1 2014 Elim Park Health Care Center Clinical Excellence and Quality Report
2 Welcome to Elim Park Health Care Center s 2014 Clinical Excellence and Quality Report. We have been providing patient focused quality care for over one hundred years. Throughout the decades the techniques and physical campus have undergone many changes. What has never changed is our dedication to clinical excellence and innovation. In this, our inaugural issue, we focus on three major quality measures Returns to Acute Care, Patient Satisfaction and Rehabilitation and Functional Outcomes. But rest assured, we are consciously monitoring and reporting to our Performance Improvement Committee over 30 clinical measures. Health care is ever changing, and the tools for tracking and trending are evolving. While our field strives to become more consistent, not all health care systems offering post-acute care in a skilled nursing setting are reporting on the types of measures you will find here. Elim Park is ahead of the curve with our scorecard processes and model of quality assurance. Our excellent state survey results are a testimony to our dedication. We are leaders in the field and our patients are the beneficiaries of our efforts. Elim Park is committed to continuing our transformation of health care. Our values of reliability and clinical excellence will not change, but our investment in staff, campus, and technology, in an effort to continually move the bar of excellence for our patients upward, remains our promise. We are committed to remaining a trusted post-acute and long-term care provider, who proudly serves the residents of Connecticut. Dear friends Wishing you a year of great health, Chris Newton, MHA Administrator of Health Services
3 Who We Are Elim Park offers a 132-bed health care center, encompassing inpatient and outpatient services. Post-acute care unit comprises 30-beds focusing on short-term rehabilitation. The 42-bed Residential Care Home provides a unique level of support for those looking for safety and security, with a high level of independence with minimal support for activities of daily living. Our Long-term skilled unit is a warm and welcoming 60-bed unit. Residents benefit from the same clinical teams who care for the postacute care patients, which includes a dedicated nursing resource team including an infection preventionist, quality and compliance nurse and education nurse manager. Elim Park Health Care Center quality measures come from a variety of assessment and survey tools. Our clinical team collects data to evaluate our residents physical condition, capabilities and goals, which allows us to report on many aspects their experience. and how we measure up Experienced and loyal staff members dedicate themselves to providing patients quality of life through 5-Star rated patient centered care. Overall Quality Quality Measures RN Staffing Staffing Choose Excellence. Choose 5-Stars. Elim Park Health Care Center takes pride in providing the highest quality care to the residents who choose our health care services. Selecting a skilled nursing facility for post-acute care can be a life changing decision. By making an informed decision and receiving care with a 5-Star Rated provider, patients are on their way to a faster recovery with better outcomes. Elim Park is Cheshire s only 5-Star Rated facility. Information about staffing and quality measures are submitted to Centers for Medicare and Medicaid Services (CMS). Nursing Home Compare, as a part of medicare.gov, conducts a rigorous data analysis and awards the ratings.
4 Patients and their families have become very informed consumers. They ask intelligent questions and are searching for insightful answers to help them make difficult choices. Research shows that facilities with the highest rates of satisfaction perform better related to other indicators, including staff stability, survey results, census and financial responsibility. Researchers in the health care field have determined that the questions which best capture the quality experienced by customers is their willingness to recommend their nursing home to others and how they respond to a question of rating overall satisfaction. These broader questions provide valuable information for people seeking care for their self or for a loved one. Measuring customer satisfaction enables skilled nursing care centers to gain essential insight into their performance. These crucial questions are subjective and provide understanding into the quality of life provided while a patient recovers. Surveys are answered by the individual served or a family member. While there is yet to be a single source of surveying, these two crucial questions are typically reported on across the country. Elim Park has implemented survey methods for both patients and their family members. Surveys are administered upon discharge for post-acute patients and quarterly for longterm care residents and those living in the residential care home. The results are shared with staff and taken into consideration when setting goals and changing the environment which directly affects the patients care, safety and comfort.
