You could sync (I am not sure V4 has solved issues in this regard), you might be able to remotely log in through internet portal if each nursing home had a means to do so.
Synching appears to be the most practical way.
But then, if it is the same laptop everywhere, you could simply copy your database to the desktop to transfer info, but if you are using multiple laptops or machines, synching is more practical.
How will you send the files to your biller? If they are in the office fine, If you are remotely sending to them, that could be done from the laptop.
I do not think you cannot selectively load demographics only. It would be an all or nothing proposition without a lot of work.
