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Medicaid Cuts Would Devastate Providers Serving ID/DD Populations<p>​<img src="/Articles/PublishingImages/2025/Medicaid.jpg" class="ms-rtePosition-2" alt="Medicaid cuts" style="margin&#58;5px;width&#58;200px;height&#58;200px;" />Medicaid cuts would be devastating to individuals with intellectual and developmental disabilities (ID/DD) and those who care for them. Virtually all 55,000 individuals with disabilities residing in the nation’s 5,300 intermediate care facilities (ICF) are on Medicaid.</p><p>ICFs provide active treatment and services for people with significant support needs. They offer 24-hour supervision, health care, therapies, activities, and training to maximize residents’ autonomy and independence.&#160;</p><p>Despite being the backbone of ID/DD care, Medicaid reimbursement rates often fall short of covering the actual cost of care, regardless of any future cuts. This underfunding has led to longer waitlists for home and community-based services programs, facility closures, and reduced access to timely, essential support that individuals desperately need.</p><p>The drop in ICFs, which has declined by more than 16 percent over the last 10 years, compounds the problem. Furthermore, newer facilities are not being built and certified at nearly the same pace as closures. This ultimately leads to fewer active Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities (ICFs/IID) and patients seeking care elsewhere or not at all.</p><p>Data show ICFs/IIDs are performing well. Centers for Medicare and Medicaid Services (CMS) survey ICFs/IIDs for regulatory compliance. Over 90 percent of surveys conducted in 2024 found zero condition-level deficiencies and demonstrated a commitment to quality care.&#160;</p><h3>Medicaid Doesn’t Cover Enough</h3><p>Medicaid does not fully cover the cost of care for individuals with intellectual and developmental disabilities. Access to quality long-term services and supports (LTSS) is at risk without adequate funding.</p><p>Provider taxes are one solution to expand services and support high-quality care. For more than 40 years, provider assessments (also called provider taxes) have helped states stabilize Medicaid funding and maintain care for vulnerable populations. There are 49 states and Washington, D.C., that rely on provider taxes to ensure that providers can continue serving Medicaid beneficiaries, and 32 of such states and D.C. apply these assessments for ICFs/IID.</p><p>Some federal budget proposals aim to lower the “Safe Harbor” limit on provider taxes from the current 6 percent, limiting states’ ability to use provider taxes. This would cut Medicaid funding without a replacement solution and reduce access to essential care for ID/DD populations while undermining efforts to recruit and retain much-needed stay in care facilities.</p><p>Medicaid is a lifeline for individuals with intellectual disabilities, especially those children and adults receiving 24-hour specialized care in ICFs/IIDs,” said Jamie L. Anthony, LSW, executive director, Developmental Options, a small non-profit organization located in Southeastern Idaho.</p><p>“ICFs provide essential access to health care, support services, and community resources, ensuring the individuals served receive necessary care and support to lead fulfilling lives and promote their independence and social inclusion,” Anthony said. “Without Medicaid, many would face significant barriers to essential services, limiting their opportunities for growth and well-being.”</p><h3>Forced to Reduce Services</h3><p>“The ICF industry has been plagued with funding challenges for over a decade, doing more with less, resulting in a significant decline in facilities nationwide,” Anthony said. “ICF providers rely upon Medicaid dollars for operation, allowing the industry to continue to survive for those individuals who benefit from the high-quality, individualized care plans and services.”</p><p>Anthony added, “Without Medicaid, or with significant cuts to Medicaid, they could face closure or be forced to reduce services. This would leave individuals with intellectual and developmental disabilities without access to critical care, potentially leading to institutionalization, neglect, or a lack of proper support in the community. Families may struggle to find alternative care options, and the overall quality of care could diminish.”</p><p>“We have reached a point where there are no further expense areas to reduce without significantly impacting essential services or operations, said Anthony. “Every line item has been carefully evaluated, and additional cuts would compromise the program’s core functions, quality of service, or overall sustainability. At this stage, the budget is already operating at minimal levels, and any additional reductions would harm the provider's ability to meet its goals.”