the former and underdeveloped in the latter—not from lack of care, but because the difference isn't obvious until it's too late.</p><p>Managing is about keeping the building running: staffing the floor, meeting regulatory requirements, monitoring quality indicators, managing Medicaid and Medicare reimbursement, preparing for surveys, and ensuring residents receive safe, high-quality care every single day. In a long term care environment where the clinical, operational, and regulatory demands never let up, this kind of management can consume everything.</p><p>Coaching is something different. It's about your team members' development—their growth as caregivers and leaders, their sense of purpose in this work, their commitment to the residents they serve, and their reasons for staying in a profession that is physically and emotionally demanding and has no shortage of other options pulling talented people away.</p><p>Workforce is the defining challenge facing long term and post-acute care providers right now. AHCA/NCAL's own advocacy and research make clear that staffing shortages, caregiver turnover, and the pipeline of future long term care professionals are among the most urgent issues in the sector. When experienced nurses, CNAs, and department leaders walk out the door, they take clinical knowledge, resident relationships, and the kind of team cohesion that directly affects care quality. The facilities that retain their best people aren't always the best-resourced—they're the ones where leaders invest in developing their people as deliberately as they invest in quality improvement and regulatory compliance.</p><h3>The High-Performer Trap</h3><p>Consider this: you have a solid team. Your most experienced nurses and department heads manage their responsibilities well, keep residents and families satisfied, and handle challenges without escalating everything to you. By every visible measure, things look fine.</p><p>Meanwhile, one of your most capable staff members has quietly disengaged. Less initiative in team huddles. Less enthusiasm for a quality improvement project you've invited them to help lead. Going through the motions on shifts they used to approach with real dedication. You notice, but tell yourself it's burnout from a difficult stretch or something going on outside of work.</p><p>Then comes the conversation you weren't expecting. They're leaving. Taking a position at another facility or stepping away from long term care entirely. And what they say stops you: "I stopped feeling like anyone here cared about where I was going about six months ago. I kept waiting for someone to ask. Nobody did."</p><p>You trusted them with your most complex residents. You put them in charge during your most demanding shifts. You relied on them to model your standards for newer staff. What more could they want?</p><p>The answer: someone invested in where they were going as a professional and a person, not just what they were delivering for the facility.</p><h3>When Clinical Competence Becomes Your Blind Spot</h3><p>Because your best people are skilled and experienced—they know the residents, they understand the care protocols, they navigate survey situations without falling apart—it's tempting to tell yourself that development isn't really your role. They know the work. What could you add?</p><p>This thinking is exactly backward.</p><p>Coaching your team isn't about second-guessing their clinical judgment. It's about helping them discover what they're capable of beyond their current role—in facility leadership, in quality improvement, in mentoring the next generation of caregivers this sector so desperately needs, in shaping how your community delivers person-centered care. And that requires questions, not performance evaluations.</p><p>Instead of defaulting to census updates and staffing issues, try asking:<br></p><ul><li>What part of your work right now is giving you the most energy?</li><li>What's wearing you down that we haven't talked about?</li><li>Is there an area of care or leadership you'd like to grow into?</li><li>What do you think we could do better for our residents or our team?</li><li>Where do you want to be in your career in a few years, and how can I help get you there?</li></ul><p>These questions can't be answered with a care plan update. They require a real conversation. And they send a clear signal that you see this person as more than a body on a shift—you see them as someone with a future in this work.</p><h3>The Shift from Best Clinician to Developer of Caregivers</h3><p>Many skilled nursing and assisted living leaders built their credibility through strong clinical skills and a track record of delivering quality care. That expertise earned the trust of residents, families, and surveyors, and that trust earned leadership. But the skills that made you an exceptional clinician are not the same skills that make you an exceptional developer of people.</p><p>The longer you lead primarily from your own clinical depth—stepping in to manage resident situations before your staff gets the chance, making every call so your team never has to develop their own judgment, handling the hard family conversations yourself instead of coaching your nurses through them—the more you limit the people around you and your facility's long-term capacity to deliver consistent, high-quality care.</p><p>The most effective long term care leaders make a deliberate shift: from being the most capable caregiver in the building to being the person who builds more capable caregivers and leaders.</p><p>That looks like asking:<br></p><ul><li>What's your instinct on how we should approach this resident situation?</li><li>What am I missing about this that you see from the floor every day?