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Nursing home operators are expanding services such as ventilator care and on-site dialysis as more residents arrive with complex medical needs. ALIYA Healthcare says a facility with more than 18 ventilator units recorded a rehospitalization rate of about 14% in a recent month; the figure is an operator-reported result, not evidence that the model will produce the same outcome elsewhere.
Several U.S. nursing home operators are expanding ventilator care, on-site dialysis and other complex services as facilities receive residents with higher medical needs after hospital stays, according to a report by Skilled Nursing News. The shift could give some residents access to care closer to where they live and reduce transfers, but operators say it requires trained staff, specialized facilities and close coordination with hospitals.
ALIYA Healthcare has expanded its ventilator program through its Thrive subsidiary, with plans to add ventilator units at two more of three facilities identified for the service. Chief Executive Efriam Weinfeld told Skilled Nursing News that the approach involves more than adding beds: facilities need their own teams to manage a higher-risk, clinically demanding service. He said the aim was to improve care and the experience of residents and families, rather than simply increase capacity.
Weinfeld said one ALIYA building with more than 18 ventilator units had 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%. The figures describe different populations and contexts; the report does not establish that the facility’s rate resulted from its ventilator program or that it is comparable to the national measure.
ALIYA also provides in-house dialysis at 12 of its 18 facilities, with dedicated treatment areas. Other providers are developing similar capabilities. Cascadia Healthcare operates ventilator units at a subacute level in a new Boise, Idaho, building and is seeking to expand in-house dialysis. The company is also considering bronchoscopies, a procedure that the report describes as relatively new to skilled nursing facilities.
More Care Moves Into Nursing Homes
When facilities can provide a complex service on site, residents may spend less time traveling to outside clinics or hospitals. Operators also see a financial rationale: providing care outside a hospital may fit value-based payment arrangements that reward outcomes and fewer avoidable readmissions. Those potential benefits depend on the facility’s ability to safely deliver the service; the source report does not provide comparative evidence that expansion by itself improves outcomes.
The change also affects hospitals and discharge planning. Oakdale Seniors Alliance Vice President of Quality Heather Haberhern said some residents with more complex conditions are being referred to nursing homes sooner, with hospital partners looking for a lower-cost setting that can still provide appropriate care. For readers and families, the key issue is whether a particular facility has the staff, equipment and clinical partnerships needed for the services a resident requires—not simply whether it advertises higher-acuity care.
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From Post-Acute Care to Complex Services
The report describes a longer-running shift toward higher acuity in skilled nursing facilities, or SNFs. Services traditionally associated with hospitals or long-term acute care hospitals (LTACHs) are being added in some nursing homes, including sophisticated ventilator support and dialysis. The providers cited include Venza Care, ALIYA Healthcare, Cascadia Healthcare and Oakdale Senior.
Expansion is not uniform. Weinfeld said ALIYA is not rolling its ventilator units out across its entire portfolio and cautioned against trying to offer every service in every building. Cascadia’s ventilator capability is currently described at a new Boise facility, while Oakdale is evaluating partnerships for hemodialysis. The report presents these as distinct company plans and operating choices, not an industry-wide standard.
Hospital relationships remain part of the model. Haberhern said nursing and direct-care staff need training for the clinical conditions of incoming residents, and that coordination with referring hospitals and medical directors helps support care. Cascadia’s Steve LaForte likewise framed nursing homes as a way to ease hospital bottlenecks rather than compete for patients.
““Making a Taj Mahal of vent units was something that we’re now moving towards with our Thrive line.””
— Efriam Weinfeld, ALIYA Healthcare chief executive, speaking to Skilled Nursing News
Safety and Outcomes Need More Evidence
The report does not provide facility-level staffing figures, detailed clinical protocols, costs, or a systematic comparison of outcomes between residents treated on site and those sent to hospitals. ALIYA’s reported 14% rehospitalization rate covers one building in a recent month, and the source does not specify the month or provide a matched comparison group. It should not be read as proof that ventilator units caused lower readmissions.
It is also unclear how quickly the planned ALIYA units will open, which Cascadia facilities may add dialysis or bronchoscopies, and whether Oakdale will complete a hemodialysis partnership. The source report’s discussion of Venza Care is limited in the supplied material, so its specific services and plans cannot be detailed here. The scale of the broader trend and its effects on residents, families and hospital use remain uncertain.
Facility Plans and Partnerships Ahead
ALIYA’s next stated step is to add ventilator units at the two remaining facilities identified for its program. Cascadia says it wants to expand in-house dialysis beyond its current operations and is considering whether to offer bronchoscopies. Oakdale is evaluating partnerships to provide hemodialysis in its communities, which Haberhern said could reduce travel time and hours spent in clinics.
Those plans will depend on implementation at individual facilities, including staffing, training, equipment and coordination with hospitals and medical directors. The report does not give timelines for the proposed expansions. Further evidence about readmissions, clinical outcomes and resident experience will be needed to judge how well the services work across different facilities.
Key Questions
What services are nursing homes adding?
Operators cited in the Skilled Nursing News report are expanding ventilator care and in-house dialysis. Cascadia Healthcare is also considering bronchoscopies, while the report describes cardiac care and dual-diagnosis support among services offered by Venza Care.
Why are more complex services being provided in nursing homes?
Operators say residents are arriving with higher medical needs and that on-site services can reduce trips to hospitals or outside clinics. They also point to potential value-based care incentives, though the report does not establish that every facility will achieve better outcomes or lower costs.
Did ALIYA report fewer hospital readmissions?
ALIYA chief executive 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 name the month or show that the ventilator program caused the rate, so the number is an operator-reported observation, not a general result.
Are nursing homes replacing hospitals for complex care?
No such broad replacement is established in the report. Providers describe working with hospitals and accepting some residents after hospital stays. They say trained staff, medical-director involvement and close referral partnerships remain necessary.
What is still unknown about the expansion?
The report does not give a full account of costs, staffing levels, clinical protocols or comparative outcomes. Timelines for planned services at ALIYA, Cascadia and Oakdale are also not specified.
Source: rss
