GreyMAR Helps Avoid Outages in Skilled Nursing on a Budget

The Skilled Nursing industry is overwhelmingly outdated, we hope we can all agree. Diving deeper into what causes outages and these frustrating concerns really falls on IT, specifically the IT company’s lack of understanding of what needs to be completely functional, who can wait, etc. GreyMAR wants to share some knowledge on how we’re able to maintain such a high level of service for our customers who are skilled nursing.

Look into backup internet service providers.

Backup internet service providers are easy to find, and usually decently priced. We would NEVER recommend a DSL backup as this is just way too slow for today’s modern programs you may be using. Getting this will dramatically improve your facilities ability to operate if your primary ISP goes down.

Ensure IT has it hooked up right, and it stays cool.

Getting a secondary internet provider is a great idea, but ensure your IT company is capable of hooking it up to your firewall/router properly. We have went into buildings that had purchased a secondary internet connection, have been paying for it monthly and it wasn’t even hooked up. We’ve also found that either the primary or secondary modem was sitting under a desk somewhere and overheating, thus causing it to not work, or work half of the time.

Generator plugs at all of your wiring rooms.

Your IT company should be able to work with your maintenance department and ensure that all of your wiring rooms, servers, etc are all on the red generator plugs. It is also recommended that all of the equipment is on a backup battery pack that has proper voltage handling capabilities so when the generator kicks over, it doesn’t blow out your equipment.

Updates on your equipment matters more than you think.

Another real life story – we had a facility in Florida that we walked into – had newer looking access points (for wifi connectivity) right? Once we got into them, we found the software was from 2013 (which is like dog years… multiple everything by 7, get what I mean?). The facility complained of horrible wifi. With simple updates, we ran our measurement tool and found 57% increase of speed just from doing that. Now a proper IT company should do an entire review of your wireless “air usage” every so often. Wireless is very sensitive to new objects such as dressers, mirrors, room movements, anything to “soak up signal” or destroy it, such as cordless phones on your med carts.

EMAR backup and ensuring staff knows how to access it.

We ended up creating an EMAR backup system for your EHR we’ve been pushing called GreyMAR. Take this simple test and walk around your facility and ask “If PCC goes down, what do you do?” and see the diverse answers you will get. We are hoping to help facilities organize and get what they need as fast as possible. Check out our site


There’s many fancy things we can do if you’re up to it.

Failover phone systems.

If you have choppy phone service that cuts in and out or constantly goes out, we have the capability to have any facility phones failover to our systems here, and we can make the phones seem like they’re the facilities, and transfer in between floors. This requires very little setup and works very well if your phone lines and/or system is down. We’ve done this for buildings up to 600 beds multiple times.

Medcarts and Kiosks failover to backup documentation program.

If you’re not happy with your computers and how your backup system is in place, there is always the option of having the GreyMAR OS (operating system) and it will automatically flip all of your clinician devices over to a backup EMAR / POC system if your EHR is detected as being down, or based on our crowd sourcing the system is down and your EHR isn’t aware yet. (Yes, we’ve done this before!)

Thanks again for reading, hopefully this provides some information and is fun to read. I have started a newsletter that you’re welcome to sign up for.

GreyMAR reduces HIPAA concerns for EMAR backups

Let’s get one thing straight – the goal of any facility that has any sort of outage needs to get their MARs and TARs printed as fast as possible, plain and simple. Having the ability to do so needs to be simple, fast, efficient, and secure. With modern struggles coupled with outdated technologies for senior living, many of these things can get quickly overlooked.

Most EHR customers are familiar with the provided solution that backups their MARs and TARs in the event of a system wide outage, internet outage, etc. With that being said, there are many concerns a modern facility should recognize during their risk assessment of their backup strategy.

With the list of HIPAA addressables declining and the rise of required items, it is extremely important that senior living facilities utilize EHRs take special note of their backup strategies.

Who maintains your current backup solution?

