How rural America is shaping the future of healthcare


What some call flyover country, I call America’s heartland. It’s the part of the map between the Rocky Mountains and the Great Lakes, in states with more cows than people and roads you can drive for an hour without seeing a gas station. 

It’s also where access to care for seniors is most at risk when policymakers create cookie-cutter policies that don’t make sense for every nursing home. The staffing rule expected this year is one unfortunate example of good intentions leading to devastating policy for our rural communities.

In her series “Rural Peril,” Kim Marselas examined the unique challenges faced by rural nursing homes and how providers are innovating to find solutions. While this comprehensive reporting outlines why I’m sounding the alarm on a one-size-fits-all staffing mandate, it also fuels my optimism because it showcases what I already knew to be true — the commitment from rural providers to serve our communities is unmatched.

There’s a lot of buzz about healthcare disruptors: Amazon, CVS, Apple, Google. 

I’m adding rural healthcare providers to that list, and here’s why. 

Global companies aren’t waking up every day asking how to solve rural America’s healthcare challenges. But we are. We know rural. If we don’t lead the way transforming the rural healthcare experience, nobody will.   

We’re at an important crossroads in the sector as we face post-pandemic headwinds, policy threats and a new generation of seniors whose needs are evolving. I’m proud of the way rural healthcare providers are shaping the future of senior care in a way that works for seniors in America’s heartland. 

In 2019, the Good Samaritan Society became part of Sanford Health, the largest rural health system in the country. We’re uniquely positioned to use our integrated health system as a catalyst for innovation and to reimagine care for our patients, residents and employees.

As an example, we built a digital bridge across our electronic medical systems. Interoperability saves an hour of paperwork for each Sanford Health patient who’s discharged to a Good Samaritan Society long-term care center, giving our caregivers time back to spend at the bedside. The technology also reduces transcription errors, which means a safer environment for our residents. 

With Sanford Health, we continue pursuing senior-focused solutions to anticipate future needs. This spring, we’re breaking ground on an innovative senior living community that will offer all levels of care under one roof and have a direct connection to a Sanford Health clinic and Lewis Drug retail pharmacy. The campus will provide a new level of comfort and convenience that seniors and their loved ones have never experienced before. 

Imagine the scenario where one spouse needs around-the-clock care while the other has support from a family caregiver with appointments and errands. At Good Samaritan Society – Founder’s Crossing, this couple can live in the same building and meet for lunch dates at the bistro without stepping outside. They can visit their primary care provider, pick up prescriptions and shop for groceries all in one place. The concept is a game changer for our seniors and their family caregivers. 

This cutting-edge campus will serve as the blueprint for senior communities of tomorrow, and it’s happening right here in Sioux Falls, SD — in the heart of rural America. 

Also in Sioux Falls, Sanford Health will open a new Virtual Care Center later this year, which will include an education institute with a simulation center, an innovation center with accelerator spaces to co-develop solutions for the future of care delivery, as well as a patient and family experience lab designed like a living room to test new tools and technologies. Clinical services like virtual nursing and remote patient monitoring will be provided from this hub. 

Fundamentally, this isn’t about a new state-of-the-art building, but about new models of care delivery. Patients and residents across the upper Midwest will have access to high-quality care at a moment’s notice, no matter their zip code.

It will take all of us working together to find solutions to today’s challenges and the ones we’ll face in the future. And while the headwinds have never been stronger, rural issues have more visibility than ever, thanks to the tireless efforts of rural providers to advocate for solutions that work for everyone.

To my colleagues in America’s heartland: keep showing up. Keep innovating. The work we’re doing is critical because a nation can only be healthy when it has a healthy heart. 

Since 2020, 30% of nursing home closures have taken place in rural communities, despite only 20% of nursing homes being in rural areas. With a federal staffing mandate coming soon, a rural healthcare access crisis is looming. The need for disruption is urgent, and the time is now. If we don’t lead the way, who will?

Nate Schema is president and CEO of the Good Samaritan Society, the nation’s largest non-profit provider of skilled nursing services.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.

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