Content contained in this newsletter may have been previously published in prior issues of the QCC newsletter.  
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The Florida Nursing Home
Quality Care Connection
This QCC Newsletter is your monthly National Nursing Home Quality Care Collaborative (NNHQCC) in Florida member update that provides information on the latest activities. It is a quick reference for information on links to improvement tools, resources, news, best practices, and success stories. 
Be a Continuous Learning Organization
To improve resident care, it is important to proactively identify issues. A continuous learning organization is one that knows where it stands with regard to key metrics and outcomes; knows when and how to change in order to meet goals and expectations; uses data to drive performance; and views itself as an interdependent system (one in which the people, structures, supplies, and resources come together to make the organization function).
Change Concepts of this strategy include:
  • Making systems-thinking the norm.
  • Tracking your progress.
  • Planning and implementing tests of change. 
For more insight and practical tips about connecting with residents, read pages 22-24 of the National Nursing Home Quality Care Collaborative Change Package.

Contact us with any questions at
Ideas for Residents With Depressive Symptoms
The quality measure (QM) for Residents Who Have Depressive Symptoms (Long Stay)  reports the percentage of long-stay residents who have had symptoms of depression during the two-week period preceding the minimum data set (MDS) 3.0 target assessment date. Learn more about the calculation of this QM in the MDS 3.0 Quality Measures User's Manual (v11) .
Central to this measure is the resident's:
·      Interest and pleasure in doing things
·      Feelings of being down, depressed, or hopeless
Because of the complexity in the Resident Mood Interview, it is important to ensure the interview is resident-focused. In other words, plan the resident interview for a time when the resident is most alert and objective about his or her needs.
  • Identify which residents have triggered this measure.
  • Review and revise their care plans accordingly.
  • Address the ways in which the organization delivers care that is individualized and person-centered.
For example, effective communication by nursing home staff members is related to a decrease in depression among residents. Communications skills training may be an effective, resident-centered approach to improving this important QM.
Next month: Tips and change ideas for decline in activities of daily living. 
QAPI Corner
Step 5: Develop Your QAPI Plan

Your plan will assist you in achieving what you have identified as the purpose, guiding principles and scope for QAPI. This is a living document that you may revisit as your facility evolves.
A written QAPI plan guides the nursing home’s quality efforts and serves as the main document to support implementation of QAPI.
The plan describes guiding principles that will be used in QAPI as well as the scope QAPI will have based on the unique characteristics and services of the nursing home. The QAPI plan should be something that is actually used and not viewed as a task that must be completed. You should continually review and refine your QAPI plan.
For more information about developing a QAPI plan, read page 13 of QAPI at a Glance. In addition, the tool provided on page 34 provides a template guide for developing a QAPI plan.
Next month: Conduct a QAPI Awareness Campaign
Hand in Hand: A Training Series for Nursing Homes
The updated Hand in Hand: A Training Series for Nursing Homes  is now available on the Centers for Medicare & Medicaid Services’ (CMS’s) Integrated Surveyor Training Website (ISTW). Hand in Hand is available as a self-paced training as well as an instructor-led course and may be accessed using the links below. The self-paced training may take approximately 24 hours to complete.
Self-Paced Online Training
Downloadable Materials for Instructor-Led Training
Training Description
This training focuses on caring for residents with dementia and on preventing abuse. CMS, supported by a team of training developers and subject matter experts, created this training to address the need for nurse aides’ in-service training on these important topics.
The Hand in Hand: A Training Series for Nursing Homes was previously developed as an instructor-led training conducted by nursing home staff members for nurse aides. The Hand in Hand training will now be available as a self-paced, online training and available to download for use as an instructor-led course.
Target Audience
Federal law requires that nurse aides complete in-service training on dementia management and resident abuse prevention. Additionally, facilities must provide dementia management and resident abuse prevention training to all facility staff members, (direct and indirect care and auxiliary functions) contractors, and volunteers.
For help with registration and all other technical issues, please contact the ISTW Helpdesk at .
CDC Antibiotic Stewardship Training Course
Sections three and four have been added to CDC’s no-cost online antibiotic stewardship training course! The entire four-section course is now available on the CDC Train site and offers up to eight hours of continuing education (CE) credit.
The following topics are covered in the course:  
  • Section 1: Antibiotic resistance and the benefits of antibiotic stewardship.
  • Section 2: Antibiotic stewardship in outpatient settings.
  • Section 3 (New): Antibiotic stewardship considerations for the management of common outpatient conditions and dentistry.
  • Section 4 (New): Antibiotic stewardship in emergency departments, hospitals, and nursing homes.
While this course is primarily for clinicians who prescribe antibiotics, the CDC recognizes that everyone plays an important role in improving antibiotic use.
This course is open to physicians, nurse practitioners, physician assistants, certified health education specialists, nurses, pharmacists, and public health practitioners with a master’s degree in public health, and they are eligible to receive up to eight hours of no cost CE credit.
To learn more about this course, as well as other CE opportunities, visit the CDC Antibiotic Use Continuing Education page .
This course fulfills Improvement Activities (IA) Patient Safety, and Practice Assessment (PSPA)_23 and PSPA_24 under the Centers for Medicare & Medicaid Services (CMS) Merit-Based Incentive Payment System (MIPS).
Create an account and register for this course directly on CDC Train
HSAG Resource Spotlight
Access to all of the CMS tools for QAPI from one easy-to-use electronic resource library.   Learn more.

Ensure resources are in place for your facility's PIP teams with this helpful one-page checklist. Learn more.

This guide helps walk your team through the action steps of developing your organization's QAPI plan. Learn more.
This material was prepared by Health Services Advisory Group, the Medicare Quality Innovation Network-Quality Improvement Organization for Arizona, California, Florida, Ohio, and the U.S. Virgin Islands, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. FL-11SOW-C.2-09262018-01