There are currently approximately 15,500 Skilled Nursing Facilities (SNFs) in the US providing care to approximately 1.5 million Americans at an annual cost of approximately $175 billion. Research has for decades demonstrated SNF care quality lags - made tragically evident by the ongoing COVID pandemic. As MedPAC termed in its recent March report, the pandemic's effects on SNF patients have been “devastating.” Dedicated podcast listeners may recall I’ve discussed SNF care quality, for example the long standing abusive use of antipsychotics as chemical restraints in December 2012, again in February 2018 when I noted in testimony before the Congress in 2007 the FDA's Dr. David Graham stated, "15,000 elderly people in nursing homes [are] dying each year from the off-label use of antipsychotic medications for an indication that the FDA knows the drug doesn't work," and again in August 2020. (Last September the The New York Times published a lengthy investigative report that found SNFs had gamed the misuse of antipsychotics by fraudulently diagnosing their elderly patients as schizophrenic.) Concerning recent policy reform proposals, they are numerous. In late February the White House published a fact sheet that identified numerous reforms, in early April the National Academy of Medicine issued a report titled, “The National Imperative to Improve Nursing Home Quality" that did the same. In mid-April CMS published its proposed 2023 SNF rule that also did so. Listeners will recall I interviewed Sherill in August 2013 regarding post-acute Medicare fraud and in September 2015 regarding a value-based home health care demo.
During this 41-minute interview Ms. Mason begins by discussing the private equity's effect on the SNF industry and CMS' recent decision to make public SNF (and hospital) ownership information. The discussion moves on to discuss policies including to improving SNF staffing ratios, payment reform, front line worker education and training, addressing the abusive use of antipsychotics and regulatory enforcement and penalties.
Ms. Sherill Mason is Principal at Mason Advisors where she specializes in federal legislative, reimbursement and regulatory initiatives that impact the post acute health care industry. Prior to establishing Mason Advisors, Ms. Mason was a senior policy analyst with Marwood Group, providing detailed analyses of post acute health care legislative and regulatory initiatives to hedge funds and mutual funds. Before joining Marwood Group, Ms. Mason operated Mason & Garvey, LLC, a private consulting practice, for six years where she analyzed health care reform legislation and its potential impact on the senior living industry. Prior still, Ms. Mason served as Senior Vice President of Resident Care & Services for Sunrise Senior Living, with responsibility for program development and the quality of care and services provided to 40,000 residents by 30,000 employees in 370 communities, operating in the United States, the United Kingdom, and Canada. For seven years Ms. Mason was a Director with the Senior Care Services advisory practice of KPMG LLP, and served as KPMG’s National Subject Matter Expert for the home health, hospice, durable medical equipment, and home infusion therapy industries. Ms. Mason is a Registered Nurse and earned a Bachelor of Arts Degree in American Studies with Distinction from Eckerd College. Her remarks regarding senior care have been published in the New York Times, Wall Street Journal.com, and MSNBC.com. In 2004, she was listed in the Washington Post as one of the top ranked business women in Washington, D.C. Ms. Mason’s writings have been published in Faulkner & Gray’s 1997 Managed Home Care Source Book; RN Magazine; CARING; ADVANCE Magazine and Nursing Spectrum. She provided advice on senior care technology to Senator John Edwards’ 2008 presidential campaign. Ms. Mason provided assistance to the Senate Finance Committee as it crafted the IMPACT Act of 2014. For several years Ms. Mason was a guest lecturer at University of Pennsylvania, lecturing senior nursing students and Wharton undergraduates on the Affordable Care Act and government reimbursement for health care.
President Biden's February 28th fact sheet is at: https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/28/fact-sheet-protecting-seniors-and-people-with-disabilities-by-improving-safety-and-quality-of-care-in-the-nations-nursing-homes/). The NAM report is at: https://www.nationalacademies.org/news/2022/04/wide-ranging-systemic-changes-needed-to-transform-nursing-homes-to-meet-needs-of-residents-families-and-staff and information regarding CMS' proposed 2023 SNF rule is at: https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2023-skilled-nursing-facility-prospective-payment-system-proposed-rule-cms-1765-p#:~:text=As%20a%20result%20of%20this,%241.7%20billion%2C%20in%20FY%202023. The NBER paper discussed during this interview is at: https://www.nber.org/papers/w28474.