New Government Rating System Causes Nearly One In Three Skilled Nursing Centers To Lose A Star

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1 June, 2015 New Government Rating System Causes Nearly One In Three Skilled Nursing Centers To Lose A Star Jackie Oberst, Managing Editor, AHCA Provider Magazine The Centers for Medicare & Medicaid Services (CMS) earlier this year recalculated its Five-Star Quality Rating System for nursing facilities, causing nearly one out of every three of the nation s postacute care providers including those in Ohio to be downgraded. The changes were not made because of any reduction in the quality, but rather to reset the points to maintain arbitrarily established percentages at each star level. Any time that nearly a third of an entire sector is impacted by a change of this magnitude, there will be confusion, said AHCA/ NCAL President and Chief Executive Officer Mark Parkinson. We re not helping patients and their families get the information they can trust when the star ratings don t match the quality care being delivered. According to AHCA s data, the reduction in quality stars comes at a time when the profession is showing marked improvement in key quality markers since the 2012 launch of its four-point Quality Initiative. Also earlier this year, CMS issued a report showing a greater-than-expected decrease in the national prevalence of antipsychotic medication use in long-stay nursing facility residents. As a result of the effort, CMS reported that 19.4 percent fewer residents (over 35,100 individuals) are receiving that particular class of psychotropic drugs. The CMS Nursing Home Compare website ( nursinghomecompare), which houses the Five-Star Quality Rating System, is one of the agency s busiest, with 1.4 million customer views each year and 85 percent of customers finding their nursing home information from it, according to the agency. CMS added the system in December Star ratings allow users to see important differences in quality among nursing homes when making care decisions, CMS says. continued on next page Ohio Health Care Association The Ohio Health Care Association (OHCA) is proud to represent more than 850 skilled nursing care facilities, assisted living communities and intermediate care facilities for individuals with intellectual disabilities (ICF-IID). The Association was established in 1946 to meet the needs of the state's growing number of long-term care professionals, which today totals more than 100,000 exceptional men and women who care for Ohio s most frail and vulnerable citizens. OHCA is a non-profit association with 2 affiliate organizations the Ohio Centers for Assisted Living (OCAL), and the Ohio Centers for Intellectual Disabilities (OCID). Many OHCA members also provide a variety of home and community-based services. OHCA is the largest long-term care association in the state, and the only chartered Ohio affiliate of the American Health Care Association, representing more than 12,000 long-term care facilities nationwide.

2 Wesley Glen Community Recognizes 11 Resident Centenarians Casey King, LNHA, CEAL, Executive Director, Wesley Glen Retirement Community Wesley Glen Retirement Community, Columbus, Ohio, recently celebrated the lives of its 11 resident centenarians -- all born in 1915 or earlier. The group has lived more than 1,100 years combined, and has seen the leadership of 17 U.S. presidents. In addition, they have witnessed the birth of remarkable social, medical, technological and engineering advances over the last century. The central Ohio facility threw a party for the centenarians, their families and the community. The Columbus Dispatch did a feature story on the event, with biographies of all 11 residents. It s a sense of history, said Barbara Holliday, who helped coordinate the event in her role as life-enrichment supervisor. There s still so much for them to give... we are constantly learning from them and their wealth of information, experiences and perspective. There are an estimated 53,000 centenarians in the United States, and to have 11 of them living in one community is remarkable. We pride ourselves on the care we provide to all residents at Wesley Glen, but the spirit and drive these 11 show is all theirs, and a tribute to a remarkable generation in our nation s history. continued from page 1 Until now, the agency rated nursing facilities on three categories: Results from onsite inspections by trained surveyors Performance on certain quality measures Staffing levels These three categories are used in calculating the overall star rating, but consumers can see and focus on any of the three individual categories, CMS says. The agency also recommends that consumers consider community reputation and visit facilities personally. Further system adjustments, involving hospital readmission rates from nursing facilities, is scheduled for Under the new system, nursing facility star ratings include: two quality measures for shortstay and long-stay patients related to antipsychotic drug use; improved calculations for staffing levels; results from onsite quality assessment surveys; and tougher standards for achieving a high-quality measure rating. CMS acknowledges that it is inappropriate to compare the previous Five-Star rankings with the new announced rankings. The level of performance we expect that was there in 2008 we don t think suffices for We expect improvement over time, said Patrick Conway, MD, CMS deputy administrator for innovation & quality and CMS chief medical officer, in Friday s press conference. Just as the Model A was excellent at its time, it would not measure up to other models today. Eric Albrecht, Dispatch photo

