With an ever increasing aging population that is sicker with higher acuities, COO Shawn Neville of SALMON Health and Retirement says capturing an accurate financial picture is a challenge for nursing homes – and an additional reason why so many are closing down.
Neville was named to his current position at the family-owned and Massachusetts-based provider about a month ago. He took over the role from COO Michele McGovern, who stepped down to focus on family.
Intending to initially become a police officer, Neville followed his mother into nursing and started out as a certified nursing assistant (CNA) at a local facility 25 years ago, working his way up to most recently serve as the director of campus operations for SALMON’s The Willows at Westborough.
Skilled Nursing News sat down with Neville to discuss his climb to his current corporate position, and what he’s excited about for SALMON and the industry in the coming years.
This conversation was edited for length and clarity.
So you’ve held operational roles throughout Covid?
I’ve been in a few different roles. In 2017 I was the executive director of Beaumont [Rehabilitation and Skilled Nursing Center] in Worcester. I started there in 2017 and ran that into the start of Covid. We transitioned into a Covid recovery center – the first in the state and I think the nation at some point, in conjunction with UMass and the Department of Public Health. UMass had actually purchased Beaumont in Worcester and then I transitioned into a director of campus operations at Westborough. That was in 2021.
How did you make your way to the skilled nursing space overall?
I was going to join the police force and that didn’t happen – my mother’s a nurse and I ended up working in a nursing home. I grew through that. I had the opportunity to leave the industry at one point in time, I sold mortgages, I put myself in positions to grow in different industries. I always came back to doing this. When you start to touch as many lives as you have over the many years that you work in the industry, it’s all you end up knowing. All you want to do is to continue to grow and have that effect on people.
So family was a big part of the decision?
I started working in a place where no one had family, you know, the residents that were in this particular nursing home were very rarely visited by others. And really, the people that work there were their family. You start to make these changes, and you start to see the effect that you have on their lives. It really takes hold of you. I realized what I was good at doing and where I should be going. It was in this field. And I think that that’s a credit to my mother and my family and how I was brought up.
Did it feel like a big transition to your new role?
It wasn’t that far a leap. In my trajectory of positions and my growth in the company. Starting as the director of campus operations in Westborough was that stepping stone. That opportunity allowed me to oversee independent living, assisted living and the skilled nursing side of the business.
What else has been top priority for you in your new role?
I’ve been in the role for about a month. It’s really just getting to understand what’s going on in the company, getting my feet wet, looking at key metrics and understanding what’s going on, what we need to do.
What changes or growth do you hope to foster at SALMON?
Covid has really set us back as an industry. Re-establishing the basics of taking care of people at a high level is priority number one and then reintroducing people to the community. We’ve been doing this for a long time, it’s a third generation family run business. We’ve been able to maintain that for a long time because of the expertise that we have in the industry.
I think just getting back to basics coming out of the pandemic is a goal, and continuing to increase our presence in the community and always striving to improve quality assurance and quality measures in skilled nursing. It’s about continuing to do what we do best, and that is providing care.
What about work toward the staffing pipeline?
We do work with Mass Senior Care. We have strong ties to the community high schools and trade schools – that’s been fruitful for us. We have a CNA program where the classes are on one of our campuses. We also do an LPN clinical round at two or three of our campuses currently. The tie to the community and the tide of the schools and the tie to our own classes and trying to grow people through SALMON, nurturing them through their career has been the most helpful for us.
Plans to expand these grassroots staffing efforts?
Absolutely, we will take on as many students as we can fit in a clinical round. We would be open to doing these types of things with any of the neighboring universities or high schools.
What are your thoughts on proper reimbursement in the industry, and how does reimbursement relate to quality of care?
You’re supposed to take care of people, and taking care of those people costs something, right? Nothing in life is free. Staff isn’t free, food’s not free, medication isn’t free. Meanwhile, your long term care population is getting older and older and older and sicker and sicker and sicker. Then you have your short term rehab population who’s getting more acute, more comorbidities, the length of stays is shorter in the nursing home when the cost is higher. You’re not able to capture certain things, or capture the rate of return on that revenue stream. It’s a big challenge, and it’s no surprise that nursing homes are closing.
As we wrap up here, I have a hypothetical for you. If you were sitting at a table with corporate leaders of 10 other SNFs, what would you ask them?
Why do you do it, and how? How can we do it together? How can we continue to do it together and provide the care that we’re supposed to?
So more collaboration among SNF operators?
If you go back two or three years, right at the beginning of the pandemic, we were all competitors, and we were all fighting for the same patients, and we were all trying to be on the cutting edge of all these different things. You snap your fingers and all of a sudden, everybody’s friends again, and everybody’s trying to help each other, and everybody’s trying to help take care of each other’s patients or residents, whether someone was able to [care for Covid patients] and someone wasn’t. You see glimpses, when something like the pandemic happens, of where people’s hearts really are. I think that we need to continue to be closer to that; the industry would be better off.
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