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The Florida Nursing Home Quality Care Connection
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Construct Solid Business Practices That Support Your Purpose
A well-run nursing home excels as a business yet feels like home. It seeks ways to effectively manage the bottom line with integrity and with the resident as the focus. It runs efficient operations, invests in equipment and supplies to provide the highest quality care, and ensures that its physical and outdoor environments are comfortable and inviting.

Change concepts for this strategy include:
  • Seek strategic and creative approaches to expand your resource base to meet your mission and serve your residents.
  • Maximize your efficiency.
  • Ensure you are making the most of your physical assets.
For more insight and practical tips, read pages 30-32 of the NNHQCC Change Package .
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Ideas for High-Risk Residents with Pressure Ulcers (Long-Stay)
The quality measure (QM) for pressure ulcers captures the percentage of long-stay, high-risk residents with Stage II-IV pressure ulcers. Central to this measure is identifying residents at high risk and ensuring that they are coded as such and included in the measure denominator. Residents are defined as high-risk if they meet one or more of the following three criteria.
  • Impaired bed mobility or transfer indicated by either or both of the following:
    • 1.1. Bed mobility, self-performance (GG0110A1) = (3, 4, 7, 8)
    • 1.2. Transfer, self-performance (G0110B1) = (3, 4, 7, 8).
  • Comatose (B0100 = [1])
  • Malnutrition or at risk of malnutrition (I5600 = [1]) (checked)
Learn more about the calculation of this QM on page 23 of the Minimum Data Set (MDS) 3.0 Quality Measures User's Manual (v9.0 08-15-2015).
Performance Improvement Project (PIP) teams should identify which residents have triggered high risk for pressure ulcer development, as well as residents who have documented Stage II-IV pressure ulcers, and review and revise their care plans accordingly.
Additionally, PIP teams should explore critical factors contributing to the development or worsening of pressure ulcers. They should devise strategies to improve processes related to identifying risk, prevention, assessment, and treatment
Next issue: Urinary Tract Infections Tips/Change Ideas
QAPI Corner
STEP 7: Develop a Strategy for Collecting and Using QAPI Data
Your QAPI team will decide what data to monitor routinely. Data from your facility CASPER Quality Measure Report is a good place to start! To determine which items to act on--and in what order--analyze the data in this report and:  
  • Set targets for performance for the areas on which you are working.
  • Identify benchmarks for performance. 
  • Develop an improvement plan for the data you collect.
  • Determine who reviews the data and how often.
Remember: Collecting information is not helpful unless it is actually used to drive improvement!
For more information on this topic, read pages 15-16 of QAPI at a Glance.

Next issue: Identify Your Gaps and Opportunities
HSAG Resource Spotlight
What You Should Know for 2015-2016 Influenza Season

Influenza (flu) is a contagious respiratory illness that can be severe and life-threatening, especially for older adults. This time of year is called "flu season." In the United States, most seasonal flu activity typically occurs between October and May. Flu activity most commonly peaks in the United States between December and February.


Adults at or over 65 years of age and residents of nursing homes and other long-term care facilities are among those at highest risk for developing flu complications that can result in being hospitalized and occasionally in death. The Centers for Disease Control and Prevention (CDC) recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against this serious disease.


People should begin getting vaccinated soon after the flu vaccine becomes available. However, as long as flu viruses are circulating in the community, it's not too late to get vaccinated. 

Visit this site for all of the information you need to protect yourself, your loved ones, and your patients during flu season. Learn more.
Refer to this toolkit as a guide to increasing flu vaccination among healthcare personnel in long-term care settings. Learn more.
Happy Holidays from HSAG!
Your Quality Care Connection newsletter will return in January 2016.
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Reducing Unnecessary Use of Antipsychotics 
December 8 
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