5 Patient Satisfaction Long-Term Care Residential Care Home Overall Satisfaction Recommend to Others Overall Satisfaction Recommend to Others 2014 Resident Satisfaction Elim Park 87% 93% 93% 93% 90% Elim Park 2014 goal Elim Park s target for achieving marks above 90% related to Overall Satisfaction was successful for FY2014 in all three distinct residents served areas: Long-term care, Post-acute care and our unique Residential Care Home. Answers provide vital insight into the perception of how care is delivered, staff attitudes and amenities. Feedback and comments are valuable tools. Specific observations provided by patients and family members allow Elim Park to recognize staff who go above and beyond and to correct inefficient processes Post-Acute Care Satisfaction Comparison 96% Overall Satisfaction 90% 89% Recommend to Others Rehab Therapy RN/LPN Service Quality of Medical Care Admissions Assistance Management Responsiveness Help with Discharge Process Elim Park 86% 85% 88% 89% 90% 91% 91% 90% Connecticut 92% 93% 93% 94% 94% 95% 96% 97% 97% 97% National 98% 98% 99% Data is compiled and reported by My InnerView, an independent research company that collects satisfaction data from nursing facility patients upon discharge.
6 Skilled nursing facilities serve a vital role in the post-acute care continuum. Following a hospitalization, half of all Medicare beneficiaries require time in a skilled nursing facility, as reported by the American Health Care Association, in order to return and remain home safely. Patients are discharged from hospitals requiring ongoing medical care and rehabilitation. At times, these medical needs require a return to the hospital. Although necessary, readmission to the hospital can: expose patients to infection increase risk for complications interrupt established routines reduce level of function upon return to post-acute care facility Since the primary goal of skilled nursing care is to help individuals maximize their functional ability and restore independence, the Centers for Medicare and Medicaid (CMS) have placed an enormous focus on reducing hospital readmissions for clinical and financial implications. Returns A robust medical staff, including board certified internal medicine, geriatricians, psychiatrists, optometrists, podiatrists, dentists, and nurse practitioners, provides consistent leadership and oversight of care to all patients in the health care center. Through the use of an electronic medical record and icare bedside technology, all members of the team are in constant communication allowing best care practice to produce excellent outcomes.
7 Elim Park uses Advancing Excellence to monitor patients returning to acute care. Over the past 12 months, the percentage of patients requiring unplanned care at a hospital ranged from as low as 4% to as high as 22%. These numbers are not surprising considering the fluctuating clinical needs and acuity of patients admitted to postacute care units. Striving for excellent clinical outcomes, Elim Park set a goal of 15% or less for patients readmitted to acute care in By utilizing the integrated care team and resources available at Elim Park, we excelled with an average rate of return of 14.1%, which is 6% less than both Connecticut and national averages, accomplishing our goal for Hospital readmissions not only have the potential for negative physical, emotional and psychological impacts on the individuals but also cost Medicare, commercial insurances and sometimes even the patient additional health care costs. Preventing transfer whenever possible has been identified by policymakers and providers as an opportunity to reduce health care costs. Being accountable for hospital readmissions helps everyone involved remain mindful of managing the patients care in the appropriate setting. Elim Park s medical team began using icare software in This portable technology allows immediate access to medical records, streamlining clinical notes, laboratory results and the status of the patient with other health care providers in real time. to Acute Care Returns to acute at Elim Park Health Care Center are tracked and trended. The lower the percentage of readmissions the better the continuity of care for the patient. The multidisciplinary team reviews patient clinical acuity, transfer details and carefully monitors their progress at the hospital in order to expedite their return when clinically appropriate Average Readmission Rates Elim Park 14.1% goal accomplished Connecticut 20.9% National 21.1% 15% Elim Park 2014 goal
8 Innovative methods of challenging patients in the 3,000 square foot gym are employed by this well trained and creative team of therapists. Individualized treatment plans take on challenging barriers and encourage patients while restoring confidence and physical ability. Rehabilitation & The team at Elim Park has one ultimate goal to make the patients goals a reality. The ACHA reports that just over a third of individuals admitted to skilled nursing facilities returned to their prior living situation, usually to their home or an assisted living community. At Elim Park, we consistently are able to facilitate the return of 80 out of every 100 patients to their prior living situation. The other 20 patients have a medical condition which requires treatment at the hospital, or their level of function requires individualized care to meet the patients needs in another setting. A universal measure of the progress a patient makes in a skilled facility is that of functional independence measures. Therapists evaluate a person s ability to complete activities of daily living (ADL), such as bed mobility, transfers, toileting, bathing and eating, upon admission. The change in ability to complete activities is scored again upon discharge. The change between these two assessments is tracked via software. Elim Park participates in data collection benchmarked by a national provider of rehabilitation services. Rehab Therapy at Elim Park earned 99% satisfaction by post-acute care patients in 2014, compared to the 99%national average of 94% and Connecticut average of 96%.
