During that same time period, 44% of nursing homes experienced technology growth, while 27% experienced no change in their technology adoption.

The scope of abandoned tech is not merely discontinued services such as outdated software, but rather a failure to provide or nurture certain technologies across an entire facility or organization, according to the study authors from the Sinclair School of Nursing at the University of Missouri and Columbia University’s nursing school. With nursing homes more reliant than ever on technology, conducting analyses on why they abandon tech are as important as studies about tech growth, the researchers stated.

The majority of nursing homes that abandoned administrative technology were larger operations of 120 beds or more, according to the study.

“Technology abandonment can increase strain on scarce resources and may impact administrators’ ability to oversee clinical operations, especially in large nursing homes,” the study authors stated. “This study can serve as a building block for others working to ensure limited resources are used effectively to improve care for nursing home residents.”

While the research doesn’t indicate whether some technology was abandoned to put new, better systems in place, some may have been discontinued to create greater efficiencies, the researchers speculated. They added that other studies have shown tech doesn’t always turn out to improve caregivers’ and staff’s workflow.

The study was published in the Journal of the American Medical Directors Association.

Longevity and Touchstone have formed an independent provider association that will serve Humana members living in the state starting in 2024. The Longevity-Humana partnership will provide special needs health plan offerings for Medicare-eligible individuals in skilled nursing facilities and senior living communities.

The companies plan to launch their initiative in a handful of additional states in 2024 and to add others in 2025.

As part of the Touchstone pact, Longevity will hire and manage specially trained care teams including advanced practice clinicians such as nurse practitioners and physician assistants, in addition to medical directors, pharmacy experts, medical assistants and others.

Those teams will work on-site in Touchstone communities to care for Humana’s enrolled members.

Beneficiaries will receive services such as no copays for primary care and behavioral health visits, transportation to medical appointments, an over-the-counter benefit for health products, preventive and hearing aid coverage and other supplemental benefits.

Humana’s Medicare Advantage plans in Texas cover more than 440,000 people, according to Humana Texas Medicare President Bill White.

“Our partnership with Longevity enables us to expand our reach as this new Institutional special needs plan (I-SNP) helps meet the specific needs of high-acuity members who live in senior living settings,” he said. n

Amid the significant increase in the number of nurses transitioning to the gig models, CareRev, Clipboard Health, IntelyCare, Kare, Nursa and ShiftKey are just a few platforms that try to match the demand for nurses with a supply of nurses, the article stated. The platforms allow nurses to take temporary positions and move on to new opportunities. Some platforms contract with staff, so they might not provide them with traditional employee benefits or training. 

Still, the platforms can create imbalances when it comes to staffing. That’s because some of the on-demand nurses may opt for the higher-paying shifts, leaving lesser-paying shifts uncovered. Also, having a different rotation of nurses could affect clinical care consistency. Some gig nurses may care more about the money than providing quality care, the analysis suggested.

In addition, businesses need to be careful about how they classify workers to prevent legal issues, rising costs and to protect their reputations, the article cautioned. In addition, healthcare laws differ from state to state, which could impact nurses, facilities and the platforms.

“The amalgamation of technology, gig economy and healthcare via on-demand nursing platforms presents opportunities such as enhanced flexibility and reduced burnout potential,” article authors observed. “Despite these advantages, concerns around worker status, legal implications, and job equity arise, demanding careful consideration.”

Researchers from the University of California-San Francisco evaluated the program, which was hosted through the telecare platform Care Ecosystem, on 780 older adults with dementia. Participants were randomized into two groups. One received telephone-based collaborative dementia care through the platform, delivered by a trained care team navigator, who provided education, support and care coordination with a team of dementia specialists, including an advanced practice nurse, social worker, and pharmacist. The other group received dementia care as usual.

After approximately one year, those in the telehealth group had average Medicare costs $526 lower than those receiving the usual model of care. This finding follows previous research by UCSF that found that the percentage of caregivers in the Care Ecosystem program with moderate-to-severe depression dropped from 13.4% to 7.9% over the course of a year, versus an upswing in depression among caregivers in the usual care cohort. Additionally, quality of life for patients in the Care Ecosystem was ranked higher, according to this research.

The investigators noted that the telecare program will launch even more broadly in July 2024, and will be available to patients with dementia who live either at home or in assisted living communities. They must be covered by Medicare fee-for-service or have dual Medicare and Medicaid eligibility. The program will include navigators that assist with drugs, transportation, respite care and day care.

“The challenges of providing constant support to patients with dementia can take a heavy emotional, physical and financial toll on unpaid caregivers. This program will enable the caregiver system to shift from crisis-oriented to proactive,” said senior author Katherine Possin, PhD, of the UCSF Department of Neurology, and co-founder of the Care Ecosystem.

Pathway Health Emerging Leader Solutions offers a comprehensive suite of services that includes interim leaders, mentorship and guidance to empower emerging and new-to-career leaders seeking a career in nursing home or senior living administration.

The profession “continues to face unprecedented leadership challenges due to a number of factors, including the growing needs of an aging population and workforce pressures resulting from leaders reaching retirement age and turnover,” said Pathway Health CEO Peter B. Schuna.

Among the new services is PathPass mentoring and licensure examination preparation to aid new leaders and undergraduate and graduate candidates. Also, CareerPrep offers career search mentorship, preparation, professional development and career placement for long-term care leaders.