</p><h3>Hiring Challenges Are Persistent</h3><p>Debbie Jenkins, advocacy director, Ohio Health Care Association, said that for a long time, ICF members have struggled to attract and retain the direct support professionals (DSPs), nurses, and other staff needed to care for their residents.</p><p>“For several years, they had to turn away people needing services because they couldn’t find enough staff to care for them,” Jenkins said.</p><p>In July 2023, the Ohio legislature passed HB 33, which invested significantly in ICF services to help increase wages. “This investment has stabilized most of our ICF providers' workforces,” Jenkins said. She said that during the past year and a half, her members told her that they have been able to adequately staff their current residents and take on a few new residents.</p><p>“However, challenges remain for serving people with significant needs requiring higher staffing ratios,” Jenkins said. “If Medicaid reimbursement for services is cut, any progress made in Ohio in the past year and a half would be lost. Providers would not be able to continue supporting their current wages, much less keep up with any future inflation.”</p><p>Additionally, Ohio has a pending provision in its budget bill that would eliminate the expansion population if the FMAP is reduced from the current 90 percent.&#160;</p><p>“Our rates do not cover these employees' full health insurance costs,” Jenkins said. Many DSPs are on Medicaid through the expansion population eligibility. If that goes away, we anticipate some DSPs will leave ICFs to find employment that includes health insurance benefits. These cuts would devastate the ICF workforce and leave many residents without care.”</p><h3>Wages a Key Determinant for Care</h3><p>Developmental Options has been actively working to raise wages for direct support staff to close the gap on open positions and attract reliable, dedicated caregivers.&#160;</p><p>“These efforts are critical to ensuring individuals receive the high-quality care they need,” Anthony said. “However, the uncertainty surrounding Medicaid funding has slowed this progress. Without stable and predictable funding, making the necessary wage adjustments and retaining staff is difficult, ultimately hindering the ability to fill positions and maintain consistent care for those who rely on these services.”</p><h3>Technology a Possible Solution</h3><p>Anthony said that better use of technology, such as artificial intelligence, could help to solve some of the funding and hiring gaps.</p><p>“It is important for our company and the industry to look for ways in which technology and AI can help us achieve more with fewer resources, allowing us to meet the regulations’ intent while maintaining high-quality programs,” Anthony said. “For example, finding software solutions that automate routine workflows reduce the time staff spends documenting while capturing critical data and allow agencies to make data-driven decisions can help improve compliance without adding staff.”</p><p><span><img src="/PublishingImages/Headshots/PaulBergeron.jpg" alt="Paul Bergeron" class="ms-rtePosition-2" style="margin&#58;5px;width&#58;140px;height&#58;140px;" /></span>“However, a hurdle regarding software solutions is that many systems only focus on a single function (billing or scheduling, for example) and don't truly integrate tools and solutions that align with the ICF/IID regulations or program structure,” said Anthony.</p><p><em>Paul Bergeron is a freelance writer based in Herndon, VA.</em><br></p>2025-04-22T04:00:00Z<img alt="" height="740" src="/Articles/PublishingImages/2025/Medicaid.jpg" width="740" style="BORDER&#58;0px solid;" />PolicyPaul BergeronDespite being the backbone of ID/DD care, Medicaid reimbursement rates often fall short of covering the actual cost of care, regardless of any future cuts. This underfunding has led to longer waitlists for home and community-based services programs, facility closures, and reduced access to timely, essential support that individuals desperately need.
5 Fundraising Must-Do’s for Your Non-Profit Facility in Today’s Economy<p>​<img src="/Articles/PublishingImages/740%20x%20740/fundraising.jpg" class="ms-rtePosition-1" alt="" style="margin&#58;5px;width&#58;200px;height&#58;200px;" />Times are changing, and if you’re a leader in a non-profit senior living facility, you’ve probably felt the pinch. Costs are climbing, donors have more choices than ever and keeping up can feel like a full-time job. In today’s dynamic economy, fundraising really is a full-time job.<br><br>That’s why more and more non-profit facilities are bringing on full-time professional fundraisers called development officers. Whether your facility is going full-time or if you as a leader have taken on the role yourself, here are five tried-and-true fundraising strategies that you should be adopting now to help keep the lights on and the care top-notch for your seniors.