Florida Nursing Home Quality Care Connection

The Florida Nursing Home Quality Care Connection

Be a Continuous Learning Organization

To improve resident care, it is important to proactively identify issues. A continuous learning organization is one that knows where it stands with regard to key metrics and outcomes; knows when and how to change in order to meet goals and expectations; uses data to drive performance; and views itself as an interdependent system (one in which the people, structures, supplies, and resources come together to make the organization function).

Change Concepts of this strategy include:

Making systems-thinking the norm.
Tracking your progress.
Planning and implementing tests of change.

For more insight and practical tips, read pages 22-25 of the National Nursing Home Quality Care Collaborative Change Package.

Ideas for Residents with Depressive Symptoms

The quality measure (QM) for Residents Who Have Depressive Symptoms (Long Stay) reports the percentage of long-stay residents who have had symptoms of depression during the two-week period preceding the minimum data set (MDS) 3.0 target assessment date. Learn more about the calculation of this QM in the MDS 3.0 Quality Measures User's Manual (v8).

Central to this measure is the resident's:

Interest and pleasure in doing things
Feelings of being down, depressed, or hopeless

Because of the complexity in the Resident Mood Interview, it is important to ensure the interview is resident-focused. In other words, plan the resident interview for a time when the resident is most alert and objective about his or her needs.

Performance Improvement Project (PIP) teams should:

Identify which residents have triggered this measure.
Review and revise their care plans accordingly.
Address the ways in which the organization delivers care that is individualized and person-centered.

For example, effective communication by nursing home staff members is related to a decrease in depression among residents. Communications skills training may be an effective, resident-centered approach to improving this important QM .

Next month: Tips and change ideas for decline in activities of daily living.

QAPI Corner

Step 5: Develop Your QAPI Plan

In July 2015, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that revises the requirements for long-term care facilities. Nursing homes will need to submit a QAPI Plan that describes how QAPI will be implemented.

According to the proposed rule, CMS intends for QAPI plans to result in "continuous quality improvement throughout the facility and enhanced quality of care, quality of life, and resident and staff satisfaction." Read more about these changes.

For more information about developing a QAPI plan, read page 13 of QAPI at a Glance. In addition, the tool provided on page 34 provides a template guide for developing a QAPI plan.

Next month: Conduct a QAPI Awareness Campaign

HSAG Resource Spotlight

QAPI Resource Library

Access all of the CMS tools for QAPI from one easy-to-use electronic resource library. Learn more.

QAPI Plan Template

Ensure resources are in place for your facility's PIP teams with this helpful one-page checklist. Learn more.

QAPI Companion Guide

This guide helps walk your team through the actions steps of developing your organization's QAPI plan. Learn more.

This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for Florida, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. FL-11SOW-C.2--09282015-01