LONG-TERM CARE
The EHR Built for the Long Stay, Not the Rehab Episode
A long-stay resident due for her annual MDS, a quarterly behavior review, a gradual-dose-reduction note, and a family meeting this week. On GlaceEMR and GlaceRCM, the assessments, the GDR timeline, the care-plan oversight, and the institutional claim all run inside one chart, billed at a percentage of collections with no base fees, backed by an institutional billing team that hits 95%+ first-pass claim adjudication and 99%+ collection of payer-allowed amounts*.
*Of payer-allowed amounts.
WHAT WE HEAR FROM LTC MEDICAL DIRECTORS
The Chart Was Built for a Stay, Not a Resident
Long-term care is a marathon, not a rehab stay. Residents live in the building for years, and most facility EHRs were built for a short post-acute episode or a hospital floor. Four pains come up in the first thirty minutes of almost every discovery call with a medical director, DON, or administrator.
The MDS schedule runs the building
Quarterly, annual, OBRA, and significant-change assessments stack on one RN coordinator working off a spreadsheet. The missed window costs a Medicaid case-mix recalculation the facility cannot recover.
Psychotropic stewardship lives in a binder
GDR attempts, declined-GDR rationale, BPSD care planning, and PASRR documentation are required. The consent forms live in paper and the GDR timeline lives in the MDS nurse’s head, so survey day is the day the deficiency lands.
Institutional billing is a different sport
837I and UB-04, RUG and PDPM from the MDS, Medicaid long-stay, managed Medicaid, dual-eligible crossovers. Ambulatory platforms cannot generate the claim, so the facility exports MDS data and retypes by hand.
Survey and readmissions are a spreadsheet
F-tag mapping, deficiency tracking, and quality measures live in workbooks the DON maintains by hand. The change-of-condition note the LPN wrote at 3 AM is not seen for six hours, and the readmission shows up only after the discharge summary returns.
GLACEEMR FOR LONG-TERM CARE
An EHR Built Around the Multi-Year Resident Record
GlaceEMR is ONC-certified and runs in private LTC facilities and the physician groups that cover them, with 30+ years of company history behind it. The long-term-care configuration is wired in before training starts, so the chart your team opens on day one already holds the long-stay assessments, restorative documentation, psychotropic monitoring, and F-tag-mapped alerts your facility runs on. Every capability below ships today, not as a roadmap promise.
MDS 3.0 engine tuned to the long-stay cadence
A full MDS 3.0 engine with quarterly, annual, OBRA admission, and significant-change scheduling that spans years rather than a single stay. PASRR Level I and II screening, care-area assessments, and trigger logic sit inside the chart. The due dates fire as facility alerts on the right unit, so your coordinator stops working off a spreadsheet and the assessment that drives the per-diem is the same one that drives the care plan.
Psychotropic stewardship, GDR, and PASRR
Structured psychotropic monitoring with the gradual-dose-reduction timeline visible against the active regimen, BPSD behavioral care planning tied to the antecedent-behavior-consequence pattern your floor RN already documents, PASRR inside the chart instead of in a binder, and consent forms generated from the record. Anticholinergic-burden and Beers-criteria checks fire against the long-stay regimen so the deprescribing actually happens.
eMAR with barcode and narcotic counting
A real eMAR with barcode medication administration, shift-change narcotic counts that reconcile against the dispensed quantity, witness signatures on schedule-II waste, psychotropic-specific tracking tied to the GDR timeline, and an audit trail the surveyor can review without leaving the workstation. PRN documentation captures pre-administration indication, post-administration effectiveness, and the duration of effect the regulation expects.
SBAR change-of-condition workflow
A structured SBAR change-of-condition pathway tied to a 24×7 provider on-call queue. The LPN documents the subtle change at 3 AM in a templated SBAR, the on-call provider receives the page, opens the chart on the mobile app, and either documents the telephone order or accepts the transfer with the discharge packet attached. The bounce-back does not happen because the day-shift RN never read the night note.
Census, ADT, and clinical surveillance
Real-time census, room and bed management, hold and leave-of-absence tracking, plus body-diagram wound mapping, falls reporting tied to a risk score, weight-trend graphing with a percent-change alert, and infection-control surveillance. The resident who came back from the hospital at 11 PM is on the census and the eMAR before the night nurse opens her cart, and the data the QAPI committee reviews Friday is the data the floor RN documented every shift.
Survey readiness with F-tag mapping
F-tag-mapped alerts fire from the same structured data the staff already documents. Deficiency tracking and plan-of-correction management live in the chart instead of in a workbook, and mock-survey tools let the administrator pull the deficiency-likelihood roster on a Tuesday morning instead of on the day the state walks in. The DON stops rebuilding the survey binder every quarter, because the chart already holds what the surveyor will ask for.
