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Nursing home operators say GLP-1 medications are increasingly common among new admissions, with one provider reporting that 30% to 40% of its incoming residents use them. The drugs may help address several health conditions, but operators and clinical experts cite frailty risks, staff oversight needs and unresolved payment responsibilities. Medicare’s temporary bridge program has been extended through 2027, while a proposed permanent program has been delayed without a new start date.
GLP-1 medications are becoming more common in nursing homes, where providers say residents are arriving on the drugs for diabetes, weight loss and other chronic health concerns. The shift is prompting new clinical monitoring and staff education, while high medication costs and uncertain coverage leave operators weighing who will pay.
Lisa Chubb, chief nursing officer at New Jersey-based Venza Care, told Skilled Nursing News that about 30% to 40% of the company’s new admissions are taking GLP-1s. She said the share is higher at facilities with more short-stay residents. Chubb described use expanding beyond diabetes and weight loss toward cardiovascular prevention and other metabolic and organ health concerns.
At Venza, interdisciplinary teams discuss residents considered at nutritional risk, and electronic health record assessments help staff document medication reviews, education and weight monitoring. Registered dietitians are involved in care for residents taking the drugs, Chubb said. The approach reflects concern that weight loss can come with muscle weakness or frailty in older adults, even when medication is being used for a health benefit.
Payment depends on coverage and the resident’s circumstances. Jessie McGill of the American Association for Post-Acute Care Nursing said Medicare’s bridge program covers certain GLP-1s prescribed for weight loss for eligible residents with Part D, with a $50 monthly fee in addition to Part D coverage. She said the program applies to Wegovy, Zepbound and Foundeo. Residents in a facility under Medicare Part A may leave the nursing home responsible for medication costs, depending on the prescription and coverage.
Care Plans Meet High Drug Costs
The increase affects both resident care and nursing home budgets. GLP-1s may be prescribed to address more than one health concern, but staff must account for each resident’s nutritional status, functional ability and other conditions. That can require closer monitoring, education across care teams and changes to facility processes.
The financial burden can also influence operational decisions. Jody O’Mara, chief nursing officer for Journey Skilled Nursing, said high-cost medications become a provider expense when a pharmacy joint venture covers them. She said she believes the benefits can outweigh those costs, but the source report does not provide comparative cost or outcome data. For residents who cannot afford the monthly fee, a coverage gap may also affect whether treatment is accessible.
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Medicare Coverage Still Incomplete
Medicare’s bridge program offers temporary coverage for some weight-loss prescriptions, but it is not a blanket benefit for all GLP-1 drugs or residents. McGill said residents must meet program criteria, and the listed eligible medications are Wegovy, Zepbound and Foundeo. The report says the program has been extended through 2027.
A proposed permanent version, called BALANCE, was delayed without a future implementation date. McGill said a possible next policy step would be asking Congress to expand consolidated billing to include high-cost medicines such as GLP-1s. The source report does not say that such an expansion has been approved.
“We see a lot of our new admissions coming in with GLP-1s. Initially it was used solely for weight loss and diabetes, but now we’re seeing it trend in other directions as well.”
— Lisa Chubb, chief nursing officer for Venza Care
Coverage and Clinical Effects Vary
The source report does not establish how many nursing home residents nationally take GLP-1s, or how use has changed across the sector over time. The 30% to 40% figure applies to Venza Care’s new admissions, not all nursing home residents. It also does not provide data comparing health outcomes, adverse effects or total costs for residents taking these drugs.
Eligibility and payment can vary by prescription, Medicare coverage, and whether a resident is under Part A or Part D. The report does not specify when BALANCE could begin, whether its terms will change, or how often residents are unable to pay the bridge program fee. Clinical experts cited in the report point to risks including nutritional problems and dehydration, but individual risks and benefits depend on the resident.
Bridge Coverage Runs Through 2027
The temporary Medicare bridge program is set to continue through 2027. The report gives no implementation date for BALANCE, so residents, families and providers do not yet have a confirmed timeline for a more permanent coverage arrangement.
In the meantime, nursing home teams are likely to continue reviewing prescriptions, monitoring weight and nutritional risk, and accounting for medication costs in care and operating plans. Providers and residents will also be watching for policy decisions on coverage, including any congressional action on consolidated billing. No such change is confirmed in the source report.
Key Questions
How common are GLP-1 medications among nursing home residents?
Venza Care’s Lisa Chubb said about 30% to 40% of the company’s new admissions are taking GLP-1s, with higher shares at facilities with more short-stay residents. That figure is specific to Venza’s admissions and is not a national estimate.
Which GLP-1 drugs are covered by the Medicare bridge program?
According to Jessie McGill of AAPACN, the program covers Wegovy, Zepbound and Foundeo for eligible residents with Medicare Part D who are prescribed a GLP-1 for weight loss. The source report describes a $50 monthly fee in addition to Part D coverage.
Who pays for a resident’s GLP-1 medication?
Payment depends on the resident’s coverage and circumstances. McGill said a nursing home may be responsible for a medication cost for a resident under Medicare Part A, while the bridge program may reduce—but not eliminate—costs for some Part D residents.
Why do nursing homes monitor residents taking GLP-1s?
Clinical staff must weigh potential health benefits against concerns such as weight loss, frailty and nutritional risk. AAPACN’s Lauren Stenson also cited nausea, vomiting, constipation and dehydration as possible adverse effects.
When will permanent Medicare coverage begin?
The proposed permanent program, called BALANCE, was delayed without a new implementation date. The temporary bridge program has been extended through 2027, according to the report.
Source: skillednursingnews.com
