AI-Powered Monitoring Gains Traction in Nursing Homes Amid Staffing Shortages and Higher Acuity

by Amy Stulick

Nursing homes are implementing clinical tech, especially AI, to support staffing.The trend could signal a broader shift as nursing homes pursue tech-enabled care coordination to remain competitive and meet increasing acuity demands.

Operators see the practice as a way to strengthen partnerships, especially with hospitals, in turn aiding in referrals. But, tight margins tied to subpar Medicaid and managed care reimbursement add financial barriers to unlocking cutting-edge tech systems that can help nursing homes level up.

All the while, more higher acuity patients are moving into nursing homes.

“If the technology is not affordable, I think the nursing homes are going to lag behind,” Matt Nieukirk, director of operations for SNF practice and home health at OSF Healthcare, told Skilled Nursing News. “The care that we give to these patients will continue to evolve, and the nursing homes are going to need to look for that extra technology, or that extra push that’s going to get them to the next level.”

OSF is an Illinois-based health care system with a network of 17 hospitals, partnering with nursing homes for operations rather than owning them outright.

But, the use of AI and other technologies should be done with purpose and strategy, said Aimee Middleton, COO for the South Dakota-based Evangelical Lutheran Good Samaritan Society. Notably, without replacing caregivers. If anything, staff roles should evolve with the use of technology, she said.

“I don’t think we have an option to not look at technology being part of our future,” said Middleton. “What are our residents looking for, and how can we get those frontline caregivers back to the actual caregiving?”

Construction with tech in mind, and rethinking staff roles

Good Samaritan this year has automated its revenue cycle task to save staff significant hours. The operator also is baking in another tech initiative – robot vacuuming and food service – at a new campus construction project in Sioux Falls, South Dakota.

“Our existing campuses will benefit from this as well – we’re going to trial some of these technologies in some of our existing campuses,” said Middleton. Housekeepers could socialize with residents more, and dietary aides can work on making sure all residents have warm food at the same time when they sit down for a meal.

In terms of revenue cycle automation, the organization can tweak certain positions to focus more on bedside care, positively impacting the quality of care, she said.

“I know it doesn’t sound very exciting, but we have five employees spending about 80 to 100 hours every single month, closing out our locations. Well, we automated that system,” said Middleton.

Virtual nurse wraparound services for night shifts have also been considered by Good Samaritan, she said. Right now, if a nurse has a question at 3 a.m., she has to call the director of nursing.

“Imagine a world where the DON doesn’t get the call. There’s a world where a virtual care RN answers the question, and the team member on the front line gets the support that they need,” said Middleton. “My DON’s job satisfaction goes up. Her work-life balance is better. That’s the world we’re dreaming of right now, and really trying to make sure that we have the network in place to be able to do it, and that we could carry this to many locations.”

Catching up with hospital tech advancements

AI is a critical step in bridging the tech gap between hospitals and nursing homes, Nieukirk said. A lot of nursing home operators lack real-time patient monitoring systems, a common pattern among acute care providers.

Such tech adoption is seen as a way to strengthen hospital-nursing home partnerships and in turn referrals. But, cost remains a major barrier to a broader rollout across the nursing home industry, he said, especially considering tight Medicaid margins across the country.

“Nursing homes for the past 25 years have been relying on human interactions. They don’t have the monitoring systems like the hospitals do. This is a great first line for nursing homes to start rolling into new technology and having AI involved,” said Nieukirk. “It puts the hospital’s mind at ease too, knowing that these facilities do have an extra layer of monitoring.”

OSF HealthCare has partnered with AI company Somato to pilot predictive monitoring technology in 25 nursing homes across Illinois, Nieukirk said, with plans to further expand the program. The tech works to improve early detection of clinical deterioration by using AI to scan electronic medical records, and flagging “out-of-range” vitals and pattern deviations.

The tech flags subtle signs of infection along with gradual temperature increases and elevated heart rates, he added. Somato case managers review alerts before notifying staff at the nursing home. The tech acts as a second pair of eyes on patients in an attempt to reduce hospital transfers.