Included with GlaceEMR vs usually an add-on
When you price out another facility EHR, count what is included before you compare the headline number. The rows below are upsells, separate vendors, or consulting fees almost everywhere else, each with its own renewal date and price increase. They ship with GlaceEMR, with no tier games and no surprise line items at renewal.
| Capability | Most facility EHRs | GlaceEMR |
|---|---|---|
| Restorative nursing with functional-maintenance goals | Add-on module | Included |
| 60+ lab interfaces and pharmacy integration | Interface fee | Included (60+ labs) |
| Hospital ADT, discharge summaries, C-CDA exchange | Interface fee | Included (15+ hospitals) |
| Quality-measure and survey-readiness reporting | Consulting or workbook | Included |
| GlaceOffice administration suite (HR, PTO, credentials) | Separate subscription | Included, free for clients |
| Native iOS and Android apps for providers and staff | Mobile-web only | Included |
A single building can grow to a multi-facility group on the same platform, with role-based access for the medical director, attending, NP, DON, MDS coordinator, charge nurse, restorative aide, social worker, and administrator, and no per-location upcharge when you add a building next quarter.
ONE DATA FLOW
From Assessment to Paid, One Record
The MDS drives the care plan, the RUG or PDPM classification flows from the assessment, the 837I institutional claim generates from the same census and eMAR your facility already runs, and your named billing specialist works the continued-stay queue to resolution. The assessment that drives the per-diem is the same data the surveyor reviews and the QAPI committee scores, so nothing gets retyped between two separate systems.
GLACERCM FOR LONG-TERM CARE
A Billing Service That Speaks Institutional and Professional
GlaceRCM bills your claims in your EMR or ours, charged at a percentage of collections with no base fees and no monthly minimums. We would rather run it on our platform, where the institutional claim flows straight from the MDS and the census, but if you are staying on your EMR our billing team works your claims there. The service is built for the LTC mix: 837I institutional per-diem, RUG and PDPM classification, managed Medicaid plan rules, and multi-POS professional billing for the group that covers the building.
95%+
First-pass claim adjudication. Most claims pay or post on the first submission, including the 837I institutional per-diem claim where the MDS section is the difference between paid and denied.
99%+
Collection rate of payer-allowed amounts*. The Medicaid, managed-Medicaid, and dual-eligible dollars the facility is owed actually arrive, because we work the continued-stay queue to resolution.
$0
Implementation fee, setup charge, and monthly minimum. We get paid when you get paid, so our interests and yours line up from the day the contract is signed.
*Of payer-allowed amounts.
837I institutional billing from the MDS
The institutional 837I and UB-04 claim is generated from the MDS, the census, and the eMAR. Per-diem billing for Medicaid long-stay, RUG and PDPM classification from the assessment, the occasional Part A skilled period, and the leave-of-absence days that flip the rate all route through one workflow. The MDS-driven classification and the institutional claim are the same data flow, not two separate exports.
Managed Medicaid and dual-eligible fluency
Managed Medicaid plan-by-plan rules are in the scrubber. Dual-eligible Medicare-Medicaid residents stack two payers on the same stay, and the crossover claim is generated against the right responsibility calculation. Continued-stay denials route to a worked queue with the supporting MDS section already attached to the appeal packet.
Multi-POS professional billing
For the medical group that covers rounds, the encounter routes to the right place of service per visit: POS 32 nursing-facility care with 99304-99310 and 99315-99316, POS 31 SNF skilled visits, and POS 13 assisted-living rounds, each landing on the right professional claim with the right modifiers. The provider stops thinking about POS, and the biller stops cleaning it up after the fact.
A named billing specialist
A dedicated account manager who knows your state’s Medicaid program, your managed-Medicaid plans, the per-diem rules, and your top denials. Not a ticket queue, not an offshore call center. They work continued-stay denials to resolution, and they know your facility by name within a month of go-live.
Percentage of collections, no base fees. Provider credentialing, payer enrollment, prior auth, resident and responsible-party statements, and a US-based billing call center are part of the service, not separate line items. The responsible party or POA calls our team about a balance, not your social worker, so the staffer who should be running a care conference is not stuck on a billing call. The percentage you pay tends to cover itself out of the continued-stay dollars a busier biller was quietly letting age past the appeal window.
AI AND FAMILY ENGAGEMENT
The Documentation, the Risk Scoring, and the Family
Every AI capability is a suggestion the medical director reviews and selects. Notes wait for signature and codes wait for approval before either reaches a claim, so the clinical judgment stays with the provider, every time. The AI is built on HIPAA-compliant infrastructure from Amazon, Google, Anthropic, Deepgram, ElevenLabs, and other enterprise AI providers, with multi-vendor architecture that preserves operational redundancy and keeps the platform improving over time.
