Shawn Scott
In an interview with Provider, Shawn Scott
, senior vice president, corporate sales, post-acute sales, Medline Industries, says amid a sea change in how providers of all sorts are reimbursed and care is delivered, more skilled nursing facilities (SNFs) will increasingly take advantage of new technology to improve their business prospects.

Below is a series of questions that he answered as part of an effort to frame current industry trends from the perspective of a longtime industry leader and board member of American Health Care Association/National Center for Assisted Living (AHCA/NCAL).

Provider: What is the current business climate in terms of challenges and opportunities for long term and post-acute care (LT/PAC) operators?

Scott: Medline is a unique company that spans the entire continuum of health care and it gives us a unique look upon how one part of the continuum has an effect on another. The effect value-based purchasing within hospitals has had on downstream partners in terms of the reduction of Medicare days, increased focus on readmissions, and increased importance on data management has been well reported.

The one thing we see that is not reported in our space is how hospitals are using technology to improve their bottom line, where PAC providers tend to be slower to adopt technology into their systems and process. My belief is you will see more skilled nursing operators in the future using technology to help improve clinical outcomes and manage their business. The technology is there, but I find there is a hesitation to change clinical and quality operations. But, I believe this change is inevitable.

SNFs are being forced to make these changes by CMS [Centers for Medicare & Medicaid Services], their referral sources, and their residents. The bottom line is they are going to have to invest in technology outside of their EMR [electronic medical record] system to stay relevant.

Provider: What about assisted living?

Scott: For assisted living operators, there is a unique opportunity to combine the medical model and the hospitality model to expand their services to help their residents with higher acuity stay in place. We have worked with many assisted living operators that are adding space for rehab. And, we are doing more education on skin health and how to prevent and treat skin breakdown. To help mitigate the increased risk of falls within assisted living, we worked with a company out of Denmark that developed a product that helps caregivers safely assist residents from the ground to a standing position that is the size of a folding chair. This eliminates the old standard Hoyer lift that most facilities don’t have or want in their hallways.

Interestingly, I’m seeing the need for skilled nursing centers to move more into the hospitality marketplace using technology as way to get there, and the need for assisted living facilities to move more toward the medical model as acuity rises in their communities. 

Provider: How has Medline worked to bring technological changes to health care?

Scott: Back in 2004, Medline decided that having a world-class distribution model and best in class products at a competitive price wasn’t good enough. We went to our customers and they told us they needed help with regulatory challenges, education, and systems to improve their operations. So, we looked internally to see what we could do and found that to really help our customers we needed to go to the experts.

In 2007, we partnered with Providigm (formerly Nursing Home Quality). Providigm’s founder was the lead architect of the Quality Indicator Survey for CMS, and the company was contracted by CMS to train surveyors nationwide. Providigm developed a quality assurance program called abaqis to equip skilled providers with the tools that they needed to manage QAPI [Quality Assurance and Performance Improvement] and survey readiness. As a result of our partnership, abaqis has become the top QA program in the country. Today 20 percent of nursing homes use this tool. And, our partners who use abaqis have seen a 50 percent reduction in survey deficiencies, an average increase of 4 percent in census, and an average reduction of $31,000 in Civil Money Penalties.

Provider: What do you think are the top priorities for facility owners, gathered from your leadership roles at Medline and AHCA/NCAL? 

Scott: The one common thread between all the customers I speak to is how hard it is to find quality staff and keep them. I see this as a huge problem for health care in general, but PAC specifically. And the demands on the workforce are going to increase. Facilities are going to have to invest in tools that will reduce the workload on their front line employees while at the same time improving resident quality of care. In other words, they are going to have to invest in ways to change the way nursing is being done today, that create efficiencies where they didn’t exist before.

Provider: How has working in the LT/PAC sector been a rewarding experience, and possibly different than being in other parts of the health care system?

Scott: In 1996, when I started this journey in health care I had no idea where it would take me. I feel extremely fortunate that I ended up in post-acute care. Every week I get to work with bright, caring and compassionate people that have a true calling for caring for others. These customers are what drive me to find solutions to help them meet their mission.

Working with AHCA/NCAL and having the honor to serve on both boards has been one of the highlights of my career. Working with the best and brightest in the industry to create a path for the future of post-acute care will be something I will always look back on with great pride.

My favorite AHCA/NCAL moments always revolve around the Congressional Briefing. I am fortunate that Medline believes it is part of our responsibility to support the financial well being of the industry both through the AHCA/NCAL PAC and sending 55 members of our leadership team to partner with AHCA/NCAL members on Capitol Hill. But, my favorite briefing was when my youngest son Zach joined me, and the Illinois Health Care Association to lobby on the Hill. The entire membership went out of their way to make him feel special and three years later he is still giving money to AHCA/NCAL PAC and has the passion for our residents and industry.