For decades, the quiet heartbeat of care in America’s senior living communities has relied on a fragile system: routine bloodwork. But today, a silent crisis is sweeping across the country—one that threatens the wellbeing of thousands of seniors and the sustainability of the very operators and providers tasked with keeping them safe.
Phlebotomy—essential, overlooked, and now vanishing
“The evolution of on-site draws over the Covid years has been remarkable. Prior to the pandemic, their necessity was minimal, but during Covid, they became essential,” said Bob Mayer, Co-Managing Partner at Vita Mobile, a mobile phlebotomy services company.
“Post-Covid, they remain indispensable and have also emerged as a matter of convenience. In most on-site testing sectors, the phlebotomists’ time is factored into the reimbursement structure. However, it appears that some of the most financially and medically vulnerable populations are left unsupported,” said Mayer. “The reimbursement policies within the senior living industry seem notably disconnected from those of other mobile services. I sincerely hope this disparity is not indicative of the overall quality of care provided to these communities.”
Labs are walking away. Senior living community leaders are scrambling. Physicians are flying blind without the data they need to deliver care. Seniors on blood thinners are dangerously exposed.
“We receive nearly weekly requests from new communities asking for blood services,” said Patrick O’Neill, President of Serviam Diagnostics. “They don’t ask about UTIs, wounds, or respiratory testing. They ask one thing: ‘Do you provide blood draws?’ Because that’s their current gap.”
“Collecting blood is not a financially stable model,” O’Neill explained. “Each draw costs around $105 to complete. We get reimbursed on average $25. That’s a $60 to $80 loss every time. Most of that loss? Phlebotomy.”
And phlebotomy providers exit the industry, the consequences ripple.
In a typical senior living community, 10 to 15 blood draws are needed each month. For residents on blood thinners like Coumadin, missing those draws can be catastrophic. “If PT/INR levels aren’t monitored, resident safety is at risk,” O’Neill said.
“For our older patients, especially those living with dementia, the ability to have their blood drawn in the comfort of their home significantly reduces anxiety and disorientation, and eliminates transportation challenges, allowing for more timely labs and optimized care. We’re concerned about how many patients are losing this option for acute and subacute needs as well as regular labs,” says Rajiv Patel, MD, CEO of Bluestone Physician Services, which delivers advanced primary care services to patients living in assisted living, independent living and group home communities. “We’re working as a team to help solve this problem so our patients continue to receive the care they deserve.”
Leading media and organizations are taking notice of the growing need to provide healthcare in senior living. Senior Housing News recently reported on senior living operators grappling with resident acuity. Seniors are moving in later, typically in their mid-80’s, which means they need more care and help. According to AHCA/NCAL: “Four in 10 are living with Alzheimer’s disease or other dementias. After a median stay around 22 months, roughly 60% of residents will move out of assisted living to transition to a skilled nursing center.”
Beyond the individual risk, the collective cost is steep: increased hospitalizations, shorter lengths of stay, diminished family trust, and damage to a community’s reputation.
Voices from the Front Lines
From the executive suite to the front lines of care, senior living leaders are sounding the alarm.
“Access to timely and reliable phlebotomy services in senior living has become increasingly difficult, often leading to delays in care, resident frustration, and unnecessary transitions to higher levels of care,” said Chris Hyatt, Co-CEO of New Perspective Senior Living. “These challenges disrupt daily operations and elevate clinical risk, placing added pressure on care teams who are already stretched thin. It’s a growing gap that demands creative, resident-centered solutions across the healthcare ecosystem.”
“In recent years, phlebotomy services have become increasingly unreliable and understaffed. Bedside manner has declined, too, with phlebotomists rushing from one stop to the next,”said Stephanie Belfield, Regional Director at Bickford Senior Living. “Assisted living and memory care communities have limited lab options, and we’re frequently told to transport residents ourselves—as if that’s convenient or appropriate. Delays can be detrimental to a resident’s health. When lab communication breaks down, something that could have been managed onsite escalates into a crisis—resulting in unnecessary hospitalizations and distress for the resident, ”said Belfield.