“What we have found is, a lot of times people that are turning septic, or they’re starting to get an infection, it doesn’t start overnight,” said Nieukirk. “[Somato’s case managers are] looking back and they’re alerting the nursing homes, and the nursing homes are taking action, whether they’re calling the physician, getting an antibiotic started, maybe getting some labs done.”

The biggest goal is to keep the patient in bed, and not have an emergency transfer to the hospital.

“We’re actually catching patients prior to them, you know, turning septic, or needing to go back into the hospital,” said Nieukirk. “It’s like you have an extra nurse sitting at your nurse’s desk and doing nothing but monitoring for you.”

Nursing homes are coming around to AI

OSF Healthcare launched the initiative in October 2023, and it took eight to nine months to get nursing home operators on board. That means the program has only been in facilities for about seven months. It’s part of a larger trend to incorporate clinical AI into post-acute care settings, Nieukirk said, especially as staffing shortages continue to challenge operations.

OSF’s nursing home partners Allure Group and Arcadia Care have implemented the technology, and initial results show a “positive impact,” Nieukirk said. Data is still rolling in and will inform any sort of refining as expansion occurs.

“I’m introducing it to administrators all the time. When you have 100 to 150 facilities using it and you’re collecting data, it’s that much easier to prove how the technology works and how the systems can help the facilities,” said Nieukirk.

Actionable alerts are limited to 15-20 per facility per month, enhancing care without overwhelming staff, Nieukirk noted. Somato filters through quite a lot of notifications, receiving between 12 and 1,500 per month for all participating facilities. 

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AI-Powered Monitoring Gains Traction in Nursing Homes Amid Staffing Shortages and Higher Acuity 

Tech plus touch is goal for senior living industry

Artificial intelligence has the potential to transform the senior living industry. From helping to drive resident satisfaction and supporting staff member retention to enhancing efficiency and streamlining processes, industry experts are optimistic about how AI can help support their operations.

At the same time, senior living leaders are mindful of the importance of human interaction in the industry and the need to maintain the right balance of what Alex Prough, chief commercial officer at Medical Guardian, called “tech plus touch.”

In a private roundtable discussion, “Exploring AI-Driven SaaS in Senior Living Operations,” sponsored by Medical Guardian, leaders from the company came together with senior living and care industry professionals to gain insights into how AI can best be used in the industry’s daily operations.  

When asked to pinpoint their most pressing operational challenges, panelists overwhelmingly cited staffing and regulatory issues. “It’s all about staff,” said Chris Winkle, a consultant and former CEO of Sunrise Senior Living. He said he believes “there’s a lot of opportunity for tech and automation to ease that labor pressure.”

“There’s not enough staff in the industry to fill positions,” agreed Mark Mitchener, corporate vice president for Greystone Communities. He added that, too often, staff members abandon jobs in the senior living industry to pursue higher-paying jobs elsewhere, with caregivers going to agencies. In states with a high minimum wage, operators find themselves competing with fast food or retail employers, and even Amazon, for employees.

Regulatory compliance issues also loom large for operators. “In some states, [senior living communities] are treated like nursing facilities when it comes to staffing ratio,” said Heather Tussing, president of The Aspenwood Company.

Valuable tool for reducing workload

From a regulatory compliance standpoint, it’s a moving target in certain states,  according toDivinia Nunez, director of operations for Sinceri Senior Living.

“All the regulatory demands are difficult for administrators,” noted Carrie Lund, vice president of operations at Principle LTC. “That’s probably one of the biggest challenges.”

The paperwork associated with meeting regulations also is a huge burden for staff members, and the panelists acknowledged that they are desperate to find ways to streamline their workflows. “Electronic records were supposed to make our job easier,” observed Mitchener. “The key is to use AI to take some of the paperwork load off caregivers and nurses and allow them to be on the floor with the residents.”

