EP319: How Do We Improve Outcomes in Skilled Nursing and Also Assisted Living Facilities? With Grace Terrell, MD

In Episode 319, Stacey Richter talks with Grace Terrell, MD, CEO of Eventus WholeHealth, about bringing advanced, whole-person primary care into skilled nursing and assisted living facilities — and why fee-for-service gives these facilities zero financial incentive to improve.

WHAT YOU'LL LEARN

✅ Why advanced primary care models are rarely applied to the most vulnerable patients in facilities

✅ Why fee-for-service gives skilled nursing facilities no real financial incentive to improve care

✅ What whole-person, integrated care actually looks like inside a long-term care facility

✅ Why this population often doesn't respond well to typical specialist-prescribed medications

✅ What integrated care requires: information access, communication, and understanding what the patient wants

WHY THIS MATTERS

Skilled nursing and assisted living facilities get paid a set Medicare/Medicaid rate whether the care is excellent or mediocre, so there's little built-in financial incentive to improve — and these facilities have been chronically underfunded and heavily regulated for years, then hit hard by COVID. Dr. Terrell's work at Eventus shows that bringing the same whole-person, integrated primary care principles that work in the community into these facilities can genuinely improve outcomes for some of health care's most medically vulnerable patients.

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

🔗 Healthcare Industry Acronyms and Terms

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00:00 Introduction.

04:09 "The industry itself is in a real pickle."

04:49 What are the fiscal opportunities that a SNF might have in a value-based care model?

09:34 What's the basic principle that needs to be true to provide the best care possible in a SNF environment?

11:05 How does whole-person care work?

15:51 "It does require integrative care; it does require somebody … to be steering the ship."

18:53 "This population doesn't necessarily do well with the typical medications that are prescribed … by a specialist."

20:49 "Most of us in health care … don't have the opportunity to build something from the ground up. You have to work in the system that you're in."

23:10 "More and more people are thinking about integrative models of care."

27:50 "Integrated care is very much based on … access to information, access to communication capabilities, the ability to know what the patient wants, … and the skills to actually provide them good care."

29:27 "Once you get past critical thinking and get into … creative thinking, you'll find that there's just a ton of folks out there who want to be with you, who want to create with you."