<br></p><h3>1. Make Donors Feel Like Family</h3><p>Nobody likes to feel like just another name on a mailing list. People give when they feel connected, so treat your donors like family. Here’s how&#58;<br></p><ul><li>Send heartfelt thank-you notes, not just receipts. It’s what I call the long-lost art of the handwritten note. And it goes a long way. </li><li>Host casual get-togethers, like coffee with the director, so donors can see firsthand the impact of their support. Don’t ask for money at these gatherings, just dote on your supporters.</li><li>Make note of and acknowledge donor birthdays, their spouse, and/or kids’ birthdays, anniversaries, and other significant events. There are innovative CRMs that will track that for you.</li></ul><p>A little warmth and personal touch will often turn one-time donors into lifelong champions of your mission.</p><h3>2. Knock on Every Grant Door You Can Find</h3><p>With government grants disappearing or shrinking, it’s time to do the hard digging. You just have to know where to look. Here’s how to make sure you don’t leave money on the table&#58;<br></p><ul><li>Partner with businesses for sponsorships—many companies love to give back to their communities. And large corporations are often required to support local non-profits.</li><li>Look into cause-marketing campaigns where a percentage of sales from a business benefits your facility.</li><li>Encourage matching gift programs so donors can double their impact with help from their employers.</li><li>And keep applying for local, state, and federal grants that support senior services. There may be less of them, but they’re still out there.</li></ul><p>Grants and corporate partnerships can help ease financial stress and open up new opportunities for your facility.</p><h3>3. Get Tech-Savvy with Fundraising</h3><p>If your fundraising efforts are still stuck in the past, it’s time for an upgrade. Online giving is bigger than ever, and it’s easier than you think.<br></p><ul><li>Host virtual or hybrid events to reach more people while cutting costs.</li><li>Start a crowdfunding campaign—people love to give when they see others chipping in too.</li><li>Use donor management software to track giving trends and personalize outreach.</li><li>Accept non-traditional donations like cryptocurrency and stocks to appeal to younger donors.</li></ul><p>By embracing technology, you’ll make giving easier, more accessible, and you’ll come off looking “in the know” with younger generations of donors.</p><h3>4. Get the Community Involved</h3><p>Your town is full of people who want to help—you just have to give them a reason to show up. Here’s how to rally the troops&#58;<br></p><ul><li>Consider a membership program where supporters get exclusive perks for a yearly donation.</li><li>Offer hands-on volunteer opportunities so people can see the impact of their efforts up close.</li><li>Work with churches, civic groups, and local businesses to co-host fundraising events.</li><li>Tap into your biggest fans and turn them into ambassadors who spread the word and bring in new donors.</li><li>And give back! Support other causes in your community. Don’t just be a taker—be a giver. You will attract new supporters that way.</li></ul><p>When the community feels invested, they’ll go the extra mile to support your mission.</p><h3>5. Make Giving Easy and Automatic</h3><p>People love to give, but they also love convenience. Setting up automatic giving options makes it easy for donors to support you without having to think about it each month. Here’s how&#58;<br></p><ul><li>Launch a “Friends of [Your Facility]” monthly giving club.</li><li>Partner with local stores and restaurants for round-up donation programs.</li><li>Encourage payroll deductions through workplace giving programs.</li><li>Sign up for passive fundraising programs like AmazonSmile and credit card donation programs.</li></ul><p>By making giving effortless, you’ll create a steady stream of income to keep things running smoothly.</p><p>Running a non-profit senior living facility isn’t for the faint of heart, but with the right fundraising strategies, we can weather any unconventional turns in the economy storm. Focus on relationships, seek out every grant opportunity, embrace digital giving, engage your community, and make donating easy. When you put in the effort, your donors will too—ensuring your seniors continue to receive the care and dignity they deserve.<br><br><em><img src="/Articles/PublishingImages/2025/Robert-Hahn.jpg" alt="Robert Hahn" class="ms-rtePosition-1" style="margin&#58;5px;width&#58;135px;" />Robert Hahn is the chief advancement officer for Birmingham Green Senior Living Facility in Manassas, Virginia. His role encompasses community engagement, mission/brand awareness, marketing, and development. Prior to serving at Birmingham, Hahn’s professional concentration was on developing non-profits that focused on rural hunger in America and poverty in Central America.</em><br></p>2025-04-17T04:00:00Z<img alt="" src="/Articles/PublishingImages/740%20x%20740/fundraising.jpg" style="BORDER&#58;0px solid;" />ManagementRobert HahnCosts are climbing, donors have more choices than ever and keeping up can feel like a full-time job. That’s why more and more non-profit facilities are bringing on full-time professional fundraisers called development officers.
