Luminary long-term care leader Mary Ousley was honored as the 2021 McKnight’s Women of Distinction Lifetime Achievement Award winner in May. It was a more than fitting choice.
Her insights have earned her industry plaudits for decades. Speaking recently at the LTC 100 conference, Ousley, a former board chairman of the American Health Care Association, told it like it is. The chief strategy officer for long-term care at PruittHealth is hardly an impartial observer. Yet she is not afraid to tell some hard truths. Even if they make some fellow providers wince.
Consider home care and home- and community-based services, which less secure skilled nursing pros might see as a threat.
“This is not a competition between HCBS and skilled nursing; it’s complementary,” she asserted. But nursing home operators are going to have to invest more in skilled staff, including infection preventionists and 24/7 registered nurse coverage, she said. Ousley says about $15 million would cover the above and, “relatively speaking, that’s not a lot of money.”
Lest you think she’s one of those eat-your-own-kind observers, she gives equally in all directions. In fact, providers may have no better advocate. She knows, for example, how to call the Centers for Medicare & Medicaid Services on the carpet.
Take the agency’s insistence that its new Patient Driven Payment Model is calibrated too high, resulting in unintendedly high provider reimbursements. Ousley, among others, reminds that a certain pandemic produced unexpectedly high needs.
When she recalls that CMS wanted every admitted resident to be treated as if they were COVID-positive, the argument against the overpayment theory makes more sense. The industry’s “numbers are lying” response becomes more plausible.
“How do we attribute the $1.7 billion to the cost of care? CMS attempted, but did not go far enough,” she matter-of-factly said.
There’s no more persuasive politician than a sweet-talking Southerner, and Mary qualifies there — when she remembers to include the sweet part, and even when she purposely doesn’t.
After chastising CMS on its spending analysis, for instance, she quickly added, “Keep in mind that this rule is not written in ugly language. It’s reasonable and collaborative. That’s hopeful.”
As long as there’s a Mary Ousley around and in there swinging in the name of candor and care, there is plenty of reason for hope.
The McKnight’s Women of Distinction program is jointly administered by McKnight’s Long-Term Care News and McKnight’s Senior Living. The program’s Diamond sponsor is PointClickCare, and the Roundtable Sponsor is Paycor.
From the July/August 2021 Issue of McKnight's Long-Term Care News