GlaceScribe
Ambient notes structured for the long-stay visit, including the dementia-care planning visit under 99483 and the advance care planning conversation under 99497 and 99498. Up to four simultaneous speakers, which is what a family meeting demands, English and Spanish patient-facing. The note lands as the structured record the auditor expects, and rounds finish faster.
GlaceIQ
30+ AI features tuned to the long stay: 30-day readmission risk scored against weight trend, behavior frequency, recent change-of-condition events, and prior hospital history, plus GDR-due and PASRR-overdue worklists and coding suggestions at signing. You review and select each one, and the high-risk residents surface on the medical director’s worked list.
GlacePhoneSmart
An AI phone agent answers as your facility in English or Spanish, fields routine family and responsible-party calls, books appointments and care conferences, and surfaces voicemail summaries so the front desk and the social worker stop drowning in calls about a resident’s status.
A practice-branded portal, mobile app, SMS, and email round out the stack, with English and Spanish on every family-facing surface, so the daughter who flew in for the weekend and the POA two states away both see the same care-conference summary and the same advance-directive status. The family asking a month later what was decided gets one answer, because the goals-of-care conversation, the directive update, and the hospice referral all link in one record instead of three separate notes and a fax queue the next shift never sees.
SWITCHING IS EASIER THAN YOU THINK
Coming From Another Facility EHR
Most LTC facilities we onboard are leaving a legacy facility EMR, a horizontal product that never fit the long-stay cadence, or a paper-and-spreadsheet hybrid that worked until the surveyor walked in. Implementation is $0, data migration is included, and your account manager runs the move and stays your account manager after go-live. EMR go-live happens in pieces by unit, not a building-wide overnight flip that risks the med pass.
DAY 1
A chart that already looks like yours
The unit goes live on a chart that already holds migrated resident history, active problem lists, current meds, the MDS and PASRR history, and the active care plans, with your care-plan templates, F-tag-mapped alerts, psychotropic and GDR workflows, and eMAR favorites wired in. The first few medication passes run slightly slower because the workflow is new; by the end of day one, the cart nurses’ hands start to remember where the barcode scanner lives.
DAY 30
The cadence runs through the engine
Your MDS coordinator is running the quarterly cadence through the engine instead of a spreadsheet, and the first quarterly submissions are on the dashboard. GlaceScribe is in use on most provider visits, your first institutional claims have gone out as 837I, and the first denial review with the account manager has happened. The change-of-condition SBAR queue is worked by the on-call provider in real time, and the survey-readiness binder is the chart, not a paper binder.
DAY 90
The switch starts paying for itself
Your first quarter’s dashboard shows cleaner institutional claims, faster Medicaid posting, and fewer continued-stay denials parked in the 60-to-90 bucket. GDR documentation, PASRR currency, and long-stay quality measures are trending where you want them, and the Five-Star-relevant measures the chart now tracks structurally are the same measures CMS scores you on. Your medical director has two hours back on rounds days, and the conversation turns from migration triage to using the platform harder next quarter.
Data migration covers resident demographics, diagnoses, medications, allergies, the MDS and PASRR history, active care plans, current orders, and the multi-year long-stay record, handled by Glenwood so your staff does not reconstruct charts. The RCM transition runs 4 to 8 weeks with payer enrollment in parallel, and we recommend a 30-to-90-day overlap with your previous vendor so the building keeps operating normally while the new chart proves itself. Training is delivered in pieces around your real shift schedule, with unlimited online training during onboarding and continued access for the CNA and LPN turnover you will see. Glenwood has been independent and privately held since 1994, when our founder helped his physician wife acquire a private practice in Connecticut: 30+ years in market, no outside investors. Support runs 7:00 AM to 8:00 PM Eastern on weekdays, with 24×7 on-call coverage for urgent issues, so the night-shift charge nurse with a change-of-condition call at 2 AM has a working chart and a person on the other end.