The facility usually employs or sub contracts an outside IT provider to handle these tasks. While IT may understand the basis of what your EMAR backup is doing, them fully understanding the concept and how a domino affect can happen is very slight. If the solution provided by the EMAR provider is not constantly maintained, you can be affected by many items as described below.

If the device was stolen, is your PHI at risk?

The computer that’s sitting there with your patients information on it isn’t secured most likely. There is a fine line between usability and security, and it’s hard to perfect. Most facilities have unencrypted backups from my experience (or none at all) and the computer can simply be picked up and taken. Without proper precautions, the device can also have a simple USB drive plugged in and PHI stolen this way as well.

How are you alerted if your backups are outdated?

The provided solution from your current EHR doesn’t include notifications if your backups are out of date. Not to mention, if you don’t have an IT guy constantly maintaining the provided solution, you are at risk for outdated EMAR backups. The program has no method for alerting and won’t let you know if something didn’t complete correctly.

How are you alerted if your backup doesn’t complete?

Similar to the last point – the provided solution by PCC doesn’t give you much to run with, and doesn’t show you errors if something doesn’t download correctly. If the file download doesn’t complete, you could be left with outdated backups, corrupt backups, or worse, no backups at all.

Does your staff know and understand how to utilize your system?

It can almost be guaranteed that if you walked up to anyone in the facility they will have little to no clue how to work the backup system. The goal is to have a fast, easy way to print out MARs and TARs, but this can be cumbersome for the everyday nurse.

What if there is a power outage? What about an internet outage?

Some facilities feel their power and internet systems are perfected, but I can tell you from experience being in the business for many years, that is far from the truth. What if the generate transfer switch burns up? Generator doesn’t kick on?

What if there is a large area-wide outage of some sort?

Area-wide outages are something we deal with daily, and it’s becoming more frequent, especially in larger cities. When there is an area wide outage, this can sometimes last for days, up to a week I have seen. We had a client that had no internet for close to a week and needed to stay operational. Luckily with the experience we’ve gathered it was easy for us to keep them operating. Facilities not under our umbrella though, I highly recommended a plan.

What if the files are corrupted?

The technology that EHR chose to rely on for their EMAR backups is very primitive, thus is prone to many system errors and may not reliably work. With that said, it is extremely important that you keep an eye on your backups, or employ an IT person to watch over this.

Are you complying with regulations on who has access to the backups?

Carefully read over the HIPAA regulations and you’ll see that there are many that explain the necessity to maintain audit trails of who has access to your PHI. Just like someone logs into your EHR with a username and password, there needs to be a way to maintain this with the backups, too.

Don’t panic! This is all easily correctable!

These were all problems that we were faced with, so you’re not alone. In fact, just by reading this article, you are likely much more caught up with technology and regulations that your peers, so go you! I’d like to introduce you to a service we’ve created to solve all of these issues.

We’ve solved all of these EMAR backup concerns with a simple product called GreyMAR. Simple put, GreyMAR is a disaster solution designed specifically for EHR customers, and we’ve tightly integrated it with their services. GreyMAR maintains, verifies, and secures your backups. We maintain everything for you automatically, and have built powerful logic into our backup system to ensure it’s up to date, encrypted at every point, and easy to access.

With GreyMAR:

To access your MARs and TARs you do the following:

  1. Go to the website, device, or medcart that your nurse is already using.
  2. Login with specific credentials (this is to maintain audit trails as required by law)
  3. Boom, everything is there, no more clicks.

I won’t go into all of the cool features we’ve built here, but you’re welcome to visit our website at and check it out, or schedule a demo with me by following this link: Schedule A Demo

But wait, there’s more!

As we continued to grow the service (we’re now backing up 5,000 records a week!) we built in fully automated and easy to use eFax. We’ve also included an emergency phone that can be hooked up into our emergency phone system for your building, but that’s another article and still currently in development.

I hope you enjoy this and learned something. Feel free to send me a your feedback!

