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.