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Several U.S. nursing home operators are adding or expanding services such as ventilator care and in-house dialysis for residents with more complex medical needs. Operators say these services can support care in lower-cost settings, but staffing, hospital partnerships and the results of expansion remain key considerations.
Several nursing home operators are expanding services such as ventilator care and on-site dialysis as their facilities receive residents with more complex medical needs, according to Skilled Nursing News. The shift brings some care traditionally provided in hospitals or long-term acute care hospitals into skilled nursing facilities, with operators citing resident care, hospital discharge needs and value-based payment incentives.
ALIYA Healthcare has expanded ventilator services through its Thrive subsidiary and is developing specialized units at three facilities that were required to have them. Chief Executive Efriam Weinfeld told Skilled Nursing News that the units are not being rolled out across the entire company. He said the effort is intended to improve care and the experience of residents and families, while requiring facilities to make changes beyond typical skilled nursing standards.
Weinfeld said one facility with more than 18 ventilator units had a rehospitalization rate of about 14% in a recent month. The figure applies to that building and period, he said. Medicare.gov data cited in the report put the national average rehospitalization rate at 23.9%; the report does not give a matching measurement period or other details to establish a direct comparison. ALIYA also operates on-site dialysis in 12 of its 18 facilities, with dedicated spaces for treatment.
Cascadia Healthcare operates several ventilator units at a subacute level in a new Boise, Idaho, building, Chief Financial Officer and Principal Steve LaForte told the outlet. He said the company is expanding in-house dialysis and considering bronchoscopies, a procedure that the report describes as relatively new in skilled nursing facilities. Oakdale Seniors Alliance is evaluating partnerships to offer hemodialysis in its communities, Vice President of Quality Heather Haberhern said. Venza Care also provides higher-acuity services, including cardiac care, dialysis and dual-diagnosis support, according to the report.
More Complex Care in Nursing Homes
Bringing more services into skilled nursing facilities could reduce the need for residents to travel to clinics or return to hospitals for some care. Haberhern said Oakdale is assessing whether community-based hemodialysis could cut transportation time and hours spent in clinics. Weinfeld said keeping services in-house can help ALIYA focus on outcomes such as avoiding hospital readmissions.
The expansion also reflects pressure on hospitals managing discharges and demand for beds. Haberhern said hospital partners are referring residents with more clinically complex conditions to nursing homes as they seek lower-cost settings that can still provide high-quality care. LaForte framed the shift as a way for providers to help relieve hospital bottlenecks. Those are the operators’ accounts of the potential benefits; the report does not establish that these programs have produced the same outcomes across facilities.
For residents and families, availability may mean receiving certain treatments closer to where they live. For providers, it requires specialized equipment, trained staff and coordination with clinicians. The services vary by facility, so a provider’s broader expansion does not mean every community can offer every procedure.
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Hospitals and Skilled Nursing Referrals
Skilled nursing facilities have long received residents who need more care after a hospital stay than a routine rehabilitation placement provides. The report describes a continuing rise in resident acuity and a corresponding expansion of services traditionally associated with hospitals or long-term acute care hospitals. Providers named in the report include ALIYA Healthcare, Cascadia Healthcare, Oakdale Seniors Alliance and Venza Care.
Some operators connect the move to value-based care, in which providers have financial reasons to focus on outcomes and avoid preventable hospital use. Weinfeld said ALIYA’s in-house approach helps align its focus with those outcomes. The report does not specify the payment arrangements involved or quantify their effect on the companies’ decisions.
The approaches remain selective. ALIYA is building ventilator units at three facilities rather than throughout its portfolio. Weinfeld said providers risk becoming mediocre if they try to offer every service everywhere, and said he would rather focus on one or two areas. Cascadia’s vent specialization is currently present in a new Boise building, while its broader dialysis expansion is still being pursued.
““Making a Taj Mahal of vent units was something that we’re now moving towards with our Thrive line.””
— Efriam Weinfeld, CEO of ALIYA Healthcare, speaking to Skilled Nursing News
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Staffing, Outcomes and Service Reach
The report does not provide staffing levels, costs, safety data or multi-month outcome figures for the programs described. ALIYA’s reported 14% rehospitalization rate covers one facility in a recent month, and the report does not establish whether that rate persisted or how comparable residents and time periods were used for the national figure.
It is also unclear how many facilities will ultimately add each service, how quickly planned expansions will proceed, or how many residents will be eligible. Cascadia is considering bronchoscopies, while Oakdale is evaluating hemodialysis partnerships; neither statement establishes that those services have begun at additional communities. The report’s discussion of Venza Care is brief and gives no facility count or implementation timeline.
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Planned Service Expansions
ALIYA plans to add ventilator units at the other two facilities identified for the program, following its initial facility, Weinfeld told Skilled Nursing News. Cascadia is seeking to expand in-house dialysis beyond its current offerings and is weighing whether to provide bronchoscopies. Oakdale continues to evaluate partners for hemodialysis in its communities.
Operators say close work with referring hospitals and medical directors will remain part of caring for residents with more complex needs. The next indicators to watch are whether proposed services reach more facilities, how providers staff them, and whether they report sustained outcomes for residents and hospital readmissions.
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Key Questions
Which services are nursing homes adding?
Providers in the report describe ventilator care and on-site dialysis. Cascadia is considering bronchoscopies, and operators also cite cardiac care and dual-diagnosis support.
Are these services available at every nursing home?
No. The examples are limited to particular operators and facilities. ALIYA’s ventilator units are planned for three facilities, and the report says its programs have not been rolled out across the full portfolio.
What rehospitalization rate did ALIYA report?
ALIYA CEO Efriam Weinfeld said one facility with more than 18 ventilator units had a rate of about 14% in a recent month. The report cites a national average of 23.9% from Medicare.gov but does not provide a matching period or enough detail for a direct comparison.
What remains uncertain about the expansion?
The report does not provide full cost, staffing or safety data, or long-term outcome results. Several plans, including Oakdale’s hemodialysis partnerships and Cascadia’s possible bronchoscopies, are still under evaluation.
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