WE KNOW YOUR CODES
We Have Billed Your Mix Before
You already know your codes. We have built the workflows, the scrubber rules, the documentation prompts, and the denial templates around them, so the reimbursement you earned is the reimbursement you collect. The list below is the short version of what runs every day inside the platform for a long-term-care facility and the medical group that covers it:
- 99304, 99305, 99306: initial nursing facility care
- 99307, 99308, 99309, 99310: subsequent nursing facility care
- 99315, 99316: nursing facility discharge services
- 99483: cognitive assessment and care plan visit (dementia)
- 99497, 99498: advance care planning, first and additional 30 minutes
- G0181, G0182: care-plan oversight services
- 96127, G0444: behavioral and depression screening
- UB-04 / 837I: institutional per-diem claim, Medicaid long-stay and managed Medicaid
- RUG / PDPM: MDS-driven classification for the institutional claim
- ICD-10 F03.90, F02.8-, Z79.899, I10, E11.9: dementia, long-term drug therapy, and chronic-disease anchors
QUESTIONS WE HEAR EVERY WEEK
Long-Term Care Facility FAQ
Short answers below; the longer conversation happens on the demo. Tap any question to expand the answer.
Does GlaceEMR handle the long-stay MDS 3.0 cadence natively?
Yes. The MDS 3.0 engine is in the chart, with full quarterly, annual, OBRA admission, and significant-change scheduling that spans years rather than a single stay. PASRR Level I and II, care-area assessments, and trigger logic all sit inside the same chart your MDS coordinator runs in. Due dates fire as facility alerts on the right unit, so the coordinator stops working off a spreadsheet and the floor RNs stop chasing her for windows. The assessment that drives the per-diem is the same assessment that drives the care plan and the institutional claim, and quality-measure performance flows off the same structured fields, so the data the surveyor reviews on Wednesday is the data your team documented on Tuesday.
How does GlaceEMR handle psychotropic stewardship and PASRR documentation?
Structured psychotropic monitoring with a visible gradual-dose-reduction timeline against the active regimen, BPSD behavioral care planning tied to the antecedent-behavior-consequence pattern your floor RN is already documenting, PASRR Level I and II inside the chart instead of in a binder, and psychotropic-consent forms generated from the record. Anticholinergic-burden and Beers-criteria checks fire against the long-stay regimen so the deprescribing actually happens. Quality views surface every resident overdue for a GDR review and every PASRR overdue for an update, so the medical director walks rounds with a worked list. The deficiency the surveyor was going to write tends not to get written, because the chart got there first.
Is GlaceScribe HIPAA-compliant, and how does it handle family meetings?
Yes, fully HIPAA-compliant. GlaceScribe runs on HIPAA-compliant AI infrastructure from Amazon, Google, Anthropic, Deepgram, ElevenLabs, and other enterprise AI providers, all under business associate agreements. The multi-vendor architecture preserves operational redundancy, so a single upstream incident does not stop your visits. Up to four simultaneous speakers are supported, which is what family meetings demand, with English and Spanish patient-facing. The dementia-care planning visit under 99483 and the advance care planning conversation under 99497 and 99498 land as the structured note the auditor expects. All coding and order suggestions surface for your review before any signing. Nothing reaches the chart until you approve it. Audio is processed in transit, the resulting note is stored in your single-tenant chart database with LUKS encryption at rest, and the data never trains a shared model that mixes your residents with anybody else’s.
Can GlaceRCM handle 837I institutional claims and Medicaid long-stay billing?
Yes. The institutional 837I and UB-04 claim is generated from the MDS, the census, and the eMAR your facility already runs. Per-diem billing for Medicaid long-stay, RUG and PDPM classification from the assessment, the occasional Part A skilled period, and the leave-of-absence days that flip the rate all route through one workflow. Managed Medicaid plan-by-plan rules are in the scrubber, and continued-stay denials route to a worked queue with the supporting MDS section already attached to the appeal packet. Dual-eligible Medicare-Medicaid residents stack two payers on the same stay, and the crossover claim is generated against the right responsibility calculation. The MDS-driven classification and the institutional claim are the same data flow, not two separate exports between systems.
Do you support multi-POS professional billing for the medical group that covers the building?
Yes. For the medical group that covers facility rounds, the encounter routes to the right place of service per visit. POS 32 nursing-facility care with 99304-99310 subsequent visits and 99315-99316 discharge codes, POS 13 assisted-living rounds with the right E&M family, POS 31 SNF skilled visits, and the 99483 dementia-care planning visit and 99497-99498 advance care planning add-ons land on the right professional claim with the right modifiers. The provider stops thinking about POS at all, and the biller stops cleaning it up after the fact. The medical director who rounds in two buildings on Mondays and runs a Tuesday-Thursday outpatient panel sees one chart, with one set of patient lists, on one mobile app.
“[Specialty-specific testimonial quote, replace with verified Long-Term Care physician quote or remove this card.]”
[Physician Name, MD]
[State]
If you also cover adjacent post-acute or geriatric panels, see how GlaceEMR runs SNF and post-acute care, geriatrics, behavioral health, and internal medicine.
See What Glenwood Can Do for Your Practice
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