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Nursing home operators including ALIYA Healthcare and Cascadia Healthcare are expanding ventilator care and on-site dialysis, while Cascadia is considering bronchoscopies. Providers say these services can support residents with more complex needs and reduce hospital transfers, but the model depends on trained staff and close hospital partnerships.
Several nursing home operators are expanding ventilator care, on-site dialysis and other services traditionally associated with hospitals as skilled nursing facilities take in residents with more complex medical needs. In reporting by Skilled Nursing News, providers described new or expanding programs, while stressing that the care requires specialized staffing and collaboration with hospitals.
ALIYA Healthcare has expanded ventilator care through its Thrive subsidiary, developing dedicated units at selected facilities rather than rolling the service out across its entire portfolio. CEO Efriam Weinfeld told Skilled Nursing News the company began with one of three facilities required to have the units, with plans to add units at the other two. Ventilator care requires a facility team able to manage a demanding clinical service, he said.
Weinfeld reported that one ALIYA building with more than 18 ventilator units had a rehospitalization rate of about 14% in a recent month. He described the result as better than some other subacute buildings. Medicare.gov data cited in the report puts the national average rehospitalization rate at 23.9%; the figures are not presented as a matched comparison by patient mix or measurement period, so they do not establish that the program caused the difference.
ALIYA also provides in-house dialysis at 12 of its 18 facilities, using dedicated areas it calls “dialysis dens.” Cascadia Healthcare operates subacute ventilator units in a new Boise, Idaho, building and is expanding in-house dialysis. Its chief financial officer and principal, Steve LaForte, said the company is also considering bronchoscopies, a procedure relatively new to skilled nursing settings. Oakdale Seniors Alliance is evaluating partnerships to provide hemodialysis at its communities, according to vice president of quality Heather Haberhern.
More Complex Care Moves Into Nursing Homes
These changes reflect a shift in where some residents receive care after a hospital stay. If a nursing home can safely provide a needed service on site, residents may spend less time traveling to outside clinics or hospitals, and hospitals may face less pressure to retain patients who can be cared for in another setting. Providers also say keeping care within a facility can help them coordinate treatment and focus on outcomes such as avoiding readmissions.
The expansion is not simply a matter of installing equipment. Ventilator management, dialysis and procedures such as bronchoscopy require staff with the relevant training, clinical oversight and protocols for complications. For residents and families, the practical issue is whether a facility has the capacity and expertise to deliver the specific care required—not just whether it advertises a specialized unit.
Operators also described a financial incentive: value-based care arrangements may reward outcomes and reduced hospital use. But the report does not quantify savings or show that these programs produce better outcomes across facilities. The potential benefits need to be weighed against the staffing, equipment and coordination required to provide higher-acuity care.
hospital ventilator care equipment
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How Operators Are Building Specialty Units
Skilled nursing facilities have increasingly taken residents with higher levels of medical need, according to the report. Some services discussed by operators were once delivered mainly in hospitals or long-term acute care hospitals. Providers named in the report include ALIYA Healthcare, Cascadia Healthcare, Oakdale Seniors Alliance and Venza Care, though the source material provides detailed examples primarily from the first three.
ALIYA’s approach is selective rather than universal. Weinfeld said operators risk being “mediocre at everything” if they attempt to offer every complex service at every location. Cascadia’s ventilator program is also based in a particular Boise facility, while the company considers broader dialysis offerings. Oakdale is exploring hemodialysis partnerships rather than reporting a launched program.
Providers framed hospital relationships as part of the model, not a replacement for hospitals. Haberhern said staff training and communication with referring hospitals and medical directors are needed as facilities accept residents with greater clinical complexity. The report also notes Venza Care offers services including cardiac care, dialysis and dual-diagnosis support, but supplies no further operational or outcome details for those programs.
““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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Outcomes and Rollout Still Unclear
The report describes operator plans and one facility’s reported rehospitalization rate, but it does not provide independent evaluations of the programs, detailed cost comparisons or outcomes across multiple sites. ALIYA’s approximate 14% monthly rate and the cited 23.9% national average refer to different populations and may not be directly comparable. The source does not establish that ventilator units caused the lower reported rate.
It is also unclear how many facilities overall offer these services, how quickly operators intend to expand them, or what staffing levels and clinical safeguards each program uses. Cascadia is considering bronchoscopies, and Oakdale is evaluating dialysis partnerships; neither item is described as a completed rollout. The report’s headline refers to complex procedures broadly, but the supplied details do not specify a launch date or operating model for every service.
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Expansion Depends on Staffing and Partners
ALIYA plans to add ventilator units at two more facilities identified by Weinfeld, while Cascadia says it needs to broaden its in-house dialysis offering. Oakdale’s next step is to assess partnerships for hemodialysis in its communities. The report does not give firm timelines for those expansions or confirm when Cascadia might begin offering bronchoscopies.
For each operator, further development will depend on whether facilities can recruit and train staff, provide appropriate clinical oversight and coordinate with hospitals and medical directors. Any assessment of the model’s results will also require clearer, comparable data on resident outcomes, transfers, costs and the time periods measured.
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Key Questions
What services are nursing homes adding?
Examples in the report include ventilator care and in-house dialysis. Cascadia Healthcare is also considering bronchoscopies, while Oakdale Seniors Alliance is evaluating partnerships for hemodialysis.
Why are facilities bringing these services on site?
Operators say on-site services can reduce travel to outside clinics or hospitals and support care coordination. They also cite value-based care incentives, but the report does not quantify financial savings or establish broad outcome effects.
Does the reported 14% rate prove ALIYA’s ventilator program reduces hospital returns?
No. ALIYA’s CEO reported an approximately 14% rehospitalization rate in a recent month for one facility with more than 18 ventilator units. The cited national average is 23.9%, but the report does not provide a matched comparison or show that the program caused the difference.
Are nursing homes replacing hospitals for complex care?
The operators described the services as an extension of care into skilled nursing facilities, not a replacement for hospitals. They said hospital partnerships, staff training and medical oversight remain important, particularly for residents with complex needs.
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