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The Florida Nursing Home
Quality Care Connection
  
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CMS Updated Long Term Care Regulations
On October 4, 2016, the Centers for Medicare & Medicaid Services (CMS) published the "Medicare and Medicaid; Reform of Requirements for Long Term Care Facilities." Heath Services Advisory Group can assist nursing homes in preparing for compliance to updated long-term care federal regulations as they relate to developing Quality Assurance & Performance Improvement (QAPI), infection prevention, and infection control programs. As part of the phase 2 implementation effective November 28, 2017, nursing homes will be required to have a written QAPI plan. As part of phase 3, effective November 28, 2019, the requirement includes full implementation of QAPI. As part of phase 2 implementation for infection control, nursing homes will need to complete a facility assessment and have an antibiotic stewardship in place. As part of phase 3 of implementation, the infection control and prevention officer will receive specialized training in infection control and prevention, and be a member of the Quality Assessment and Assurance Committee.

Note: Phase 1 of implementation occurred November 28, 2016.

Nourish Teamwork and Communication
Nursing homes should expect and support effective communication to connect people and build relationships between staff members and residents. Disseminating information in a complete, consistent, and timely manner can help nourish strong teamwork and communication. Consider these strategies:
  • Implement formal communication between shifts.
  • Conduct regular staff surveys and share results.
  • Create opportunities for people across departments to pitch in and break down job silos.
  • Look for coaching opportunities to strengthen team relationships.
For more insight and practical tips about connecting with residents, read pages 19-21 of the Quality Care Collaborative Change Package.

Contact us with any questions at FL-NNHQCC@hsag.com.
Preventing Falls with Major Injury
Falls are a serious issue among nursing home residents, and can result in disability, functional decline, and reduced quality of life. Furthermore, a fear of falling can cause a loss of function, depression, feelings of helplessness, and social isolation. Falls can have a variety of causes, including muscle weakness, environmental hazards, and medications.
 
The Centers for Disease Control and Prevention (CDC) recommends a number of fall interventions that could be used in nursing home performance improvement projects (PIPs):
  1. Medication review to assess risks and benefits.
  2. Changes in the nursing home environment to help residents move safely (e.g., grab bars, handrails, and lowering bed heights).
  3. Exercise programs to improve residents' balance, strength, and physical functioning.
For more fall prevention resources, visit the resource section of the Health Services Advisory Group website or the Centers for Disease Control and Prevention (CDC) STEADI (Stopping Elderly Accidents, Deaths & Injuries) initiative website, which is aimed at preventing falls among older adults.

Next month: Tips and change ideas for depressive symptoms.
QAPI Corner
Step 4: Identify Your Organization's Guiding Principles
The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule that revises the requirements long-term care facilities must meet to participate. Quality Assurance & Performance Improvement (QAPI) is a major component of the proposed regulations.
 
For QAPI to be successful, it is important to establish a purpose and guiding principles, which describe the organization's beliefs and philosophy pertaining to QAPI. The principles should guide what th organization does, why it does it, and how. This is important because nursing homes are complex organizations, and clear guiding principles can unify the various departments that depend on each other to provide high-quality resident care.
 
For more information about QAPI guiding principles,  read page 12 of QAPI At-a-Glance. Also review the tool on page 32 to see examples of guiding principles.
  
Next month: Developing your QAPI plan.
HSAG Resource Spotlight
Access all of the CMS tools for QAPI from one easy-to-use electronic resource library. Learn more.
QAPI Plan Template
This template helps guide nursing home staff members as they develop specific quality improvement plans for their organizations.
This guide walks your team through root cause analysis to investigate events in your facility and start a PIP.      
Learn more.
 
Have you completed your QAPI Self-Assessment? 

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