PATHTalks

Advance Care Planning (ACP) takes on added complexity when supporting individuals living with dementia. In post-acute and long-term care settings, leaders are increasingly called upon to guide teams through conversations that balance clinical realities, resident dignity, and family emotions. ACP is not simply a regulatory requirement; it is a foundational element of person-directed care that ensures decisions align with an individu...

Advance Care Planning (ACP) is one of the most meaningful and complex responsibilities in post-acute and long-term care. When done well, ACP ensures that residents’ values and preferences guide care decisions throughout their journey. When done inconsistently, it can lead to confusion, conflict, and care that does not align with what residents want most.

Organizations that approach ACP as a structured, integrated program are better...

Selecting the Assessment Reference Date (ARD) for the Medicare 5-Day and Interim Payment Assessment (IPA) is one of the most consequential decisions in the MDS process. Yet, it is often treated as a routine task rather than a strategic one. In today’s complex reimbursement environment, ARD selection directly influences payment accuracy, compliance integrity, and an organization’s ability to capture the full scope of care delivered.

Licensed nurses in long-term care carry one of the most complex and autonomous roles in healthcare today.

Unlike many acute care settings, licensed nurses in long-term care practice with significant autonomy. This autonomy is both empowering and demanding. Each shift places responsibility not only for direct care, but also for supervision, delegation, assessment, communication, and documentation across an entire care team.

In today...

At its core, person-centered care planning is about honoring individuality, ensuring that care reflects each resident’s preferences, values, goals, and lived experience. When done well, the care plan becomes more than documentation; it becomes a guide for how care teams support a resident’s daily life.

In post-acute and long-term care, leaders play a critical role in ensuring that care planning moves beyond templates and checklists...

Quality Measures (QMs) are central to how organizations are evaluated, reimbursed, and perceived by regulators, payers, and consumers. While many leaders associate QMs primarily with the MDS department, successful performance requires a far broader, interdisciplinary approach rooted in clinical practice, documentation accuracy, and operational leadership.

At the center of this work is the MDS process, which serves as a primary sour...

In today’s post-acute and senior living environments, staffing pressure can push leaders toward fast decisions that feel necessary in the moment but often create long-term consequences. Vacancies, overtime, agency reliance, and staff fatigue make “quick hiring” tempting. Yet, ineffective and rushed hiring is one of the most common drivers of turnover, disengagement, and instability.

Quick hiring typically occurs when organizations ...

Recruitment may get people in the door, but retention determines whether organizations truly stabilize their workforce. In post-acute and senior living, turnover remains one of the most persistent challenges, with a significant portion occurring within the first 90 days of employment.

Bubble wrapping is a metaphor for intentionally protecting new hires during their most vulnerable period, the first 90 days. Nearly 40% of turnover i...

Culture is one of the most talked-about concepts in post-acute and long-term care and one of the most misunderstood. Leaders often describe the culture they want, but culture is not defined by intention alone. It is defined by actions, consistency, and what leaders choose to reinforce or allow every single day.

In care environments shaped by regulatory pressure, staffing challenges, and emotional complexity, culture is not static. ...

Post-acute and long-term care leaders are navigating unprecedented pressure, from staffing instability and regulatory scrutiny to reimbursement constraints and rising expectations. While many of these challenges feel external and uncontrollable, one truth consistently emerges: sustainable success is rooted in leadership.

Strong leadership does not eliminate complexity, but it does create teams capable of navigating it. At its core,...

Workforce challenges continue to be one of the most complex and persistent issues facing post-acute and senior care leaders. While recruitment and retention are often discussed as HR responsibilities, the reality is far more nuanced. When it comes to staffing, success is not achieved through isolated efforts or siloed departments. It requires alignment, accountability, and shared ownership across the organization.

When staffing eff...

In today’s post-acute and long-term care environment, leaders are constantly balancing daily operations with the ongoing need to improve quality outcomes. QAPI (Quality Assurance and Performance Improvement) goes beyond a regulatory requirement. It is a culture, a framework for continuous learning, and a core leadership responsibility.

While quarterly QAPI meetings are required in skilled nursing, and monthly meetings are often bes...

In long-term and post-acute care, QAPI (Quality Assurance and Performance Improvement) is often talked about as a meeting, a task, or a regulatory requirement. However, QAPI is fundamentally a culture that requires full engagement from every department and every staff member, not just leadership.

Historically, QAPI meetings were treated like data dumps. Teams gathered monthly or quarterly, reviewed reports, and moved on. But today’...

In today’s complex long-term care environment, leaders often ask: How many Performance Improvement Projects (PIPs) do we need? Which ones do we prioritize? And how do we implement them effectively? PIPs are one of the most powerful tools in the QAPI framework, yet they are also among the most misunderstood.

PIPs aim to improve care delivery and enhance residents' quality of life. However, many leaders find themselves overwhelmed by...

Natural disasters are becoming more frequent, severe, and widespread, creating serious risks for long-term care organizations. Floods, wildfires, extreme heat, and severe storms now impact regions once considered low risk, putting additional pressure on facilities already managing rising resident acuity and aging infrastructure. This shift raises a critical leadership question: Are we truly prepared? While organizations have emerge...

As skilled nursing facilities face rising admissions of younger residents, individuals with complex mental health needs, and those requiring specialized behavioral supports, F645 PASARR compliance has become a leading focus for surveyors nationwide. Yet, many facilities still misunderstand or misapply the regulation—placing them at significant risk.

Tune into our latest PATHTalks episode to gain powerful insights from Pathway Healt...

With more than 10,000 Americans turning 65 every day, ageism has become a national concern that influences healthcare delivery, policy development, and daily operations in senior care environments. The impact of ageism in the post-acute and long-term care sector is intensifying, and, as demographic shifts accelerate and more adults age with chronic conditions, age-based bias affects health outcomes, care quality, and the well-being...

As the senior living landscape rapidly evolves, leaders across assisted living, home and community-based services, and post-acute care are navigating rising expectations and increasingly complex resident needs. Older adults are choosing to age in place, bringing higher acuity, multiple chronic conditions, and new service expectations into assisted living settings—areas once designed for lower-intensity support.

As resident needs ar...

Medication safety is a key predictor of quality outcomes in skilled nursing facilities. However, F761 – Labeling and Storage of Drugs and Biologicals has risen into the Top 10 most cited deficiencies nationwide, indicating a significant risk for organizations across

In our latest PATHTalks episode, our Director of Regulatory and Consulting Services, Nancy Foss, explores why this f-tag citation is spiking, where facilities are most ...