Telehealth Settings: Post-Acute and Long-Term Care Facilities

Telehealth Settings: Post-Acute and Long-Term Care Facilities

Introduction

Post-acute and long-term care (PALTC) facilities—including skilled nursing facilities (SNFs), nursing homes, assisted living, and residential care settings—serve individuals with complex medical, behavioral health, and functional needs. These settings often face challenges related to workforce shortages, access to specialty care, and care coordination, particularly in rural and underserved areas.

Telehealth offers PALTC facilities an opportunity to expand access to care, support on-site staff, reduce avoidable hospital transfers, and improve continuity of care while keeping residents in familiar environments.

Telehealth Applications in PALTC Settings

Telehealth is increasingly used across post-acute and long-term care settings to support both routine and urgent care needs. Common applications include:

• Specialty consults, such as geriatrics, psychiatry, cardiology, neurology, and wound care
• Behavioral health services, including telepsychiatry and therapy
• After-hours and on-call coverage to support nursing staff and reduce emergency department transfers
• Care transitions and hospital discharge follow-up
• Family engagement, particularly when caregivers are unable to be on site

When implemented thoughtfully, telehealth can support quality improvement initiatives, workforce sustainability, and resident-centered care.

I'm interested in implementing telehealth in a post-acute or long-term care setting. How do I get started?

Getting started with telehealth in PALTC facilities typically involves a mix of clinical, operational, and regulatory planning:

• Identify priority use cases
  Common starting points include behavioral health, specialty consults, after-hours coverage, and hospital transfer avoidance.
• Engage key stakeholders
  Involve facility leadership, nursing staff, medical directors, IT support, and external telehealth partners to align goals and workflows.
• Assess infrastructure and workflows
  Evaluate broadband connectivity, available devices, private spaces for visits, and how telehealth will fit into daily clinical operations.
• Understand regulatory and reimbursement considerations
  Review state and federal policies related to telehealth in nursing facilities, including Medicare, Medicaid, and licensure requirements.
• Select appropriate technology and partners
  Choose platforms and equipment that are easy for staff to use, support accessibility needs, and integrate with existing systems when possible.
• Train staff and pilot the program
  Start small, provide hands-on training, and use early feedback to refine workflows before scaling.

Federal and State Law & Policy Considerations

Telehealth laws and policies vary by care setting, payer, and state. Post-acute and long-term care facilities should review applicable federal and state requirements early in the planning process to support compliant and sustainable telehealth services.

Key considerations include Medicare and Medicaid coverage rules for nursing facilities, provider licensure and scope of practice, on-site staffing requirements, and resident consent and documentation standards. Because telehealth policies continue to evolve, facilities should monitor updates at both the federal and state levels.

Policy Resources & Guidance

• Centers for Medicare & Medicaid Services
  CMS guidance on how telehealth services may be furnished and billed, including limitations on originating site requirements and practitioner roles.
• Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule
• Skilled Nursing Facility Billing Resource - CMS

PALTC Resources

• Post-Acute and Long-Term Care Medical Association - The Post-Acute and Long-Term Care Medical Association (PALTmed) is the national medical specialty society representing clinicians who provide care in post-acute and long-term care settings, including medical directors, physicians, nurse practitioners, and physician assistants.
• LeadingAge's Center for Aging Services Technologies (CAST): leading the charge to expedite the development, evaluation, and adoption of emerging technologies that can improve the aging experience.
• Center of Excellence for Telehealth and Aging - A targeted resource for advancing telehealth best practices in older adult care.
• Implementing Age-Inclusive Telehealth in Post-Acute and Long-Term Care Settings - Toolkit
• Telehealth Solutions to Enhance Services in Post-Acute and Long-Term Care Settings - Webinar

Regional Highlights

• Telepsychiatry and Project ECHO for Skilled Nursing Facilities - University of Rochester Medical Center
• Northwell Health TeleSNF Program (New York)
  A large-scale telehealth program connecting skilled nursing facilities with hospital-based clinicians using telemedicine carts, supporting on-demand consults and reducing unnecessary hospital transfers.