As nursing home operators seek wraparound services to help with staff burnout, turnover and retention, leaders in the sector say it’s unwise to overlook the use of robotics, while others consider it to be too big of a technological leap.
Robotics that help with cleaning, dietary and menu selection in particular seem to be more within reach for a lot of operators, freeing up staff to focus on more complicated tasks. But robotics adoption in skilled nursing is still early and limited, Heitz Technologies Founder and Ignite Medical Resorts Consultant Rob Heitz told Skilled Nursing News, with only a small segment of the U.S. nursing home market using robotic technology at scale.
Latest innovations involving robotics include getting high-acuity patients up and moving – a major challenge in skilled nursing. Without robotics, getting such patients up and moving is labor intensive and risky for both the patients and the staff, requiring multiple therapists, Heitz said.
Heitz’s background is in neurological rehabilitation robotics, including robotic exoskeletons, virtual reality and sensor-based systems that support gait training and mobility for patients who might otherwise remain bed- or wheelchair-bound.
And while the industry has made some headway with staff numbers, many patients don’t receive as much mobility therapy as they should. The goal here is earlier, safer mobilization of patients and faster functional improvement, but not at the expense of a staff position. Indeed, tools for physical therapy robotics are meant to make clinical practice more efficient, Heitz said, while also reducing injury risk and improving job satisfaction.
The greater use of robotics could help with staff recruitment and retention as well, Heitz said.
“Having those advanced tools, it’s attractive. It helps retention, it helps attract better staff and maintain high quality staff because they have access to technology and to more advanced tools,” Heitz said. “[In] moving around a heavy, low functioning patient, if they fall, you could get hurt as a caregiver.”
And this is where Ignite shines, he said, given that it is the only skilled nursing operator in the U.S. known to have integrated physical therapy robotics at scale, with 18 robotic devices across 28 facilities.
“They’re definitely integrating it on the largest scale … really getting people up on the first day that they’re there, getting them up and moving to a better condition more quickly,” said Heitz. “It’s not too dissimilar from the application of robotics in other industries. It’s not necessarily replacing the user, but really facilitating them to do their job more efficiently, more effectively, and oftentimes at lower risk of [incurring] their own injuries.”
Monarch Healthcare Management, meanwhile, has seen its robotics collaboration generally foster excitement among residents and staff, resulting in reduced fear of technology for any future investments.
Positive public perception was an unanticipated result of using robotics in their facilities, according to Dan Strittmater, vice president of innovation and bench strength for the Minnesota operator.
“Robots in nursing homes make amazing positive press – we had tons of local and national coverage,” said Strittmater.
Monarch uses Pepper Softbank Robots for resident interaction, in collaboration with the University of Minnesota Duluth robotics program, Strittmater said. Pepper robots are more hospitality focused with emotion recognition and customer service programmed in. Monarch has also attempted to collaborate with local high school and college robotics clubs, but didn’t see as much success.
While the overall experience was positive, Strittmater said the robots didn’t reduce staff workload, given that it took extra time in the day to work the social functions of the robots. That said, a surprise benefit of robots was that residents seemed more willing to share information with the robots than with people, he added, regardless of cognitive status.
A high price to pay
Most existing research on rehabilitation robotics focuses on hospitals and inpatient rehabilitation rather than skilled nursing. It’s a common pattern for these settings to see new health care technologies before filtering down to other care settings like nursing homes, Heitz said.
“New innovations in health care are typically designed with the mindset of the hospital, or the largest market that has more funding available,” said Heitz. “[Tech companies] develop technologies for that market segment, and then skilled nursing and other types of health care providers need to figure out how to adapt that technology to work for them.”
Robots typically require a capital investment ranging between $50,000 and $150,000, Heitz said, with physical therapy robots priced at the higher end and task-based bots, like floor-cleaning robots, at the lower end.
Outside of Ignite, most robotics departments in skilled nursing and rehabilitation are being run as small pilot programs since such equipment has high capital costs and unclear return on investment, Heitz said.
“I would still consider us in the very early stages of adopting robotics in skilled nursing,” Heitz said. “The combination of intelligence with robotics really opens up a lot of opportunities. We are very hungry for robotics that can directly interact with patients on a more autonomous level.”
Robotics purchases in the U.S. are funded through philanthropy or foundation grants rather than operating budgets, he said. Currently, there’s little to no federal or state funding for robotics in nursing homes, but that may change once return on investment and payer savings comes into focus.
Task-based robotics offers clearer return on investment, while therapy robotics rely more on indirect benefits such as safety, outcomes, differentiation and workforce stability. Improved financial performance could potentially translate to higher wages for staff, but this hasn’t been observed as yet, Heitz said.
Overall, robotics is too large a technological leap right now given current capabilities, Strittmater said. Smaller, incremental advances in “smart” equipment and software are more doable for the sector like interactive video, virtual reality, smart lifts, sit-to-stand devices, algorithms and AI-driven tools. These offer better return on investment at a lower cost.
“Maybe floor cleaning can keep common areas clean and delivery robots can run trays for CNAs,” Strittmater said. “[Currently] many nursing homes are older buildings so the robots don’t work perfectly – some buildings have sloping floors that can create an issue. So, if you were building a new nursing home it would be good to consider robots.”
Proof at scale
Humanoid or semi-humanoid robots that can help nursing home staff with direct patient interaction, repositioning and routine tasks are anticipated in the U.S. within the next two to three years, Heitz said.
But dexterity and general-purpose functionality remain major challenges, he said.
In the near term, task-specific robots like cleaning, food service and logistics will expand, along with greater integration of artificial intelligence (AI). This means more autonomous and interactive systems in facilities, Heitz said.
Robotics has already been proven effective in other countries, with Japan in particular using robots to lift, move and rotate nursing home patients in beds and around rooms, as well as mobility robots used by patients to move around and bathe, according to a study published in January 2025 by the University of Notre Dame.
The study found that robot use was associated with increased employment and employee retention, along with improved productivity and a higher quality of care.
Most studies of robots in the workplace have focused on other industries including manufacturing and the industrial sector, according to Yong Suk Lee, associate professor of technology, economy and global affairs at Notre Dame’s Keough School of Global Affairs.
Lee and his colleagues looked at surveys conducted of Japanese nursing homes between 2020 and 2022.
“Our research focused on Japan because it is a super-aging society that provides a good example of what the future could entail elsewhere — a declining population, a growing share of senior citizens and a declining share of working-age people,” Lee said in a report published by Notre Dame. “We need to be ready for this new reality.”
Robots assisting with patient transfers, mobility and monitoring were shown to reduce physical strain on workers and in turn helped retain staff – this was especially true for part-time workers and staff with less experience.
And, facilities using robots reported fewer patient restraints and pressure ulcers, researchers of the Notre Dame study found.
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