How Nursing Homes Can Revitalize Their Nursing School Partnerships<p><img src="/Articles/PublishingImages/740%20x%20740/nurses.jpg" class="ms-rtePosition-1" alt="" style="margin&#58;5px;width&#58;200px;height&#58;200px;" />​Spring is a time to clean, organize, and prepare for warmer days. Nursing homes can use this season of transition as an opportunity to refresh their partnerships, including those with schools of nursing. Whether a nursing home has an established partnership with a school of nursing or is looking for a new partner, nursing homes and schools of nursing can forge effective, stimulating partnerships with mutual benefits.</p><p>Schools of nursing can provide value to nursing homes that want to enhance the quality of care for residents and diversify their talent recruitment strategies. Positive, impactful clinical experiences for nursing students in nursing homes can expose a new generation of nurses to the benefits of working with older adults while also helping them strengthen their gerontological nursing skills. Nursing faculty can be an invaluable resource for nursing home leadership through the sharing of clinical processes, techniques, and evidence-based programs.</p><p>However, nursing homes have not always been satisfied with their school of nursing partners. Many nursing home leaders believe they don’t have the resources or time to invest in clinical education for nursing students, especially with ongoing staffing challenges. They may also find it stressful to work with clinical faculty who have no prior nursing home experience.</p><p>Effectively partnering with schools of nursing is an effort in creativity and requires work on both sides. But like all work that is worth doing—there are tremendous rewards for both partners.</p><h3>Partnerships in Pennsylvania</h3><p>Over the past four years, nursing homes from the <a href="https&#58;//www.patnhc.org/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Pennsylvania Teaching Nursing Home Collaborative</a> have identified promising practices for how to reinvigorate academic-practice partnerships between nursing homes and schools of nursing. The Collaborative’s lead nursing home partners in Pennsylvania, including Presbyterian SeniorCare The Willows, UPMC Canterbury Place, Centre Care, and Wesley Enhanced Living Main Line, have worked closely with their partner schools of nursing to strengthen their working relationships and improve experiences for residents, nursing home staff, nursing students, and faculty.</p><p>“Showing nursing students this specialty of care allows them to see the autonomy and critical thinking skills that the long-term care nurse possesses,” said Taylor McMahon, RN, director of nursing at Presbyterian SeniorCare The Willows. “This will help long-term care recruit the future workforce by giving them the opportunity to pursue a career that makes a difference by serving older adults.”</p><p>Nursing homes can use the following strategies validated by the Collaborative’s partners to revitalize their partnerships with schools of nursing.&#160;</p><h3>Assess What Has and Hasn’t Worked In the Past&#160;</h3><ul><li><strong>Take a step back.</strong> Reflect on what has and hasn’t worked well with current and/or previous partnerships. Be sure to involve direct caregivers and licensed nurses in this conversation. Determine if a previous partnership didn’t work because of the nursing home, the school of nursing, or both, and whether it can be salvaged.</li><li><strong>Establish goals.</strong> What would be most beneficial for the facility? Does the nursing home need to test a new way to engage local nursing students? How could nursing students most benefit the residents during their clinical time in the facility? </li></ul><h3>Update or Create New Partnership Structures&#160;</h3><ul><li><strong>Find a new partner.</strong> Nursing home leaders can connect with local schools of nursing at networking events, conferences, or by reaching out via email to the school’s dean, lead clinical coordinator, or faculty who focus on gerontological nursing. Nursing homes located in Pennsylvania can access resources from the <a href="https&#58;//www.patnhc.org/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Pennsylvania Teaching Nursing Home Collaborative</a> to find local nursing programs that are open to new partnerships. </li><li><strong>Build a team.