In addition, PathPro will connect Pathway Health professionals with current leaders who are seeking mentorship and professional career development support.

“We aim to not only support new-to-career leaders as they start their career journey but also provide ongoing mentorship for existing leaders to achieve a successful, long-standing career,” Schuna said.

PointClickCare did just that when it introduced platform upgrades at the American Health Care Association/National Center for Assisted Living Convention & Expo and HLTH 2023. Changes focus on the importance of stronger care collaboration to ensure providers have access to the same data across the continuum. 

“From the ongoing staffing shortage to the continued evolution of value-based care and alternative payment models, the LTPAC space has seen a great deal of change and challenge this year,” said Travis Palmquist, senior vice president and general manager of senior care at PointClickCare. 

“Our focus has always been to help our customers thrive with changing models of care, and with the right solutions, we can be the catalyst to help address some of the biggest challenges around occupancy and standardization of care that our customers are facing.”

During a session at AHCA’s conference, Cheryl Field, MSN, discussed a keen awareness  across LTC roles that success requires attention to residentcentric details. She said those should roll up into organizational outcomes measured in revenue, risk and reputation.

“We know early identification leads to lower cost and improved healthcare outcomes, but too often we don’t have time to critically think about the data elements constantly being collected in an electronic health record, until now,” Field said. “New technologies are leveraging massive amounts of everyday data, to build predictive measures which add value to the decisions made in senior care every day.”

These technologies, she added, save staff time and improve care outcomes by doing some analysis of the data that humans simply don’t have time or computing capacity to perform.

Also at AHCA’s annual meeting, Bill Charnetski, PointClickCare’s executive vice president of health system solutions and government affairs, was elected to the AHCA Board of Governors as associate business member president.

Over the course of nine years, researchers looked at how often people worked shifts, the type of shift they worked, and how many years they worked shifts. They found a higher risk of depression and anxiety was positively associated with shift frequency. They did not find a difference in risk whether the person worked nights or days. 

Results in JAMA Network Open also suggested the associations of shift work with anxiety and depression may be partly explained by smoking, sleep duration and  body mass index (BMI). Those factors made up 31% of the link between shift work and depression and 21% of the association between shift work and anxiety.

The research involved an analysis of data from 87 nursing homes, including administrative data for 10,000 residents and survey data for 3,500 nursing assistants. Results showed residents on care units with higher best practice use among CNAs had 32% higher odds of reporting mild pain compared with residents on care units with lower levels of best practice use among nursing assistants.

Best practices include CNAs recognizing verbal and nonverbal signs of possible pain among residents, and then reporting this new or worsened pain to their supervisors (usually nurses). Researchers said earlier pain recognition and reporting by aides could lead to better assessment and pain management by licensed clinicians.

“Nursing assistants are rarely involved in guideline development and quality improvement programs or offered continuing education about pain management,” the study’s authors wrote. “Their important role at the forefront of pain detection should be acknowledged and their capacity better optimized, for example, through more attention to this pivotal workforce with respect to both basic and ongoing education.” 

The study appeared in the Journal of the American Geriatrics Society. 

Despite these gains in usage, however, telehealth visits within long-term care remain underutilized generally, and could use some additional support, experts said.

Researchers from several Boston universities and medical centers found that from January 2019 to February 2020, telemedicine visits accounted for less than 1% of all health visits for nursing home residents. That number increased to 15% of routine SNF visits and 37% of other outpatient visits in SNFs in early 2020, before dropping again and stabilizing at 2% of routine SNF encounters by mid-2021. Half of all telemedicine visits in 2020 and 2021 were clustered in 18% of nursing facilities. 

In 2019, just three Midwestern states — where a lack of local specialists created high need — had more than 1% of health visits delivered via technology. A year later, all US states were using telemedicine at higher levels. But by the first half of 2022, just one state used telemedicine for more than 10% of nursing facility visits and eight states had  returned to using it less than 1% of the time. 

“Our results should be a wake-up call that telemedicine has not been a ‘field of dreams’ situation where SNFs just come and use the technology without any further systems in place,” said study author Michael L. Barnett, MD, associate professor of Health Policy and Management at Harvard T. H. Chan School of Public Health.

The study showed more LTC residents are using telemedicine for psychiatry visits than ever before, and that it improved access. Older adults remain the least likely group to seek mental health assistance overall: Just 9% of seniors seek mental health treatment, previous studies have shown.

“A policy to encourage continued telemedicine use may facilitate further access to important services as the technology matures,” the researchers wrote in JAMA Network Open. 

Curana’s model offers residents on-site and virtual primary and post-acute care. The partnership allows SALMON to improve the experience for its residents through integrated and coordinated care with the goal of reducing unnecessary hospitalizations.

Embedded clinicians help facilities provide a consistent model of care to all residents, improve census, and create a more personalized resident care experience that results in higher-quality outcomes, said Michael Emery, executive vice president for senior living at Curana Health. Services typically include preventative care, sick visits, lab work, wound care, and blood pressure clinics. Curana also coordinates care with residents’ specialists and other care teams and offers 24/7 access to advanced practice providers who specialize in geriatric care.

“Curana is excited to partner with groups like SALMON who share the belief in creating innovative partnerships to build new clinical models for senior living that reflect what this generation of seniors wants, expects, and deserves,” Emery said. “We are delivering a more convenient and coordinated care experience, rooted in access to high quality, multi-specialty care terms that are true partners with residents and their families.”