According to a Bureau of Health Workforce analysis published in November 2024, the average age of registered nurses across the United States was over 43 years old, while the population of Americans over age 65 is expected to increase from 58 to 82 million by 2050.

These changes, paired with an increasingly difficult task of hiring in rural hospitals and clinics, mean healthcare organizations are seeking new and innovative ways to deliver care while providing opportunities for their aging nurses to remain active and in the workforce.

Avera Health, based in Sioux Falls, South Dakota, will expand services through Distance Learning and Technologies (DLT), thanks in part to a USDA Rural Development DLT grant. Their most recent investment is being used to maintain patient safety in 25 rural hospitals across the region.

Kris Becker is the director of Virtual Health at Avera. She said Avera began with a pilot program at their main campus in Sioux Falls, and a secondary location at St. Mary’s Hospital in Pierre.

“We currently have 200 beds being monitored remotely between the two facilities,” said Kris. “Currently, we have had 12 Registered Nurses and 25 full-time monitoring technicians providing 24-hour virtual care, including monitoring for fall risk, which has dramatically freed up local staff to provide more in-depth care instead of sitting at a nurse’s station.”

Kris adds that while staff satisfaction has increased, nurse retention has also been positively impacted by this program.

It just gives them a peace of mind

As for patients and their families, Kris said the reaction has been positive, knowing the patient is being monitored so closely.

“There have been very few concerns about someone watching through a camera,” Kris said. “In fact, we have had families say, ‘you mean I can go sleep in my own bed and not have to stay to watch my family member?’ It just gives them a peace of mind.”

The DLT grant for virtual nursing services is just the latest in a long line of USDA Rural Development DLT investments through Avera Health. In all, Avera has received more than $8.6 million through 23 grants.

The facilities across Avera’s networks have witnessed first-hand the benefits of working together towards a common goal of caring for patients no matter where they live.

“Rural does not mean less,” said John Neth, Avera’s Director of Grant Compliance. “Because we can connect to specialists through e-consults, patients aren’t traveling for hours to a big hospital to receive that level of care. It means nurses have automatic medication dispensing machines through our e-pharmacy services, which helps maintain better control on medications and alleviates higher costs for rural hospitals.”

Whether it’s an ambulance crew consulting with a physician while transporting a patient to the hospital, a rural emergency doctor needs a second opinion, or a newborn infant needs to stay in the NICU, the DLT grants have helped bring high-quality care closer to home for patients in rural communities.

 “We have had such good experience with these grants. Our hospitals are aware of the benefits these grants bring to their facilities, and so they’re always bringing fresh ideas to us,” said Rachel Sherard, Senior Vice President for Rural Health.

The Avera team agreed: it’s not always about profit. It’s about stewardship.

“The USDA grants allow facilities to put to use new equipment without the huge overhead costs,” said Nick Hoeltzner, Manager of Grant Finance for Avera. “Our rural clinics don’t have a lot of room in their budgets to invest in new equipment, to expand their services and be innovative. Often, it’s a matter of tapping into the resources available because of the investments across the entire network.”

With support through the Rural Development investments, Avera will continue to expand throughout the region, adding new services to include admissions, assessments, discharge education, and other tasks that are normally done at the bedside by a nurse working on the unit. These virtual services will free up local nurses for tasks that must be administered locally.

To learn more about USDA Rural Development Distance Learning and Technology grants, visit RD.USDA.Gov/SD.