The pandemic has changed the ground rules for defining, measuring, and reimbursing quality.

While the COVID pandemic has changed much in post-acute and long term care, efforts to provide quality care and track outcomes, trends, and opportunities for improvement have continued unabated. Facilities didn’t swap quality measures for COVID care, they just added it to what they were already doing.
Yet the pandemic has put a spotlight on how quality is defined, measured, and reimbursed, and it has exposed what works and where changes are needed.
“It is crystal clear that our nursing home residents are a vulnerable population that should not be exposed to the risk of pandemic, either because they are sent to hospitals or emergency rooms [ERs] unnecessarily or because new patients with potential infections are allowed to come into a building that is not yet exposed to the infection,” says Rajeev Kumar, MD, CMD, FACP, chief medical officer at Symbria in Chicago.
“Hopefully, surveyors and CMS [Centers for Medicare & Medicaid Services] will work collaboratively with nursing facilities to minimize bad outcomes, rather than go on a witch hunt to find and use unfortunate outcomes to penalize nursing homes.”
Read more at

“Alarming Spike” in COVID-19 Cases Seen in SNFs.

A new report released today by the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) shows skilled nursing facilities (SNFs) experiencing an “alarming spike” in COVID-19 cases due to community spread among the general population. The findings are based on recent data from the Centers for Medicare & Medicaid Services (CMS).

http://www.providermagazine.com/news/Pages/2020/AUGUST/Community-Spread-Causes-Spike-in-new-COVID-19-Cases-in-Skilled-Nursing-Centers.aspx

Improving Acute Skills to Achieve Better Outcomes.

In this recent article from Provider magazine, Betty Halvorson, RN,  encourages providers to evaluate the current level of care their facilities are producing  and to ask themselves, “Is this care evidence-based?”

Learn more at:

 http://www.providermagazine.com/archives/2019_Archives/Pages/0819/Improving-Acute-Skills-to-Achieve-Better-Outomes.aspx#magazine-article

Staff Training and Competency: A Growing Challenge

Among the most difficult challenges facing skilled nursing centers today is ensuring that staff are adequately trained to care for their increasingly frail and medically complex residents. While training requirements are included in the initial phase of the final rule, and much more substantially in Phase 3, training and competency are more than a survey compliance issue.

Providing compassionate person-centered care for frail elders, many with severe cognitive and/or physical disabilities, requires staff to be well trained in understanding and addressing a range of resident needs and behaviors. Basic nursing and nurse assistant training provides a necessary starting point, and “caring” goes a long way, but even the most well-intended of us can benefit from training that builds upon knowledge and practice in eldercare.

Training requirements already included in the new regulations and survey relate to abuse and neglect for all staff, in-service training for nurse assistants on dementia management and abuse prevention, care of those with cognitive impairments, and training of feeding assistants. Training in these areas is essential to prepare staff to better understand the needs of those who are most vulnerable and/or difficult for caretakers to understand.

Phase 3 of the final rule will substantially increase the emphasis on training and competency with requirements relating to communication, resident rights, infection control, compliance, and ethics—especially in regard to person-centered care, behavioral health, and Quality Assurance and Performance Improvement. These specific areas are accompanied by the general training requirement that staff are trained to care for all resident needs identified in the facility assessment.

With competency requirements in these areas a year away (Nov. 28, 2019), nursing centers need to begin designing and implementing a systematic training program today. A combination of training methods is encouraged, including in-person instruction, web-based training, and/or supervised practical training.
Due to the steady evolution in resident care needs and treatment, training is required for both new and existing staff.

For nurse assistants, in-service training of at least 12 hours per year is expected to reflect an assessment of their knowledge and skills and how well they know the resident population. To determine the adequacy of in-service training, providers will be required to demonstrate competencies, not just completion of in-service hours.

Many nursing centers will require investment in training specific to the growing frailty and complexity of the long-stay resident population and the higher acuity of post-acute residents. High staff turnover and shortages of nursing staff with the necessary qualifications to take care of today’s elders will continue to be a challenge. Training programs must therefore be ongoing and sustainable so that they continue and evolve as resident needs change and staff capabilities change.

Balancing these training needs with caring for residents is a daunting task. That said, investments in staff training can make caretaking less challenging and more rewarding for staff members. These not only lead to greater staff satisfaction and retention, but the commitment to excellence will not go unnoticed by residents and families.

For a printable version of this article, go to:

http://www.providermagazine.com/archives/2018_Archives/Pages/1218/Staff-Training-and-Competency-A-Growing-Challenge.aspx

 

What Caregivers Need To Know About Aging Eyes

Exams for early detection of diseases afflicting the eyes are imperative to reducing unnecessary vision loss.

With the aging of the baby boomer generation, the growing prevalence of eye diseases and vision loss has become a major public health concern. As such, directors of skilled nursing care, assisted living, and rehabilitation centers need to be equipped with science-based information to educate and train staff on key eye health issues affecting their residents and patients.

Source- http://www.providermagazine.com/archives/2016_Archives/Pages/0716/What-Caregivers-Need-To-Know-About-Aging-Eyes.aspx

CMS Offers Help With New Staffing Data Requirement

When families come together to make the important and often difficult decision of moving a loved one to a nursing home, they want the peace of mind that their family member is getting the best care they need to stay healthy. That includes knowing that the facility has sufficient highly trained staff to devote to all residents.

We at the Centers for Medicare & Medicaid Services (CMS) also believe that staffing is a vital component of a nursing home’s ability to provide quality care. That’s why nursing home staffing information is listed on the Nursing Home Compare website, where families making these important decisions can research the quality of facilities in their communities.

Source- http://www.providermagazine.com/columns/Pages/2016/CMS-Offers-Help-With-New-Staffing-Data-Requirement.aspx

Certified Nurses Improve Facility Quality

Training for gerontological certification turns out to be a win-win proposition for nurses, administrators, and residents.

Registered nurse (RN) staff are in a unique position to affect quality in long term care settings at the bedside and to influence the care delivered by both individual staff members and the team as a whole.
GeroNursePrep
RN staff in long term care settings need to have well-focused clinical assessment and judgment skills, as they are usually the primary assessor of the patient. Medical support is not always immediately accessible, so the nursing staff must analyze clinical situations and have the confidence to make decisions concerning when residents need additional care.

Europe Struggles With High Antipsychotic Rates, Study Finds

We are engaged in a battle to reduce the unnecessary use of antipsychotics to control behavior in our long term care facilities, favoring the use of behavioral interventions instead. Turns out that our struggles in this effort are not unique to the United States.

antipsychotic

Nearly two out every five European elders who suffer from dementia are being given antipsychotic drugs, a new study has found.  Click HERE to read more.