</li><li>If this decision were yours to make, what would you do?</li></ul><p>These questions build confidence and clinical judgment. They signal that you trust your people to think and lead, not just to execute. And they develop the long term care professionals your facility—and this sector—urgently needs.</p><h3>What This Actually Requires</h3><p>You don't need a coaching certification. You need genuine curiosity about your team members' growth—and the discipline to ask about it consistently, even when census pressure, survey windows, and staffing gaps are all demanding your attention at once.</p><p>It means treating one-on-ones as development conversations, not just staffing check-ins. It means asking "What are you proud of this month?" before diving into what went sideways on second shift. It means creating space for your nurses and caregivers to think out loud about their careers and their ideas, even when the next care conference is tomorrow and you're short on the floor.</p><p>Long term and post-acute care is navigating a genuinely difficult moment—workforce shortages, reimbursement pressure, evolving regulatory requirements, and an aging population that needs more from this sector than ever before. <a href="https://www.ahcancal.org/Advocacy/Pages/Caregivers-for-Tomorrow.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Caregivers for Tomorrow">AHCA/NCAL's Caregivers for Tomorrow</a> initiative reflects what providers on the ground already know: the future of long term care depends entirely on the quality, commitment, and sustainability of the workforce delivering it.</p><p>That workforce isn't built through advocacy alone. It's built one conversation at a time—in the hallways, in the break room, in the small moments where a leader asks a caregiver not just how the shift went, but where they want to go.</p><p><img src="/Articles/PublishingImages/2026/John-Chilkotowsky.jpg" alt="John Chilkotowsky" class="ms-rtePosition-2" style="margin:5px;width:150px;height:165px;" />What's one question you could ask one of your best team members this week that's about them, not the census? And what becomes possible for your residents—and the future of long term care—when your caregivers and leaders know you're as invested in their growth as you are in five-star quality?<br><br><em>John Chilkotowsky, PCC, is an executive leadership coach and speaker with NorthStar Coaching, LLC. He holds an ICF Professional Certified Coach credential, along with certifications as an International Systemic Team Coach and Intensive Group Coach, and he is a member of the MacLean/Harvard Medical School Institute of Coaching.</em></p><p><span class="ms-rteFontSize-1"><em></em></span></p><p><span class="ms-rteFontSize-1"><em><br></em></span></p><p><span class="ms-rteFontSize-1"><em>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. </span><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"><span class="ms-rteFontSize-1">Learn how to submit an article.</span></a><br></p> | 2026-05-05T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/dr_staff.jpg" style="BORDER:0px solid;" /> | Workforce;Management | John Chilkotowsky | Workforce is the defining challenge facing long term and post-acute care providers right now. AHCA/NCAL's own advocacy and research make clear that staffing shortages, caregiver turnover, and the pipeline of future long term care professionals are among the most urgent issues in the sector. |
| The Mighty Mission of Intellectual and Development Disabilities Care | <p style="text-align:center;"><img src="/Articles/PublishingImages/2026/iStock-2148215087.jpg" alt="" style="margin:5px;" /></p><p>Small in number but mighty in mission, the American Health Care Association’s (AHCA) intellectual and developmental disability (ID/DD) care providers are in many ways superheroes for those they serve. Their role comes with great responsibility. Their clients are vulnerable children, adults, and elderly individuals with complex medical and behavioral health conditions. Many of them require care interventions several times a day. But severity of their clients’ conditions doesn’t hold them back. Operating amid steep Medicaid cuts and workforce shortage challenges, ID/DD providers, with their laser focus on providing comprehensive care, do all in their power to ensure that their clients live the most autonomous and fulfilling life possible </p><h3>Letting Kids be Kids</h3><p>
<span>
<img src="/Articles/PublishingImages/2026/Jay-Hayston.jpg" alt="Jay Hayston" class="ms-rtePosition-2" style="margin:5px;" /></span>Cedarcrest, based in Keene, NH, is a specialized pediatric medical facility and school caring for children with complex medical and developmental needs from infants through age 22. It is the only facility of its kind in the state and about 40 percent of children rely on a ventilator.</p><p>Cedarcrest is all about addressing medical needs so that the kids can be kids. “The most important value for us is that we don't want a child to worry about their ventilator,” says Jay Hayston, president and chief executive officer (CEO). “We want them to worry about their project that they're working on for school, seeing their friends, or getting out to a birthday party.”</p><h3>How It Works</h3><p>Powered by a dedicated staff, children are in school from 8:30-2:30pm, with elementary, middle, and high school classrooms on site. Afterwards, children enjoy downtime with a little fun. Be it listening to Taylor Swift’s latest song, or doing quiet activities of choice, kids transition into an evening care routine for relaxation.