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Struggling to Define Success Beyond PDPM? Sustaining QMs is the Solution!

SNFs have been bombarded with changes to many key performance indicators – such as Quality Measures, Five Star Ratings and the Quality Reporting Program – and will be expected to sustain and even grow quality improvements over time.  Read up on all the new changes here. (And have you heard the latest: CMS recently implemented a process whereby the QM thresholds will increase by 50% of the average rate of improvement in QM scores.)  

Based on these obvious smoke signals from CMS, the industry pundits foresee: Quality Measures just might be CMS’s way of monitoring for appropriate levels of skilled rehabilitation services after the October 1 transition to PDPM.   

In light of this prediction, consider your facility’s QM performance in highly monitored areas – such as skin integrity, falls, ADL performance, weight loss, functional mobility, pain, etc. 

Ask:  Are these areas recurrent concerns for your SNF?  

If so, HealthPRO® Heritage advises:

With only 4 months until October 1, your IDT is likely spending more time learning and preparing for the major transition to PDPM; leverage this time to fortify your QAPI process, too!  After all, as key members of your QAPI committee, your Nursing and Therapy professionals should already be working collaboratively to address both the short and long stay populations and dig deeper to discover meaningful solutions. In other words, with Nursing and Therapy working together, they are more likely to uncover the true etiology of common problem areas – like pain, falls and skin alterations – and not slip into the habit of settling for the most obvious reasons to explain recurrent deficiencies. 
The bottom line: a solid QAPI process can be a platform for sustained Quality Measures, too!

It all adds up! 
Solid QAPI Process + Enhancing Quality Measures + Payment Reform Readiness = Successful PDPM Transition & Beyond

As a strategic partner, HealthPRO® Heritage is well prepared to drive meaningful QAPI process changes that result in enhanced performance and reduced risk.  We start by asking important questions to facilitate change and leverage your IDT’s strengths:

  • Who is the leader of your QAPI committee?  Is he/she asking the right questions of your IDT?  
  • What are the steps in the QAPI process and do they promote structure?  
  • Are your organizational goals reasonable/attainable? How often do the goals get revised/updated?  
  • Goal-setting is the first step:  Identify facility goals and state specifically how it will benefit your patient population and staff.   Once set, how will the team track and monitor data to identify success? Is the team able to grasp the process? To contribute towards achieving goals?  To generate new ones?  
  • Does the daily clinical meeting require an overhaul? 
  • Could diagnosis coding improve with more specificity to represent all groups defined under PDPM?
  • Which areas are the most critical to address?  Likewise, consider that there may be areas that have been on the radar for too long and need to be retired.

Beyond Therapy.  Beyond PDPM.  Beyond Ordinary.
HealthPRO® Heritage is prepared to help you execute and succeed in the New World of PDPM and beyond! We understand the key drivers required for success and have the ability to support SNFs in assessing risk, making necessary changes, and developing collaborative care management processes aligned with PDPM (and the Big Picture of health care reform initiatives!)  In addition, as a trusted therapy partner, we want to be involved in developing protocols and driving clinical and performance outcomes in support of fiscal, compliance, and quality objectives. 

Click here for full printable article. 

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Tags: Patient-Driven Payment Model, PDPM, CMS Update 2019