Listen now (42 mins) | 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.