3 Two Nurses Earn Second EFOHCA Scholarships Jamie Brose, Director of Operations, Health Care Management Group Two LPNs show what a little motivation and a passion for their jobs can accomplish. Ashley Washington and Dalisa Walker, both employed by facilities run by The Health Care Management Group of Cincinnati, took the initiative to further their education and better prepare themselves as caregivers. The Education Foundation of OHCA (EFOHCA) offers several channels to help medical professionals stay informed, from seminars and webinars to online courses and conventions. They also reach out to those still in school with scholarships designed to keep financial worries from stopping them from reaching their goals. While employers often tell their young nurses of the scholarships, the responsibility is on the nurse after that. An individual wishing to receive an EFOHCA scholarship must be pro-active by filling out an application and submitting it online. Then they must write an essay on why they should receive the support and how they will use what they learn in their careers. Two-time recipient Ashley Washington has been an LPN with The Health Care Management Group for six years. She is also a mother of one and working on a BSN from Hondros College with the goal of becoming an educator in a dementia/alzheimer s unit. I love making connections with my residents, said Ashley. It means the world to them and to me. The scholarship will help me do even more. Ashley s Director of Nursing adds, Ashley s a model nurse. She s bright, cheerful, hardworking, and many families in our Assisted Care Unit requested her to be their family member s nurse. But when she was placed in our memory care unit, I saw her light up with purpose. That s when she first went after those scholarships. Dalisa, busy mother of three teenagers, first got the call to caregiving when her aunt was ill. Inspired, she juggled family and school to become an STNA and then an LPN, and is now pursuing her RN degree at Cincinnati State College. I d love to be a traveling nurse, so I could serve rural areas that really, really need good nurses. Her Director of Nursing says the scholarships will help Dalisa make great strides in her career. She s worked in every unit at our facility with enthusiasm and competence, so we ve recently promoted her to an Unit Manager in Long Term Care. EFOHCA makes this kind of success possible for people like Dalisa. OHCA represents nearly 850 nursing facilities, ICF-IID and residential care facilities in Ohio, so competition for the scholarships can be fierce. Since 1989, its educational foundation has followed a mission to foster professional careers in long-term care. EFOHCA has now awarded over $1.4-million to nearly 750 students. Steve Boymel, President of The Health Care Management Group, says We put an emphasis on good staff, from doctors and nurses to administration. We make sure our younger employees know about OHCA and what it offers. I want to see people take advantage of those resources.

4 Country Lawn Center for Rehabilitation & Nursing Care Earns National Recognition for Rehabilitation, Post-Acute Care Catherine Adolph, Administrator, Country Lawn Center for Rehabilitation & Nursing Care Country Lawn Center for Rehabilitation & Nursing Care earlier this year was recognized as a 2014 recipient of the Silver Achievement in Quality Award. The American Health Care Association and the National Center for Assisted Living (AHCA/NCAL) honored 77 long-term and post-acute care centers with the Silver Award, one of three distinct awards possible through the AHCA/NCAL National Quality Award Program, which honors select centers across the nation that serve as models of excellence in providing high-quality long term care. A CMS 5-Star Provider, Country Lawn Center has earned a welldeserved reputation as a caring provider. In the most recent resident survey from the Ohio Department of Aging, 98% of residents indicated that they liked the facility. The facility has also earned a place on the NorthCoast 99 Award list for the past 11 years, honoring great workplaces for top talent in Northeast Ohio. An 88-bed facility located in rural Navarre, Ohio, Country Lawn Center s main services are skilled nursing and intermediate care, along with dementia/alzheimer s. Country Lawn also specializes in wound care with a certified wound nurse and physician on staff. The Ohio Department of Health issued a perfect survey report in 2014, one of only 45 issued that year. The facility provides specialized rehabilitation capabilities and postacute medical services in addition to skilled nursing care, restorative nursing and hospice care. The staff at Country Lawn is excited to be awarded the American Healthcare Association s Silver Award for Quality Improvement, and views it as a step toward the facility s ultimate goal of achieving the continued on next page Care Conversations: Changing the Conversation Seventy percent of us will need long-term care after age 65, yet few of us openly discuss care needs and wishes. Care Conversations ( org/home.aspx) is bringing people together to change this conversation trend. The website provides information and resources to get people talking with loved ones, health care providers and industry experts. Working together, we can plan and prepare for our future and ensure care needs are met every step of the way. Conversations focuses on people and the honest discussions needed to plan and prepare for the future. Finding care may seem difficult or even overwhelming at first. Whether you re seeking care for yourself or for a loved one such as a spouse, parent or sibling, Care Conversations can help you every step of the way. Worry less about tomorrow. Start a conversation today. Getting Started with Care Conversations Because everyone's situation is different, no two Care Conversations will be the same. The website helps you start a conversation, explore options, and find solutions that are right for you. The website allows users to: Hear others share their personal experiences. Watch featured conversations throughout the site and in the video library. Learn how to start a Care Conversation.

5 continued from page 4 Gold Award for Quality Improvement. We are elated to be awarded this distinguished honor. We know the challenges of continuing our quality improvement journey and the rewards it provides when we achieve it. Implemented by AHCA/NCAL in 1996, the National Quality Award Program is centered on the core values and criteria of the Baldrige Performance Excellence Program. The program assists providers of long term and post-acute care services in achieving their performance excellence goals. Faces of LongTerm Care Many Ohioans have had their lives touched by long-term care as a resident, care provider, family member or loved one. Even if they have not had direct experience, chances are they know someone who has. Faces of Long-Term Care is an initiative to give a voice and public presence to residents and caregivers through a variety of forums. The Ohio Health Care Association is working with the American Health Care Association (AHCA) to establish a presence on Facebook, websites and other social media featuring the images and words of residents, family members, caregivers and others. The first step in this initiative features a series of weekly Faces of Long-Term Care posts to the OHCA Facebook page, which have resulted in numerous likes and re-posts. In addition, AHCA/NCAL has established a Faces of Assisted Living website that will serve as the base for future efforts. Providers, family members and residents who would like to take part in this program can post images, stories and quotes directly to the Association s Facebook page. Providers posting images or quotes from residents should have signed releases in the residents files. Watch for future activity as this initiative kicks off. Faces of Long-Term Care is designed to grow into a rewarding community where participants can share and enjoy the experiences and successes of others. Find us on the web:

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