If you’re interested in more, sign up for our newsletter here.

Sleep Challenges for Residents in Assisted Living Facilities

In one of her most recent posts, Dr. Eleanor Barbera, an accomplished speaker and consultant with over 20 years of experience as a psychologist in long-term care, dissected sleep challenges of older adults. Dr. Barbera explains the negative side effects coming from these challenges and how they effect basic patient care practices.

“Poor sleep is associated with cognitive and physical deficits. It can impair residents’ ability to participate in rehab and negatively affect their moods and their interactions with others, including the staff members there to help them (whose job is hard enough).

Residents who can’t sleep through the night due to elements within the control of the facility are not happy with this situation. They’re less satisfied with their stays and therefore less likely to recommend the facility to their friends and neighbors.

As illuminating as it would be, you needn’t sleep in your facility for a week to find out which staff training and policies will remedy the problem. The residents have told me what keeps them up at night and I’ve outlined a “sleep hygiene” training program based on that. 

A basic “sleep hygiene” program will:

·      Set the expectation that employees are working in the residents’ homes and should be mindful of their slumber. This includes talking in calm, hushed tones and turning off unnecessary lights after nighttime care.

·      Limit fluids in the evening, provide toileting before bedtime and offer swift, calm and prepared mid-night care that increases the likelihood that residents can go back to sleep.

·      Communicate between shifts so that the elders who have gotten up earliest get to bed soonest if they desire.

·      Prioritize pain management, particularly if it’s interfering with sleep.

·      Refer residents experiencing sleep difficulty due to anxiety or depression to the consulting psychologist.

·      Attend to agitated residents immediately so that they don’t wake their neighbors.

·      Find peaceful nighttime pursuits for elders with dementia-related sleep disturbance such as magazines, drawing or music on headsets.

·      Replace noisy medical equipment such as oxygen machines with quieter models.

·      Select roommates with attention to sleep habits and nighttime needs.

·      Create a policy for quiet hours after, say, 10 p.m. and require low volumes or headsets for electronics after that.

·      Train teams to collaborate between shifts so that they identify and assist residents who are asleep during the day and up at night to reestablish regular sleep patterns.”

We thought Dr. Barbera listed important benefits from using a “sleep hygiene program” and wanted to share them with you!

To read Dr. Barbera’s full post, click here.

Inconveniences in Assisted Living Facilities

GreyMAR recently came across the blog of nursing home resident Kathleen Mears. Kathleen has been blogging about her life as a resident for the past 21 years! Her blog gives us an interesting look into the life of a resident in an assisted living facility.

Her post on October 9, 2017 tells about when the assisted living faculty’s fire prevention consultant came for a visit. It’s hard to understand just how big a small inconvenience can be for a resident, but Kathleen gives us an inside look.

Below she recalls some of her experience:

“The fire prevention consultant said my PC’s line surge protector was too close to my bed. He said, in Ohio, surge protectors within 6 feet of a resident bed must be 1363 A, fire code compliant. I had him write down all the information. I thought I need to buy one to continue using my PC.

I searched on a major shopping website and found a six-outlet 1363 A fire code compliant power strip. I was not surprised that it cost $63. I also found a computer line surge protector but the fine print said it cannot be used within six feet of a resident’s bed.

The compliant power strip cost was more than the line surge protector I was using. I wondered if existing and higher-priced line surge protectors might be more fire code compliant than the inexpensive power strips with a breaker switch. However, I could not find the answer to that question online.”

We sympathize with Kathleen and any resident in an assisted living facility that has to deal with inconveniences like this. GreyMAR is on a mission to make assisted living facilities better than ever, and we hope Kathleen continues to offer us her insight!

Read Kathleen Mears’ full blog post at

Photo of Kathleen MearsNOTICE:  Kathleen Mears is a long-time blogger who has been a nursing home resident for 21 years. She gives us a rare insight to life in a nursing home. Her blog can be accessed at


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