3 Skilled Nursing Missteps for Senior Living to Avoid

Substantial challenges lie ahead for the senior living industry in critical areas such as staffing and regulations.

The skilled nursing industry can provide some cautionary lessons in what not to do in confronting these challenges, suggested PointClickCare Vice President and General Manager for Senior Living Travis Palmquist, who spoke Tuesday at the electronic health record (EHR) software company’s 2017 SUMMIT in Orlando, Florida.

Palmquist has worked in the long-term post-acute industry for more than 25 years—beginning with a stint in skilled nursing. In those early years, he said, some hospital executives believed that if skilled nursing providers hired a good, qualified nurse, the facility would run itself.


Obviously, that mentality has not carried into senior living, and for good reason. There are a few other skilled nursing strategies that should be avoided by today’s senior housing providers at all costs, including:

1. Settling for an institutional environment.

Skilled nursing facilities can often feel fairly institutional, Palmquist said. Still, even though senior living providers are increasingly caring for higher-acuity residents—the average assisted living resident is on nine medications, he noted—that doesn’t mean that assisted living should start to resemble skilled nursing in terms of environment.


“[That’s] one of the No. 1 things senior living providers want to avoid,” Palmquist said.

2. Letting regulations write themselves. 

Currently, there is no standard assessment for assisted living communities nationwide. This is both a blessing and a curse, Palmquist implied.

“I know we don’t want federal oversight… [but] I never in my life thought I’d miss an MDS so much,” he said, referring to the Minimum Data Set, part of the federally mandated process for clinically assessing skilled nursing residents.

It’s possible that the federal U.S. government is going to start playing a bigger role in senior living, and providers should begin to work with industry associations to help guarantee that the regulations coming down the pike are beneficial, rather than a hindrance.

While skilled nursing facilities worked closely with associations, they could have done more when it came to playing a more active role in their regulatory destiny. “We’ve still got an opportunity on the senior living side to be very active,” Palmquist said.

“To sit back and just think that the regulatory process is going to work itself out… doesn’t turn out so well,” Palmquist added. “We’ve seen that move before, and it’s called skilled nursing.”

3. Not being creative enough to retain staff.

The senior living industry will need to hire 1 million more people over the next seven years, according to Palmquist.

“That is awe-inspiring,” he said.

Palmist knows firsthand how difficult it can be to recruit and retain quality workers in senior care. When he worked in skilled nursing, he often felt frustrated because “the hospital[s] just kept pilfering our staff.”

To make sure this doesn’t happen to senior living, providers need to think outside of the box.

“We need to get creative,” he said.

Technology can play an important role by making employees’ lives easier and their jobs more resident-focused, he concluded.

Written by Mary Kate Nelson

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