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4 Key Areas Of Focus To Improve Your Skilled Nursing Facility CMS Rating

All Posts December 5, 2022

By: Sarah Wallingford

Earlier this year, the White House tightened requirements for nursing homes that fall under its Special Focus Facilities (SFF) program. In response, the Centers for Medicare & Medicaid Services (CMS) are increasing enforcement actions against skilled nursing facilities (SNFs) that fail to improve. CMS hopes the harsher penalties will encourage operators to work harder to exit the program more quickly. As a result, CMS could focus its efforts on new facilities. CMS also hopes it will prevent facilities from regressing post-program.

“Let us be clear: we are cracking down on enforcement of our nation’s poorest-performing nursing homes,” said Xavier Becerra, Secretary of the Department of Health and Human Services (HHS). “As President Biden directed, we are increasing scrutiny and taking aggressive action to ensure everyone living in nursing homes gets the high-quality care they deserve. We are demanding better, because our seniors deserve better.”
Chiquita Brooks-LaSure echoed Beccerra’s comments on providing nursing home residents with safe and quality care and holding accountable facilities that cannot provide this care.

“People in this country’s nursing homes deserve access to safe and high-quality care, and facilities that aren’t providing that level of service need to improve their performance or face the consequences,” Brooks-Lasure said. Adding, “Poor-performing nursing homes have the opportunity to improve, but if they fail to do so, the changes we are making to CMS’ Special Focus Facilities Program will hold these facilities accountable for the health and safety of their residents.”

In order to ensure that nursing homes are improving their care delivery, the SFF program identifies the poorest-performing nursing homes in the country and inspects them no less than once every six months. The facilities may be subject to significant enforcement actions if they do not demonstrate improvements. To exit the program, they must pass two consecutive inspections.

In this article, we identify four key areas that nursing homes in the program or those at risk of entering the program fail at, and how facilities can improve in these areas.

Percentage of Residents with One or More Falls with Major Injury

The reality is falls in nursing homes are common. It is true that most falls can be benign and injury-free, but this is not always the case. Every year, 3 million seniors are treated in emergency rooms for fall injuries, and over 800,000 patients are hospitalized as a result of falls, according to the Centers for Disease Control (CDC). More than 95% of all hip fractures are caused by falls, and falls are the leading cause of traumatic brain injuries. Furthermore, seniors who suffer a fall are twice as likely to suffer another fall, thus increasing their risk of injury.

Any skilled nursing facility must strive to reduce the total number of falls as well as the rate of falls-related injuries. You can improve your CMS rating by implementing a comprehensive fall prevention program to ensure the safety of your residents.

In community settings, 30% to 50% of falls among older adults are caused by environmental factors such as poor lighting or uneven surfaces, as reported by the National Library of Medicine. Take a look at the environment of your community and make changes where necessary in order to keep your residents safe.
As well as making environmental changes, one of the most effective things a community can do to prevent falls is to adopt technology that can be used to assist their caregivers in this endeavor. In order to ensure the safety of your residents, consider life safety technology with motion sensors and RTLS technology, which can assist staff with knowing where residents are in your community at all times. Staff can now be notified if a resident enters an unsafe area such as an outdoor area with uneven ground and an alert will be sent to the nearest caregiver to help.  It is also possible to send an alert to staff if a resident walks away from needed medical equipment, such as a walker. When a resident falls, these technologies can even alert a care team so they can assist the resident, possibly preventing serious injury.

Percentage of Residents who Were Re-Hospitalized After a Nursing Home Admission

As nursing homes have evolved over the past several decades, their role has evolved significantly from that of a residential facility that primarily accommodates older, cognitively impaired, and functionally dependent individuals to that of a post-acute facility that provides skilled care to medically complex patients often discharged directly from intensive care units. However, there have been instances where nursing home facilities have failed to meet these requirements forcing patients to be readmitted back to the hospital at high rates. Those “bounce back” hospitalizations are what CMS is concerned about with regard to the SFF program.

Approximately one in five Medicare beneficiaries discharged from the hospital receive post-acute care in a skilled nursing facility, and nearly one-quarter of those admitted to such facilities are re-hospitalized within 30 days. Reducing re-hospitalizations of nursing home residents through the use of technology is the most effective way to achieve this goal.

You can assist your care staff look after residents while maintaining dignity by installing a life-safety system that includes bed sensors, incontinence sensors, and RTLS. These technologies can assist your staff in mitigating risk and actually help prevent adverse events such as falls and urinary tract infections. Taking a proactive rather than a reactive approach to your care. Contributing to the reduction of re-hospitalization rates in your community.

Percentage of Residents with Pressure Ulcers or Pressure Injuries That are New or Worsened

According to the CDC, 11% of nursing home residents suffer from pressure ulcers, with stage 2 pressure ulcers being the most common. Doctors have often instructed staff to move residents every two hours, but those instructions are not being followed. Things like these have typically fallen through the cracks due to inadequate staffing levels.

Staffing challenges existed even before the pandemic, but since 2020, the great resignation has strained nursing home staff. As a result, this already overworked staff is being asked to perform more and more tasks. Using technology to pick up the slack will help relieve pressure on your already overburdened personnel.

Automating rules and breaking down silos in order to integrate systems can assist in increasing the efficiency and effectiveness of your staff. Your staff can easily fill out paper work with the help of a life safety system that integrates electronic medical records (EMR). As a result, they will be able to devote more time to caring for residents.

In addition, a life safety system with sensors and alerts can warn your care staff when a resident needs to be moved in order to prevent pressure ulcers from becoming worse, or better yet, preventing them from forming in the first place.

Number of Outpatient Emergency Department Visits per 1000 Long-Stay Resident Days

CDC statistics indicate that 36% of falls, 19% of heart conditions, 12% of pneumonia cases, and 33% of other conditions (mental status changes, urinary tract infections, etc.) that result in emergency department visits from nursing homes are preventable. It is true that not all emergency department visits can be prevented, but a significant number of them can be avoided with better care.

You may be able to provide better care by using technology that could assist your staff in preventing adverse events before they occur. Consider a life safety platform that will gather thousands of data points and analyze the information using machine learning in order to help you detect changes in your patients’ health that are normally unnoticed by the human eye. Preventing these events early will not only improve your nursing home’s rating with CMS but will also provide your residents with better care and an extended stay.

Ensure360℠ a Proven Solution with Powerful New Technology

One solution to help tackle all these key areas is Ensure360 from Sentrics. Ensure360 combines RTLS technology, contact tracing and case management with the industry’s best nurse call systems, to collect and analyze data on the resident, community, and caregiver conditions. It includes sophisticated data-capture and analytics technology to provide staff with the insights they need to optimize their processes, reduce costs, and improve healthcare outcomes. Ensure360 is part of an integrated suite that gives communities a 360-view of a resident’s physical, medical, social and behavioral needs. To find out more, click HERE or call (888) 988-8210.

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