April Young, chief operating officer at Sinceri Senior Living, bemoaned “too many software platforms for employees to get lost in” at the expense of “customer service and engaging with residents and families.”

As with many other senior living companies that are beginning to explore ways that AI can assist in care and service delivery, resident engagement, documentation and compliance, Young said that Sinceri Senior Living is experimenting with AI to “determine how we could be more efficient and run more smoothly.”

Varied applications for AI

“I’ve seen applications from the marketing side to the procurement side to the capital side,” Winkle said. He described an AI tool that links procurement to the menu to lock in food cost.

Jenni Bost, vice president of marketing for Radiant Senior Living, described how her company has been more successful gathering survey information using an AI-driven chatbot than when using a live person. “We use it in our sales, marketing and with our [customer relationship management platform]. I use it for distilling survey information, and we’re able to do that faster than before,” she said.

Michener noted that his company is using AI to distill tome-like referrals down to two pages so staff members can more easily digest information and make decisions quickly. 

The panelists agreed that AI has the potential to enhance rather than detract from the level of human touch that residents receive. For example, AI can help ensure that the needs of all residents are being met. Winkle noted that AI can be applied to electronic health records data to determine which care plan residents should be on and whether their actual care reflects that assessment.

“Typically, the sickest people need the most attention, but we want to make sure that people that are less sick don’t get neglected,” observed Jim Reilly, senior director of MGLiving for Medical Guardian. 

AI also can be used to boost customer satisfaction. Howard Teicher, senior vice president for MGLiving and channel partners for Medical Guardian, explained that the company has created a wellness check-in campaign through which residents rate how they feel physically and emotionally. If a resident says he or she isn’t feeling well, then staff members receive a prompt to call the resident’s caregiver to suggest a check-in. 

“AI can give you visibility. You can make that outreach greater,” explained Terri Williams, senior director of healthcare marketing for Medical Guardian.

Tussing said that The Aspenwood Company has uploaded information on individual residents’ specific interests and is using AI to create unique experiences for residents, such as “one-on-one experiences or LinkedIn Learning courses.”

Enhancing outreach is an ongoing focus for Medical Guardian, company representatives said, adding that the firm is working to create an outreach coordinator program for its clients that can supply Silver Sneakers-approved providers to run activities.

Powerful tool to enhance care 

AI also can provide valuable insights into fall risk assessment, according to panelists.

“We’re seeing real promise in leveraging AI to work upstream to help prevent falls,” Prough said. “We are now doing dynamic fall risk scoring and starting to move the needle on emergency department utilization and other things for some of the communities we help support. We feel like there’s a lot of promise there.”

“There’s also an opportunity on the independent living side for a bot to answer a lot of the questions that nurses or staff members field, so that they can spend more time with residents,” Michener said.

Giving staff members the right tools can enhance job performance and job satisfaction, panelists said. 

“If staff members have something to help guide them through issues and give them the right answers, we’re better operators and have less liability risk,” Reilly said. That automation is especially helpful at helping keep those employees with the least experience from feeling overburdened, he added.

The panelists agreed that AI can be a huge benefit to lessening the workload of an overburdened workforce plagued by high burnout and turnover rates.

“It certainly helped with my staff burnout,” Bost said. “I could do much more than I could ever do before.”

“There is more we can do to prevent that burnout with our teams by utilizing AI,” Michener said. “We’re just scratching the surface at our organization.”

The increased use of AI also will require additional staff training, so the panelists stressed the importance of communicating to staff members that the training will make their jobs easier in the long run.

Michener concluded that “AI is coming, whether we like it or not.”

“We need to learn how to use it in our industry to have the best impact on our residents’ and staffs’ lives,” he said. “We do need to put the brakes on a bit to make sure our systems are all in place.”

To get the greatest value from AI, the panelists said that data need to be integrated, and they stressed the importance of sharing data across platforms.

“There are even more opportunities to create a centralized hub of data to support residents in a more meaningful way,” Prough said.

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Tech plus touch is goal for senior living industry