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Several skilled nursing providers are expanding services such as ventilator care and in-house dialysis for residents with increasingly complex needs. Operators say these services can reduce hospital transfers and clinic travel, but they require specialized staff and close coordination with hospitals; the reported examples do not establish results across the sector.
Several skilled nursing providers are expanding or evaluating complex services, including ventilator care, on-site dialysis and bronchoscopies, as nursing homes receive residents with greater medical needs, according to a report by Skilled Nursing News. The shift brings some care traditionally provided in hospitals or long-term acute care hospitals into skilled nursing facilities, while operators say it depends on specialized staffing and hospital partnerships.
ALIYA Healthcare has developed ventilator units through its Thrive subsidiary, though the units are not being rolled out across its entire portfolio. Chief Executive Efriam Weinfeld said the company began with one of three facilities identified for the program and plans to add units at the other two. He described the aim as improving care and the experience of residents and families, not simply increasing capacity. Ventilator care requires a facility team to manage a clinically demanding service, the report said.
Weinfeld told Skilled Nursing News that one ALIYA building with more than 18 ventilator units recorded a rehospitalization rate of about 14% in a recent month. He said the rate was better than at some other subacute buildings. That is a single facility’s reported result for one month, not evidence of a companywide or industrywide outcome. For comparison, Medicare.gov data cited by the report put the national average rehospitalization rate at 23.9%; the figures may not describe identical patient groups or measurement conditions.
ALIYA also provides in-house dialysis at 12 of its 18 facilities, using dedicated areas it calls “dialysis dens.” Weinfeld said keeping services within a facility can help align care with goals such as avoiding hospital readmissions, but cautioned against trying to offer every service everywhere. Other providers are pursuing different approaches: Cascadia Healthcare operates subacute ventilator units at a new Boise, Idaho, building and is expanding in-house dialysis, while Oakdale Seniors Alliance is evaluating partnerships to provide hemodialysis. Cascadia is also considering bronchoscopies, a procedure the report describes as relatively new to skilled nursing facilities.
More Complex Care Moves Into Nursing Homes
The reported changes matter because they could alter where some residents receive care after leaving a hospital. Providing services such as dialysis or advanced respiratory support on site may reduce transportation and clinic time, and may give hospitals another setting for patients who no longer need hospital care but still have substantial clinical needs. Oakdale vice president of quality Heather Haberhern said hospitals are referring residents with more complex conditions to nursing homes as they seek lower-cost settings that can still provide high-quality care.
These services also carry operational demands. Ventilator programs need trained nurses and direct-care staff, appropriate equipment and clinical oversight; a specialized service cannot be judged solely by whether a facility has installed it. The example ALIYA shared is encouraging as an operator-reported metric, but a one-month figure from one building does not show whether the approach causes lower rehospitalization or can be reproduced elsewhere. The source does not provide comparable outcome data for the other providers.
For residents and families, the practical question is whether a particular facility can safely meet an individual’s care needs and coordinate with the hospital and clinicians involved. For providers and payers, the question is whether added capabilities improve care and reduce avoidable transfers without creating gaps in staffing, quality or oversight. The report presents expansion as a response to rising acuity, not as proof that every nursing home should offer hospital-level procedures.
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Providers Build Specialized Services
The report describes a broader move toward higher-acuity care in skilled nursing facilities, which traditionally have not provided many services associated with hospitals or long-term acute care hospitals. It identifies Venza Care, ALIYA Healthcare, Cascadia Healthcare and Oakdale Senior among providers expanding or exploring more complex services. The examples differ: some programs are operating, while others remain under evaluation or consideration.
ALIYA’s ventilator program is being developed through Thrive and is not planned for every facility. Cascadia, which the report says operates more than 61 long-term care facilities across Washington, Oregon, Montana, Idaho and Arizona, has subacute ventilator units at a new Boise location and says it is broadening in-house dialysis. Oakdale is assessing hemodialysis partnerships. The report also mentions Venza Care’s higher-acuity services, including cardiac care, dialysis and dual-diagnosis support, but gives limited detail about those programs.
Operators describe these services as a way to respond to residents’ needs and, in some cases, avoid sending them out for treatment. The report also links the business case to value-based care, in which payment arrangements may reward outcomes such as avoiding readmissions. However, it does not provide contract details, financial results or evidence that the services have produced savings across the organizations.
““Making a Taj Mahal of vent units was something that we’re now moving towards with our Thrive line.””
— Efriam Weinfeld, chief executive of ALIYA Healthcare
Outcomes and Safety Data Are Limited
The report does not establish how widespread these programs are across the nursing home sector, or whether the reported expansions will lead to consistently better outcomes. The ALIYA rehospitalization figure is an operator-provided rate for one building in a recent month; details on the exact month, calculation method and resident mix are not supplied. It should not be treated as directly comparable to the national average without those details.
It is also unclear how many facilities have the staffing, equipment and clinical oversight needed to provide each procedure, or what safeguards and quality measures providers use. Cascadia’s possible expansion into bronchoscopies and Oakdale’s hemodialysis partnerships are described as under consideration or evaluation, not completed programs. The source gives little detail on Venza Care’s services and does not report patient outcomes, costs or independent assessments for the providers’ programs.
Expansion Depends on Staff and Partnerships
ALIYA plans to add ventilator units at two more facilities in the group Weinfeld identified, while its existing dialysis service covers 12 of its 18 facilities. Cascadia says it is working to expand in-house dialysis and is considering whether to offer bronchoscopies. Oakdale is evaluating hemodialysis partnerships. The report does not specify launch dates for those plans.
Hospitals and nursing homes will remain central to the next stage, according to the operators and quality leader quoted. Haberhern said Oakdale wants close relationships with referring hospitals and medical directors, supported by staff training. Further information about program locations, staffing, safety practices and comparable outcomes would help show whether these services are improving care and reducing avoidable hospital transfers.
Key Questions
What services are nursing homes adding?
Providers cited in the report are offering or considering ventilator care, in-house dialysis and bronchoscopies. Other higher-acuity services mentioned include cardiac care and dual-diagnosis support at Venza Care.
Which providers are expanding these services?
The report names ALIYA Healthcare, Cascadia Healthcare, Oakdale Seniors Alliance and Venza Care. Their plans differ: some services are already operating, while others are still being evaluated or considered.
Did ALIYA report lower hospital readmissions?
ALIYA CEO Efriam Weinfeld said one building with more than 18 ventilator units had a rehospitalization rate of about 14% in a recent month. The report does not provide the precise month or enough methodological detail to establish a direct comparison with the cited 23.9% national average.
Are these services replacing hospital care?
Operators described them as a way to provide selected care in skilled nursing facilities and ease pressure on hospitals, not as a replacement for hospital partnerships. The source says coordination with hospitals and medical directors remains important.
What is still unknown about the expansion?
The report does not establish the overall scale of the trend, the comparative safety or cost of each service, or whether the reported approaches improve outcomes across facilities. Some plans, including Oakdale’s hemodialysis partnerships and Cascadia’s possible bronchoscopies, remain under consideration.
Source: rss
