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Skilled nursing providers are expanding services such as ventilator care and on-site dialysis as they care for residents with more complex needs. Operators describe potential clinical and operational benefits, but also stress that specialized staffing and hospital partnerships remain necessary.
Several nursing-home operators are expanding complex clinical services such as ventilator care and on-site dialysis as more residents arrive with needs once handled mainly in hospitals or long-term acute care hospitals. In a report published by Skilled Nursing News, providers said the shift is prompting facility upgrades and closer hospital coordination, while requiring specialist staff and careful decisions about which services each site can safely deliver.
ALIYA Healthcare has developed ventilator units through its Thrive subsidiary, though the model has not been introduced across its full portfolio. CEO Efriam Weinfeld told Skilled Nursing News that the company began with one of three facilities identified for the units, with plans to add them at the other two. The company has also installed dedicated dialysis spaces at 12 of its 18 facilities.
Weinfeld said ALIYA’s ventilator program is intended to improve care and the experience of residents and families, rather than simply increase capacity. He reported that one building, which had more than 18 ventilator patients, recorded a rehospitalization rate of about 14% in a recent month. Medicare.gov data cited in the report put the national average rehospitalization rate at 23.9%. Those figures describe different populations and the report does not establish that the facility’s rate resulted from the ventilator program.
Cascadia Healthcare operates several ventilator units at a subacute level, including at a newer Boise, Idaho, facility, according to CFO and Principal Steve LaForte. The company is also looking to expand in-house dialysis and is considering bronchoscopies, which the report describes as a newer service for skilled nursing facilities. Oakdale Seniors Alliance is evaluating partnerships to provide hemodialysis in its communities, while Venza Care offers higher-acuity services including cardiac care, dialysis and dual-diagnosis support.
More Care Moving Beyond Hospitals
Providing services on site could reduce some resident travel to hospitals or dialysis clinics and may give nursing-home teams more control over care. Oakdale quality vice president Heather Haberhern said residents with more complex conditions are being referred to nursing homes after expedited hospital discharges, with providers seeking a lower-cost setting that can still offer appropriate care. Operators also see a connection to value-based care, where outcomes such as avoiding readmissions can affect financial incentives.
The shift also changes what facilities must be prepared to manage. Ventilator care and dialysis demand trained staff, appropriate equipment and clinical oversight. Providers told the publication that services should not be expanded indiscriminately: a facility’s capacity and expertise matter, and partnerships with hospitals and medical directors remain part of supporting residents with complex conditions.
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Acuity Reshapes Skilled Nursing
The report describes a longer-running trend: nursing-home residents are arriving with higher clinical acuity, and skilled nursing facilities are taking on care traditionally associated with hospitals and long-term acute care hospitals. Examples cited include ventilator support, kidney dialysis and bronchoscopies. The providers named in the report are adapting in different ways rather than applying one model across every location.
ALIYA’s Weinfeld said the company prefers to develop strength in selected services rather than attempt to offer everything everywhere. Cascadia’s LaForte likewise framed expanded nursing-home care as a way to address demand and hospital bottlenecks, not as an effort to compete with hospitals. The article also notes that complex services can depend on close collaboration with outside clinicians and referring hospitals.
“Making a Taj Mahal of vent units was something that we’re now moving towards with our Thrive line.”
— Efriam Weinfeld, ALIYA Healthcare CEO
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Limits of the Available Evidence
The report does not establish whether these services improve outcomes across nursing homes or how widely the approaches will be adopted. ALIYA’s reported 14% monthly rehospitalization rate is a figure for one building, and the source does not provide a matched comparison group, the full measurement details or evidence that the ventilator program caused the result. The national figure cited is a separate benchmark.
It is also unclear how many facilities can recruit and retain staff with the training needed to deliver these services, what the expansion costs, or which procedures will be added at which locations. Oakdale is evaluating dialysis partnerships, and Cascadia is considering bronchoscopies; the report does not say those plans have been completed. The source material provided also ends during its discussion of Venza Care, so it does not detail that operator’s full approach to complex care.
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Expansion Depends on Readiness
ALIYA’s next stated step is to add ventilator units at the two other facilities identified for its program. Oakdale is assessing hemodialysis partnerships, while Cascadia says it needs to broaden its in-house dialysis offering and is considering whether to provide bronchoscopies. The report does not give timelines for those evaluations or expansions.
Operators’ plans will depend on their ability to prepare staff, equip facilities and coordinate with hospitals and medical directors. Further reporting would be needed to show how widely these services spread and whether they are associated with changes in resident outcomes, hospital transfers or costs.
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Key Questions
What services are nursing homes adding?
Providers in the report describe ventilator care and on-site dialysis, as well as cardiac care and consideration of bronchoscopies. Services vary by operator and facility.
Why are operators expanding complex care?
They say residents are arriving with more complex needs, and on-site services may reduce travel to hospitals or clinics. Some operators also connect the approach to value-based care and goals such as avoiding readmissions.
Does the reported 14% rehospitalization rate prove the program works?
No. ALIYA’s CEO reported that rate for one facility during a recent month. The report does not provide evidence that the ventilator program caused it or that the figure can be compared directly with the national benchmark.
Are nursing homes replacing hospitals for complex care?
The operators quoted describe the change as a way to provide more care in skilled nursing settings while continuing to work with hospitals. They stress that trained staff and clinical partnerships remain necessary.
Source: rss
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