</strong> Include people from multiple departments to help coordinate the partnership. Ideally, they will have both interest and time. Assign roles such as who will work with instructors to design clinical experiences that benefit both the nursing students and residents, and who will manage and teach students during their rotations. </li><li><strong>Establish standing meetings.</strong> During the first meeting, nursing home leaders can clearly communicate their goals for the partnership while also hearing from the school of nursing about their goals for students’ clinical experiences. These meetings are an opportunity to create a plan that meets both partners’ needs. Plan for debrief meetings with the nursing home team after students’ clinical experiences to ensure concerns are addressed quickly.</li><li><strong>Orient faculty.</strong> Before students’ clinical rotations begin, invite nursing faculty to tour the nursing home so that instructors can get to know layout of the facility, confirm the goals for the clinical rotation, and pre-determine any needs the students might have such as parking or public transit routes.</li></ul><h3>Embrace Co-Design for Clinical Rotations</h3><ul><li><strong>All teach, all learn.</strong> Create an environment where everyone can teach and learn from each other. Invite faculty to share new methods of care delivery they are seeing in other settings. Encourage nursing home team members to highlight their care delivery methods that students and faculty may not encounter in any other clinical setting. </li><li><strong>Create a common language.</strong> Nursing homes can implement the <a href="https&#58;//www.ihi.org/networks/initiatives/age-friendly-health-systems" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Age-Friendly Health Systems 4Ms framework</a> to 1) enhance the quality of their person-centered care approaches, and 2) use the 4Ms as a “common language” to ease communication with faculty and teach nursing students essential gerontological nursing skills. </li><li><strong>Leverage “What Matters.”</strong> Residents enjoy spending time with students, in particular with the 4Ms “What Matters” activities where residents can share their personal stories and students can improve their interpersonal communication skills. </li><li><strong>Highlight the uniqueness.</strong> Nursing home staff can show students that nursing homes are a unique opportunity for nurses to work in an environment that is not only clinical but also residents’ homes, where collaborating across departments is critical to ensuring residents are healthy, safe, and happy.</li></ul><p>“We don’t expect this to be a quick fix for our staffing issues, but rather we are planting the seeds for the future,” said Kim Ratliff, RN, director of nursing at Wesley Enhanced Living Main Line.</p><p><img src="/Articles/PublishingImages/2025/Sophie-Campbell.jpg" alt="Sophie Campbell" class="ms-rtePosition-2" style="margin&#58;5px;width&#58;130px;height&#58;160px;" />As nursing schools begin to prepare for the next academic year, spring is the perfect time for nursing homes to rethink and renew their partnerships. The <a href="https&#58;//www.patnhc.org/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Pennsylvania Teaching Nursing Home Collaborative</a> provides free resources that have been created for and by nursing homes and schools of nursing committed to improving their academic-practice partnerships. <br><br><em>Sophie Campbell, MSN, RN, CRRN, RAC-CT, CNDLTC, is the executive director of the Pennsylvania Association of Directors of Nursing Administration (PADONA). </em><br></p>2025-04-08T04:00:00Z<img alt="" src="/Articles/PublishingImages/740%20x%20740/nurses.jpg" style="BORDER&#58;0px solid;" />ManagementSophie Campbell, RNNursing homes can use this season of transition as an opportunity to refresh their partnerships, including those with schools of nursing.
Ask This Critical Question Before Retrofitting a Building<p><img src="/Articles/PublishingImages/2025/senior_room.jpg" class="ms-rtePosition-2" alt="" style="margin&#58;5px;width&#58;200px;height&#58;200px;" />​One of the most important questions to ask before starting a facility retrofit project often goes unanswered&#58; “How are people actually using the building?”</p><p>It is easy to make assumptions. Residents spend the majority of their time in their rooms or apartments, the dining hall, and social areas. Visitors follow residents and staff work on dedicated floors or wings. But what if these assertions were only partially true?</p><p>What if data tells you when residents are most likely to want to socialize or are more susceptible to falls. Similarly, you may learn that the first stop for visitors is in one-on-one meetings with medical staff or the business office manager. Further, staff are often pulled in to help residents all over the community, instead of a dedicated floor, to fill ongoing staffing gaps. Those insights can shape the resident, staff, and visitor experience and influence retrofits.