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Nursing home operators report that GLP-1 medications are increasingly common among new residents, with one operator saying 30% to 40% arrive taking them. Staff are adapting monitoring and nutrition practices, while Medicare coverage remains limited: a temporary bridge program is extended through 2027, and a more permanent plan has been delayed.
GLP-1 medications are increasingly reaching nursing homes as residents arrive taking the drugs for diabetes, weight loss and other conditions, prompting operators to expand clinical monitoring while confronting uncertainty over who pays. At Venza Care, 30% to 40% of new admissions are taking a GLP-1, according to the company’s chief nursing officer, as Medicare’s temporary coverage arrangement continues and a longer-term plan remains delayed.
Lisa Chubb, chief nursing officer for New Jersey-based Venza Care, told Skilled Nursing News that GLP-1 use among new admissions has broadened beyond diabetes and weight loss. She said providers are increasingly seeing the medicines used in connection with cardiovascular health, metabolic conditions and organ health. The share of residents taking them is higher at facilities with more short-stay patients, Chubb said.
Venza has added weekly “nutrition at risk” meetings among interdisciplinary teams, as well as electronic health record assessments to document medication review, resident education and weight monitoring. Registered dietitians are involved in care for residents taking the drugs, Chubb said. She described the clinical balance as respecting resident choice while watching for weight loss that could contribute to muscle weakness or frailty.
Payment depends on the resident’s coverage and circumstances. Jessie McGill, a senior curriculum development specialist at the American Association for Post-Acute Care Nursing, said Medicare’s bridge program adds a $50 monthly fee to Part D coverage for eligible residents taking certain drugs for weight loss. The program covers Wegovy, Zepbound and Foundeo, she said. It does not eliminate all costs, and residents with limited income may still struggle to pay the fee.
Care Teams Face New Monitoring Demands
For nursing homes, wider use of GLP-1s changes both clinical routines and operating costs. Residents may have frailty, multiple chronic conditions, nutritional risks or limits on daily functioning that differ from the populations commonly discussed in relation to these medications. Weight loss, often a treatment goal, may not be beneficial for every older adult.
Lauren Stenson, a curriculum development specialist at AAPACN, pointed to possible adverse effects including nausea, vomiting, constipation and dehydration. Those risks make observation and coordination among nursing, dietary and other clinical staff especially relevant. Operators also have to account for medication expense when deciding how to manage admissions and facility budgets.
Jody O’Mara, chief nursing officer for Journey Skilled Nursing, said GLP-1s could affect facility assessments, the residents operators accept and quality-assurance programs. Her view that the health benefits could outweigh costs is an operator’s assessment, not evidence that the drugs will produce the same results for every nursing home resident.
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Medicare Coverage Remains in Flux
According to McGill, the bridge program applies to certain GLP-1 prescriptions for weight loss when a resident has not already been prescribed a GLP-1 for diabetes; she said diabetes prescriptions are covered under Part D. Eligibility includes criteria involving body mass index and other chronic conditions. The program was extended through 2027.
A more permanent coverage proposal, known as BALANCE, was delayed without a new implementation date in the report. For residents covered under Medicare Part A, McGill said the nursing home may be responsible for a prescribed GLP-1’s cost. If a drug is not eligible for the bridge program, that expense can be substantial for a facility, she said.
McGill said one possible policy change would be for Congress to expand consolidated billing to include high-cost drugs such as GLP-1s. She noted that some excluded medications, including chemotherapy and dialysis drugs, can be billed directly to Medicare Part B. That expansion has not been established as policy.
“We see a lot of our new admissions coming in with GLP-1s.”
— Lisa Chubb, chief nursing officer for Venza Care
Coverage and Resident Outcomes Unsettled
BALANCE has no future start date in the report, and it is not clear whether Congress will expand consolidated billing to include GLP-1s. The precise payment responsibility can vary with a resident’s Medicare coverage, eligibility for the bridge program, prescription and facility circumstances.
The report gives no overall count of nursing home residents using GLP-1s, nor comparative evidence on outcomes in this population. Venza’s admission figure is an operator-reported share, not a national estimate. It also remains unclear how often potential side effects occur among nursing home residents and how facilities will balance weight-management goals against risks related to nutrition, muscle and functional status.
Facilities Prepare for Continued Use
The immediate developments to watch are whether CMS sets a new timeline for BALANCE, how coverage works as the bridge program continues through 2027, and whether Congress considers changes to consolidated billing. In the meantime, facilities will need to weigh medication costs and resident coverage as part of operational planning.
Providers are also likely to keep adapting assessments, staff education and monitoring practices as more residents arrive with GLP-1 prescriptions. The report does not identify a single national protocol or a defined next policy milestone. For now, the key questions are how reimbursement will develop and what clinical approaches best address the needs of older residents taking these medicines.
Key Questions
How common are GLP-1 medications among nursing home residents?
There is no national figure in the report. Venza Care’s chief nursing officer said 30% to 40% of new admissions at the company are taking a GLP-1, with a higher share at facilities with more short-stay residents.
What does Medicare’s bridge program cover?
AAPACN’s Jessie McGill said the program adds a $50 monthly fee to Part D coverage for eligible weight-loss prescriptions. She identified Wegovy, Zepbound and Foundeo as eligible drugs. Eligibility rules apply, and the fee may still be difficult for some residents to afford.
Who may pay for a GLP-1 prescription in a nursing home?
Payment depends on the resident’s coverage and whether the prescription qualifies for the bridge program. McGill said a nursing home may be responsible for the medication cost for residents on Medicare Part A; a drug outside the program can be a significant facility expense.
Why are nursing homes concerned about side effects?
Older residents may already have frailty, nutritional concerns or functional limitations. AAPACN’s Lauren Stenson cited possible effects including nausea, vomiting, constipation and dehydration, making individualized monitoring relevant.
Source: skillednursingnews.com