</p><p>Amid terminal diagnoses, complicated need profiles, and other realities, children enjoy a weekly field trip out in the community. “There are heavy circumstances in our building, but the air is never heavy here,” says Hayston. “The feeling of our work is joyous.” </p><h3>Resident Goals </h3><p>Learning about resident goals and helping them succeed is a part of the mission at Billings Fairchild Care Center, located in Billings, OK. Billings cares for residents age 18-86, operating four intermediate care facilities (ICF). </p><p>Consuela Dolezal, administrator at Billings Care Center in Enid, Oka., loves watching people learn new things, which happens a lot at Billings.</p><p>Dolezal will sit down with a client to ask what their overall goal is. “We talk about what we need to learn to obtain that goal,” says Dolezal. “If its money management, it could be showing them how to write a check or pay a bill online.”</p><p>One client told Dolezal he wanted to get a job as a waiter. Staff set up a mock station where the resident could role play. That included learning the abbreviations of items via YouTube, taking an order of another client, and bringing the items on a tray. </p><h3>Active Treatment</h3><p>
<span>“The crux of everything that we do is active treatment, says Dolezal. “That's helping to promote the client's individual independence, helping them to find that autonomy that they deserve, and that sense of accomplishment.”</span><br></p><center><table cellspacing="0" class="ms-rteTable-3" style="width:75%;height:250px;"><tbody><tr class="ms-rteTableEvenRow-3"><td class="ms-rteTableEvenCol-3" style="width:50%;height:343px;text-align:center;">
<img src="/Articles/PublishingImages/2026/tour%20at%20Billings%20Care%20Center.jpg" class="ms-rtePosition-4" alt="" style="margin:5px;width:400px;height:327px;" />
</td></tr><tr class="ms-rteTableOddRow-3" style="text-align:center;"><td class="ms-rteTableEvenCol-3">
<span class="ms-rteFontSize-1"><strong>From left, Jasmine and Cynthia, residents of Billings Care </strong>
<strong>C</strong><strong>enter; AHCA’s Dana Ritchie; Dolezal; and Natashia Mason from the Oklahoma Association of Health Care Providers.</strong></span></td></tr></tbody></table><p>
<br>
</p><p style="text-align:left;">In a recent tour with representatives of Care Providers Oklahoma and AHCA, Dolezal invited residents to give the tour, and they did, with flying colors. They gave participants insight into what Billings does and introduced them to staff and other residents.</p><h3 style="text-align:left;">Stages and Settings</h3><p style="text-align:left;">Supporting individuals with ID/DD often spans through life in different stages and settings.</p><p style="text-align:left;">Jaime Anthony is chair of the AHCA ID/DD Committee and executive director at Developmental Options, a private nonprofit corporation operating ICFs in Southeast Idaho.</p><p style="text-align:left;">Client age ranges from seven to 67. The door to entry can be a parent who is in crisis, trying to locate care for their child, or a parent who needs help caring for their child because they are aging.</p><p style="text-align:left;">Individuals may start out in an ICF setting, but as they age and learn skills, they may advance into their own apartment, receiving support. Here they may be working and have independence, and as they get older, they may need home health hospice.</p><p style="text-align:left;">“It progresses as that person ages through every part of their life, and we’re providing those supports so that they can be successful,” she says. </p><h3 style="text-align:left;">Common Challenges, Different Story</h3><p style="text-align:left;">In Oklahoma, 37 of the ICFs operating in the state are members of Care Providers Oklahoma. Steven Buck, president and CEO and father of an ICF resident, says that because ICFs are often put into the same category with nursing homes via state and federal policy. One challenge is to articulate to lawmakers the differences in payor mix and treatment/care goals.</p><p style="text-align:left;">A viable nursing home community may typically have a payer mix that includes Medicaid, Medicare, etc. In Oklahoma, most ICF communities are 100 percent Medicaid funded, including Billings. Because of the state’s reimbursement methodology, ICF reimbursements are based on a rate with a two-year lag in inflation adjustments and lack the ability to diversify their revenue to keep up.</p><p style="text-align:left;">“A robust Medicaid rate is essential to the success of ICF communities,” says Buck. The One Big Beautiful Bill Act (H.R.1) brings additional pressures. “In Medicaid expansion states like Oklahoma where we wrestle with the new realities of H.R.1 and the pressure on state budgets that it will bring, it is imperative that these communities receive payment consistent with their cost of care.”</p><h3 style="text-align:left;">Always a Reason</h3><p style="text-align:left;">Hayston credits New Hampshire’s federal delegation for their support of the profession, but as multiple priorities compete for Congressional attention, it’s easy for a niche or acute service priority to slip through the awareness cracks.</p><p style="text-align:left;">“It's making sure that legislators are aware that it is a responsible fiscal choice to support and empower providers like us,” says Hayston.</p><p style="text-align:left;">An example of this comes down to dollars and cents. If not for Cedarcrest, the constellation of needs a resident has would require a specialty bed at the local children's hospital, which would cost many times more. </p><h3 style="text-align:left;">The Utah Experience</h3><p style="text-align:left;">Currently seven members of the Utah Healthcare Association (UHCA) are ID/DD providers. As part of their membership, they serve on an ID/DD committee, and one member also serves on the board of directors.