LeadingAge INsights. Market Intelligence Suite. flourish

Transcription

1 LeadingAge INsights Market Intelligence Suite Tools designed to help your organization flourish

2 Introductions JASON GOTTSCHALK EXECUTIVE DIRECTOR THE VILLAGE AT ROCKVILLE A NATIONAL LUTHERAN COMMUNITY ANN PATTERSON HEALTH CARE ADMINISTRATOR BROADMEAD, INC. CO-CHAIR EDUCATION COMMITTEE LEADINGAGE MARYLAND

3 First things first login information

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15 CMS Changes 5-Star Rating Methodology (Feb 2015) Staffing A facility now needs to achieve a 4 star rating in either the RN or total nursing rating in order to achieve a 4 star overall staffing rating Quality Measures Added the two antipsychotic measures (long-stay and short-stay) Re-scaled the cut points for each star level so it now takes more total points to achieve a 5-star QM rating (from 616 to 760) Results A decline in the percentage of overall 5-star nursing homes nationally from 28.9% to 21.9% An increase in the percentage of overall 1-star nursing homes nationally from 8.5% to 16.2%

16 CMS New Quality Measures (April 2016) 1-5 will impact five-star rating (July 2016) 1. Percentage of short-stay residents who were successfully discharged to the community (Claims-based) 2. Percentage of short-stay residents who have had an outpatient emergency department visit (Claims-based) 3. Percentage of short-stay residents who were re-hospitalized after a nursing home admission (Claims-based) 4. Percentage of short-stay residents who made improvements in function (MDS-based) 5. Percentage of long-stay residents whose ability to move independently worsened (MDS-based) 6. Percentage of long-stay residents who received an antianxiety or hypnotic medication (MDS-based) (Not affecting five-star)

17 5 Star Analysis SEE SAMPLE REPORT HANDOUT

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20 Ask the Avalere Expert frequently asked questions: 1. I cannot access my facility s report? What does this mean? - Low volume of data in The community was a Medicaid only provider Avalere reports are based on Medicare FFS (fee for service) claims data - The community was not in operation in What is the difference between these reports? Q1 Readmission report Q2 Market Share Report Q3 Length of stay report 3. What is the data year? All reports are populated from data analytics available in Avalere s Vantage Care Positioning System (Vantage CPS). To create episodes of care, Vantage CPS used 2013 CMS standard analytic files in combination with other CMS data. The files include claims data from January 1, 2013 December 31, The reports are based on Medicare Part A claims data and provider information by CMA. The data from 2014 should be available in March, My readmission report lacks data why? HIPAA constraints say that any data with a value less than 11 cannot be displayed and is listed as not reportable.

21 LeadingAge Survey and Certification Reports

22 Survey and Certification reports

23 What will the report tell you? The reports are prepared using data from the Online Survey Certification and Reporting (OSCAR) network. These reports offer members and state affiliates a comprehensive overview of survey deficiency metrics on regional, state, and national levels, and they include information on staffing levels, inspection results, and other statistics by state and type of ownership. Nursing Homes can also download a 1-page summary statement of their individualized report, with specific data on staffing levels, inspection results, and other statistics compared to that of their state, region and the country. With this additional facilityspecific benchmarking report, Nursing Homes will have a more comprehensive overview of their survey deficiency metrics.

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29 Ask the Housing Expert

30 Ask the Housing Expert Real-time responses to your biggest preservation and finance-related housing questions from Gates Dunaway, a national expert on affordable housing preservation. She can also be a resource for members who may have targeted questions on existing guidance related to preservation opportunities being considered or processes under way.

31 Ask the MDS Expert

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33 Market SnapShots Reports

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39 Questions? Comments? THOUGHTS?

40 Thank you! For more information visit