9 Elim Park is one of the few rehabilitation programs in Connecticut which provides a home evaluation visit by a licensed therapist prior to discharge. This allows safety recommendations to be addressed before the patient arrives home. Common items include suggestions to remove throw rugs and arrange for frequently used items to be moved within arm s reach. Filling more challenging equipment needs and endorsing furniture changes can keep falls from occurring, avoiding readmission to the hospital. Functional Outcomes The therapy team at Elim Park consistently enables patients to achieve above average increases in function. Patient experience is rated as excellent and reinforced by the positive comments returned on surveys and in the form of patient testimonials.
10 When the increase in function is compared to rehabilitation facilities across the North East, Elim Park far exceeds the competition: Patients change in Activities of Daily Living was 42% higher than patients discharged from other skilled facilities. Patients change in Home Management skills were 27% higher than patients discharged from other skilled facilities. Patients change in Mobility skills were 34% higher than patients discharged from other skilled facilities. Elim Park ADL 1.89 Average ADL 1.33 Elim Park Home/Community Skills 3.15 Average Home/Community Skills 2.49 Elim Park Mobility 2.04 Elim Park LOS 17.6 National Average LOS 27.0 Days Spent in Post-Acute Care Rehab A patient s length of stay (LOS) acts as another measure of success. Patients want to return home to be reunited with family, pets and familiar surroundings. For the top five diagnosis groups served at Elim Park Cardiac, Debility, Medically Complex, Orthopedic, and Pulmonary the average LOS is 9.4 days shorter than the national average, as reported by MEDPAC This translates to a shorter time away from home and a higher return of function. Since the entire team focuses their energy on the patient s safety and assistance in meeting their personal goals, we take great pride in reporting these outstanding measures of success. Average Mobility 1.52 An additional definitive example of unmatched rehab services was introduced to the team mid-way through A national provider of rehabilitation services began to track and report the increase of a patient s function using daily averages. This demonstrates that not only does the entire stay at Elim provide a quality outcome, but the gain recognized every day is greater than at other post-acute facilities. Using a sample of 2014 data, Elim Park was ranked fourth out of 27 facilities for the highest average increase in ADLs and ranked third highest average increase in mobility.
11 Admissions Elim Park Health Care Center offers innovative programming delivered by a dynamic staff. Providing comprehensive care for recovery and restoration of function, Elim Park accepts transfers from acute care settings following illness or injury. A responsive admissions team will advise the referring hospital of clinical appropriateness and bed availability, while making themselves available for patient and family questions. Elim Park is a not-for-profit Continuing Care Retirement Community whose mission is to provide quality care through comprehensive wellness programs and medical facilities for our residents in a Christ-centered environment. Elim Park looks upon its mission as an extension of the Church ministry within the Baptist General Conference (now also known as Converge Northeast) and gives admission priority to its members. Residents are encouraged to grow spiritually as they live out their lives at a level of wellness and independence appropriate to their individual situation. Our Mission
12 Elim Park is Cheshire s premier Continuing Care Retirement Community. In addition to the 132-bed Health Care Center, Elim Park offers independent living at Elim Park Place, performing arts at Nelson Hall, and a robust outpatient therapy program. Our comfortable and beautiful campus features unique wellness programming, gracious outdoor patio and gardens, and a newly remodeled health care center. All are welcome at Elim Park Health Care Center. Take a tour with our caring staff and experience all that we have to offer. 140 Cook Hill Road Cheshire, Connecticut elimpark.org Main number: Rehabilitation Division: ext 384 Admissions/Marketing: ext 123/139
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