</p><p style="text-align:left;">Allison Spanger, president and CEO of UHCA, says ID/DD care awareness is crucial to ensuring that individuals with ID/DD not only get the medical care they need, but the social and community support as well. “Many residents living in ID/DD communities have jobs or they go to vocational rehab to help build their personal skills according to the goals that they’ve made with their care staff and clinicians,” says Spangler.</p><p style="text-align:left;">“Without these providers, I think that there would be much bigger problems for not just Utah, but around the country and for the cost of care as it relates to the appropriate setting for these types of patients.” </p><h3 style="text-align:left;">Challenges and Opportunities</h3><p style="text-align:left;">One measure that has helped is the Utah Quality Incentive Program, a federal and state funded program that incentivizes providers. Specifically, they may submit proposals for improvement projects such as dining enhancements or additional vehicles for transportation. Another way to apply for funding is to demonstrate quality outcomes to meet a performance incentive.</p><p style="text-align:left;">“This program really has been a blessing to providers because they've been able to do things that they normally wouldn't have because of their funding,” says Spangler.</p><p style="text-align:left;">Opportunities like the annual AHCA ID/DD Fly In offer providers a chance to raise awareness directly with Congressional members and staff and learn the latest policy developments from Capitol Hill.</p><p style="text-align:left;">This year, Spangler attended with a diverse group of ID/DD providers and state association executives. She surprised her eleven-year-old daughter by taking her along for the event, where she learned about the ID/DD profession and what advocacy means on Capitol Hill.</p><p style="text-align:left;">“It was a good opportunity for her to see the vital role that ID/DD care facilities play and also how she can use her own voice,” says Spangler. “She'll be a voter one day. She'll be employed. I think that's important for anyone to understand how important their voice is.”</p><h3 style="text-align:left;">Working on Workforce Challenges</h3><p style="text-align:left;">When it comes to workforce challenges, Anthony points out her team’s revamp of their approach post-COVID, when already existing workforce shortages were exacerbated. The first area of focus was ensuring that the ICF Medicaid reimbursement rate allowed facilities to be competitive in their wages, an area where progress has been made. The team also reevaluated the training curriculum to help ensure that it was preparing staff who have different profiles to be successful in the role.</p><p style="text-align:left;">“This is a college town, so you may get staff from the university. Other staff are here because this is the career they want,” says Anthony. “We look at all these things, including retirement. At the same time, we ensure that we are being clear on the demands of the role, because it is a challenging job.”</p><h3 style="text-align:left;">Why Can’t We?</h3><p style="text-align:left;">Amid the advocacy in states and on Capitol Hill, the superhero strength of ID/DD care providers can be seen in the stories of clients who, amid a full schedule of care and education, are also realizing their dreams.</p><p style="text-align:left;">A few years ago, Hayston was in the high school classroom when one of the young men used his communication device to tell him that he wanted to see penguins. Hayston asked what he meant. The child explained that he had never been to an aquarium before and he always wanted to see penguins in person. He also shared that, because he was on a ventilator, he understood that this wasn’t an easy thing to do.</p><p style="text-align:left;">“I pulled the teacher aside and said, ‘We’re going to figure out how to do this,’” says Hayston. What followed was planning and coordination on how to get multiple ventilators, nurses, and vans to carry it all two hours away in Boston. The staff made it happen, and it’s a memory that continues to inspire.</p><p style="text-align:left;">“I have the best job in the world,” says Hayston. “I get to ask a question, ‘Why can't we? Why can't we bring him to meet the penguins?’”</p><p style="text-align:left;"></p><table cellspacing="0" class="ms-rteTable-9" style="width:75%;"></table><table style="background-color:#ebcbc5;"><tbody><tr class="ms-rteTableEvenRow-9"><td class="ms-rteTableEvenCol-9" style="width:100%;text-align:left;padding:10px;"><span><span>If you would like to learn more about AHCA’s ID/DD care providers and committee and ways to get involved, please contact AHCA’s Associate Vice President of Workforce & Constituency Services, Dana Ritchie, at
<a href="mailto:dritchie@ahca.org" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Email Dana!">dritchie@ahca.org</a>.</span></span></td></tr></tbody></table><p style="text-align:left;"></p><p style="text-align:left;">
<em>Amy Mendoza is a freelance writer and editor specializing in long term care, health policy, and health care operations.</em></p><p style="text-align:left;">
<span class="ms-rteFontSize-1">
<em>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. </span><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"><span class="ms-rteFontSize-1">Learn how to submit an article.</span></a><br></p></center> | 2026-04-30T04:00:00Z | <img alt="" src="/Articles/PublishingImages/2026/iStock-2148215087.jpg" style="BORDER:0px solid;" /> | Caregiving | Amy Mendoza | Operating amid steep Medicaid cuts and workforce shortage challenges, ID/DD providers, with their laser focus on providing comprehensive care, do all in their power to ensure that their clients live the most autonomous and fulfilling life possible |