A Prescriptive Approach to Implementing EHR in a Senior Living Setting


Senior living is changing. Older adults who need help with day-to-day life no longer face the all-or-nothing approach of traditional nursing homes. Instead, they can choose assisted living communities that offer 24/7 support tailored to their specific social and physical needs, allowing them to retain their independence and active lifestyle while getting the care they need.

The ideal community is small enough for staff and residents to know one another but large enough to provide plentiful activities and wellness options to keep elders and their families healthy and happy. And that’s what we’ve built at Monarch Cottage La Jolla.

Establishing a Welcoming Community 

I moved to the West Coast six years ago after nearly a decade in the senior living industry. The Haffner Family hired me to help open an entirely new community, and because it was new, we had a lot of decisions to make. Monarch Cottage is a Haffner family company, and our core values focus on our residents and their families equally. I sat down with our executive director and discussed the type of environment we wanted to create for older adults with memory impairment. It’s important that we get to know our residents and their families as we work to address their every need.

Although our La Jolla community was built from the ground up to incorporate the latest developments in senior care and cognitive science, our medical records setup wasn’t quite cutting edge. We used a hybrid paper and digital system, including paper-based charts that worked well when we first opened but grew cumbersome as we reached capacity and added a waitlist. We could input nursing notes, author service plans, and generate printable facesheets online, but there was no intercommunication between this system and our caregivers.

Printing and filing paperwork is time- and space-consuming, and it can complicate the audit process.

Instead, we had to print these documents—sometimes that would be 60–80 sheets of paper over the course of two shifts—for our caregivers, who would review and sign off on them. Then we’d have to organize the documents into dozens of patient and assignment binders, which took up a lot of space. Not only was printing and filing paperwork time- and space-consuming, but it complicated the audit process.

Replacing Our Outdated Systems

Recognizing that our systems were outdated, I started researching electronic health record (EHR) providers and contacted several vendors. Most of the systems we found, however, focused primarily on skilled nursing and were too complicated for our personal care assistants. During the search, one of our nurses asked about PointClickCare.

The company had recently acquired QuickMAR, the electronic medication administration record (eMAR) we use to administer medications for our residents. We were very happy with the product and had experienced a seamless transition to PointClickCare after the acquisition. PointClickCare EHR was easy to use and simple enough for our personal care team. We could customize it to reflect their day-to-day use cases while retaining the option to create an interface tailored to nurses’ skills. They also offered a quicker turnaround than other providers: We could be up and running in a few weeks.

I drafted a proposal for my executive director and our owners, highlighting the problems we were experiencing, including the lack of storage space in our small offices and the inefficiencies of working with paper-based charts. They agreed that PointClickCare was the way forward. We met with PointClickCare within a few days, and a couple of weeks after that, we began transitioning to our new EHR. 

Hands-on Structured Training

Rolling out PointClickCare was incredibly smooth. We started by meeting with various experts on different parts of the system, including billing, clinical operations, and case management. We also had a project manager who oversaw our implementation. We had an entire team supporting us and we established a training schedule with a detailed syllabus and regular check-ins as part of PointClickCare’s SmartStart Program. 

Structured training happened over Zoom. We met with experts who focused on a specific part of the system and gave us homework, including further online training. We also had access to a PointClickCare training portal, where we could practice what we learned and access our live database to input the information we needed ahead of the formal launch. We were learning the specifics of the platform while also preparing to go live.  

Interactive training courses enable people to become confident users of a platform instead of navigating a confusing new system while trying to do their job.

I’m a hands-on learner, so I appreciated this approach. And even though the sessions were virtual, they were incredibly interactive. Our trainer would walk us through PointClickCare, and we would share our screens for further guidance and corrections as we learned to navigate the application. By the time we rolled out the new EHR, we were already confident users of the platform instead of navigating a confusing new system while trying to do our job.  

Easier Access on an Accelerated Timeline

We worked on an accelerated timeline. Our kick-off call was on August 22, 2022, and we went live on November 8th. By the start of 2023, we had 25 personal care assistants using the system at Monarch Cottage La Jolla. We do our charting on tablets, which saves a lot of money, space, and time compared to printing and filing everything. It also makes it easier to find information and make changes to residents’ service plans.


Instead of sending text messages or printing out instructions, we now leave detailed notes in PointClickCare, which has become our single source of truth. There’s less confusion because we can look back through a resident’s history to confirm we’ve made appropriate adjustments to how we deliver care. The changes are instantly available to me, caregivers, and our on-staff nurses and physicians.

With PointClickCare, I can look at residents’ charts from any location instead of calling a medication technician and asking them to look up specific information and dictate a visit summary or other details. We even store all faxes, doctors’ orders, lab requisitions, and test results in PointClickCare. Anyone with the proper authorization can access them anywhere on-site or remotely, 24/7.

We have also added waitlisted seniors into PointClickCare. We can assess them and add all their information to the system. We don’t have to look through folders when they eventually move in because we have their baseline information at our fingertips. If they’ve waited more than a year, we’ll reassess them and make the appropriate changes, but we don’t have to re-enter all that information if they’re stable. In either case, we can start working on a service plan and assign tasks to a personal care assistant with less fuss and fewer steps.  

Sparking Moments of Joy with PointClickCare

Thanks to PointClickCare, our care team is better informed and updated on every resident’s condition. We no longer search through binders to find information, and we have streamlined how we complete charts. This leaves us more time to spend with residents and find new ways to improve care delivery, including more specialized training and innovative new tools for our personal care assistants. As a result, our entire team can focus on creating a community where our staff and residents can live their best lives. 

Streamlined charting and workflows leave healthcare professionals more time to spend with residents and find new ways to improve care delivery.

PointClickCare is helping Monarch Cottage La Jolla fulfill our mission of providing a welcoming environment for our residents and their families while providing the support seniors need to maintain an active lifestyle. It has opened up conversations and facilitated communication about residents’ needs, giving us the tools to better connect with the people we serve and provide personal care that sparks moments of joy.