</p><p>Yet when it comes time for the building or community to undergo a retrofit, these assumptions are carried out in the planning and construction because real data on actual behaviors is not used.<br></p><h3>The Impact of Relying on Assumptions During Retrofits&#160;</h3><p>While the building and amenities get an appealing facelift, a retrofit based on assumptions miss an opportunity to optimize the human experience within the building.</p><p>Here are a few examples of what happens. Dedicated visiting areas feature expensive new furniture that goes unused. The latest tech tools and digital apps looked great and easy to use during the demo, but months later your staff still faces a steep learning curve. Meanwhile, residents find it difficult to adapt to the changes, impacting their quality of life. These issues can be avoided by having a better understanding of how the building is used before the retrofit starts.</p><p>With 42 percent of senior care communities in the U.S. being at least 25 years old, there is a pressing need to upgrade and modernize facilities. This is becoming increasingly critical as demographics shift. By the year 2030, there will be more adults over 60 than there are under that age.</p><h3>Getting Real-Time Insights Without Compromising Privacy</h3><p>Without real insights into how residents, staff and visitors use the buildings, retrofit investments won’t pay off. But how do you get that information?</p><p>You can monitor behavior but that is time consuming, invasive, and lends itself to personal bias. Or you can look at research, but it is often an additional cost and is based on empirical data as opposed to intel specific to your community. Another option is to ask people to participate in a survey, but that, too, is time consuming and opinion based.</p><p>Lately, one way that senior care communities are resolving this issue is by capturing real data on how humans interact in buildings using newer technologies that ensure privacy.</p><p>For example, using thermal heat-sensing technology provides insight into human movements in a space without knowing the individuals that are present. The thermal technology depicts humans as small circles that are moving or stationary. This technology can come in the form of a sensor that goes on the wall, blending into the retrofit design.</p><p>What senior care administrators can infer from the sensor data are insights such as the best location for a visiting area, or when residents are most likely to engage in social activities based on their behaviors as opposed to a scheduled time. From a health perspective, being notified of changes in a resident’s movement allows staff to respond faster to emergencies. These urgent notifications, often a text, reduce technology learning curves because the complex computing is done behind the scenes.</p><h3>The Benefits of Building Insight&#58; Safety, Compliance, and Revenue</h3><p>Having insight into how humans use a building before investing in a retrofit creates an opportunity to boost safety, ensure compliance, and improve the continuum of resident care.</p><p>It can also deliver better returns on the retrofit investment, according to administrators at Ranagård Community, which is using privacy-friendly heat-based sensors in over 700 apartments.</p><p>The sensors work with nurse call systems and immediately alert staff to incidents such as wandering, falls, or an increase in trips to the bathroom. This makes better use of staff time that was previously spent doing scheduled resident check-ins. They also have a digital record of activities, care, and responses in the event of an inquiry.</p><p><span><img src="/Articles/PublishingImages/2024/Honghao-Deng.jpg" alt="Honghao Deng" class="ms-rtePosition-2" style="margin&#58;5px;width&#58;124px;height&#58;171px;" /></span>The community estimates they save $1,875,000 per year by reducing 0.5 falls per year based on an average cost of $5,000 cost per fall, which requires two nurses to accompany a resident to the hospital. With safer buildings, they believe they can increase occupancy by 250 beds, resulting in an additional $2,160,000 per year.</p><p>Each community must determine their own return on investment on retrofits. Yet as the need for senior care rises and residents demand modern buildings, the retrofit process should always start with a clear understanding of how the building is being used.<br><br><em>Honghao Deng is CEO and co-founder of </em><a href="https&#58;//www.butlr.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><em>Butlr</em></a><em>.</em><br></p>2025-03-25T04:00:00Z<img alt="" src="/Articles/PublishingImages/2025/senior_room.jpg" style="BORDER&#58;0px solid;" />Design;ArchitectureHonghao DengEach community must determine their own return on investment on retrofits. Yet as the need for senior care rises and residents demand modern buildings, the retrofit process should always start with a clear understanding of how the building is being used.