Expert Recommendations

Forbes had a great article by Dr. Kenneth Scott. He is CEO and founder of SilverSage Management Services. He discussed the Biden Administration’s plan to improve the quality of care administered in nursing homes across the nation. Biden announced a series of actions designed to increase accountability against the worst-performing facilities.

Biden and CMS plan to improve the nursing home experience by cracking down on substandard facilities, accentuating new areas of emphasis and bringing down rehospitalization rates. Dr. Scott has recommendations.

Proactive v. Reactive

“The first thing I would suggest is changing your mindset, starting with attitudes set by each facility’s leadership. I’ve noticed one of the biggest problems healthcare institutions face today is the mentality of being reactive instead of proactive. Thinking proactively may be a challenge at first—not only because habits are hard to break but also because the rules are changing so rapidly that it’s hard sticking to long-term plans.”

QAPI meetings should look at deficiencies cited on a monthly basis. Management should evaluate measurable statistics monthly.


Biden’s plan for strengthening skilled nursing facilities (SNFs) continues to involve fortifying the Value-Based Purchasing (VBP) program. In particular, the VBP recognizes the quality of care based on readmission rates from nursing homes to hospitals. One way of reducing rehospitalizations would be to have a full-time doctor on staff at each SNF.

Readmission rates and patient danger should be reduced by recognizing changes to a patient’s condition and communicating to nurses and doctors.

Finally, Scott argues that rehospitalizations may not be necessary if other options are explained to the families.