So why hasn’t the industry sounded the alarm?
A System on the Brink
Serviam Diagnostics is now fielding weekly calls from communities left in a lurch. Longstanding national labs are pulling out of the space altogether, or quietly dropping phlebotomy services. Some communities are cobbling together solutions. Others are simply going without.
“It’s frustrating,” said O’Neill. “Providers are scrambling behind closed doors. This isn’t just a business problem. This is a quality of care issue.”
And it’s one Serviam Diagnostics refuses to ignore.
Collaborating Toward Solutions
The phlebotomy crisis isn’t caused by greed or incompetence. It’s a systemic breakdown, rooted in a misaligned economic model.
Phlebotomy costs are high. Reimbursement is low. Providers need the blood data. Labs lose money providing it. Communities can’t—or won’t—pay. And CMS reimbursement structures haven’t caught up.
“We’ve always been willing to take a loss,” said O’Neill. “But not $80 per blood. Simply put, we can’t operate any longer with the current model so we had to make a tough call. Starting May 1, we’re no longer paying for phlebotomy ourselves. To be clear, we are still very much committed to processing blood specimens in our lab.”
Instead of walking away, Serviam is coordinating solutions: connecting operators with trusted phlebotomy vendors, encouraging provider groups to take on draws themselves, and even helping communities explore in-house certification programs to train care staff to do the work directly.
“It’s about creating a path forward that works for all parties and keeps residents safe and providers informed,” said O’Neill.
One such option? Leveraging existing medical assistants within provider groups.
“Providers need this data most,” said O’Neill. “One immediate step is leveraging provider staff who are already trained, on-site, and can draw blood. We are exploring this model now with Bluestone Physician Services in Minnesota and Wisconsin, an area of the country where blood / phlebotomy services are dwindling at an alarming rate.”
Doing the Right Thing, Even When It’s Hard
Serviam’s mission is simple and unwavering: to be in service of the transformation of how America cares for seniors. That’s not a tagline—it’s a conviction.
“We’re not here because it’s easy,” said O’Neill. “We’re here because it’s the right thing to do. We can’t stand by while seniors fall through the cracks of a broken reimbursement system. That’s why we’re working across the ecosystem to find solutions that actually work.”
Solutions like helping providers take on phlebotomy services themselves. Or working with communities to upskill staff and provide alternative career paths. Even if it means giving up control or market share, Serviam is committed to making sure seniors aren’t left behind.
“We’re facilitating relationships, coordinating regional partnerships, even encouraging communities to work with local hospitals when necessary,” O’Neill added. “This isn’t about protecting our turf—it’s about protecting the people we serve.”
Some communities are exploring wellness surcharges to help cover costs. Others, like New Perspective and Bickford, are collaborating with providers to ensure coverage stays intact.
“There’s no one-size-fits-all solution,” said O’Neill. “But the bottom line is, someone has to sound the alarm. And Serviam is stepping up.”
A Path Forward—If We Can Find It Together
Ultimately, this is a financial problem with human consequences. CMS reimbursement rates haven’t evolved. Labs can’t continue to operate at a loss. Communities don’t want to take on new costs. And providers—despite being closest to the data—haven’t traditionally taken responsibility for blood draws.
But the cost of doing nothing is far greater.
“This is healthcare,” O’Neill said. “This is someone’s mother, someone’s father, someone’s loved one. And we’re watching the infrastructure to support them crumble beneath us. If we can’t get a basic blood draw done, what does that say about our industry?”
The real solution may involve policy change, new partnerships, and a rethinking of priorities. But the first step is awareness.
“This problem is growing fast, and people are starting to take notice,” O’Neill said. “It’s time we start talking about it.”
If you represent a senior living operator, community, or healthcare partner impacted by this issue—or if you’re working on a solution—reach out. The time to act is now.