Having spent years working in such facilities, I see some potential here, primarily because they are supplementing telemedicine with the use of local care speci

Having spent years working in such facilities, I see some potential here, primarily because they are supplementing telemedicine with the use of local care specialists, and not just relying on the facility’s nursing staff. The issue becomes, who pays for it? Regulations require the facility have a medical director to help them set procedure and policy and to be able to provide overall care if the pcp is not available. So they are already paying for the medical director who they expect to be able to perform this task - even though the commitment of the director varies greatly from facility to facility. Many facilities also hire nurse practicioners now to help manage patients acute medical issues that arise within the facility. And finally there are times the patients really need to go back to the ER - if as a hospital you are trying to push them out in the shortest amount of time possible, you shouldn’t be surprised by this. Personally I think , in the era of value based care, the entire concept of skilled nursing and how it is paid for and regulated, needs to be completely reworked.