Congratulations! We exceeded expectations!
Per the CMS Blog posted in January 2017, we have enjoyed a sharp reduction in avoidable hospitalizations among long-term care residents.
CMS states, “For long-term care facility residents, avoidable hospitalizations can be dangerous, disruptive and disorienting. Keeping our most vulnerable citizens healthy when they are residents of long-term care facilities and reducing potentially avoidable hospital stays has been a point of emphasis for the Centers of Medicare & Medicaid Services (CMS). Specifically, between 2010 and 2015, the hospitalization rate for potentially avoidable conditions decreased by 31 percent for Medicare and Medicaid dually-eligible beneficiaries living in long-term care facilities.”
Our communities are doing a better job in many areas, including preventing falls. However, the rehospitalization data only focuses on six (6) specific conditions: bacterial pneumonia, urinary tract infections, congestive heart failure, dehydration, chronic obstructive pulmonary disease/asthma and skin ulcers.
Bottom line: we're identifying subtle changes in condition earlier, which helps to initiate earlier treatment and stops the progression of the disease process.
There's room for improvement, but this is a great start. CMS is recognizing that by tracking the data (and data never lies), our communities are working toward the same goal: quality care for all long-term care residents.
Now let’s move forward and continue to improve the outcomes for our frail residents.
Building on Successful Quality Care
Start by educating staff to be alert to subtle changes that often go overlooked. In a recent visit to a center, the Administrator asked, “Do I need a special software program to help me identify change in condition?” No, but maybe go down and find out why Mrs. Smith refused to go to lunch today. Your staff member came and talked to you about the refusal and said it was unusual for this resident. This is the a-ha moment—the staff member identified something out of the ordinary and you need to react! Yes, the resident could be having a “blue moment,” but did it get investigated?
What about the resident who gets up, eats breakfast, and climbs right back under the covers and doesn’t get up the rest of the day? Is he just tired today, or is there something brewing under the surface?
Your Residents Are Giving Subtle Clues
Changes can be very subtle. Don’t wait for the resident to become lethargic, diaphoretic, and unresponsive before you notice a change. Listen to the roommates and tablemates—they often notice changes in their friends earlier then we do!
Do you need a fancy system? No. You just need to continue caring, being alert, and LISTENING to your staff and residents. There's a lot to be learned from everyone who interacts with your residents—from licensed staff to housekeepers, dietary aides, and family members.
Download the CMS data brief and share it with your staff. If you're managing a skilled nursing community, review your Quality Measures and rehospitalization rates, and see if there's room for improvement.
Many centers post employee injury days and challenge staff to use safe body mechanics while providing care, then celebrate when injury days decrease. Consider doing something similar with rehospitalization rates—post statistics, set goals, and celebrate successes! This will encourage staff to be more alert and know that you are watching and care about resident outcomes.
