Mid-Morning Breakouts (1.0 CEUs)
9:50a - 10:50a
Achieving Stability in Unstable Times
Transitioning & Implementing new technologies
The New England QIN-QIO’s Nursing Home Quality Care Collaborative (NHQCC) is working to help address high staff turnover in nursing homes and assisted living facilities. Staff turnover has implications not just financially but in quality measure outcome as well; Costs go far beyond the obvious expenses of recruiting new employees. In today’s world of having to constantly do more with less, are you unnecessarily spending too much money recruiting and training staff just to have them leave? Do you know exactly what staff stability is costing your nursing center in terms of time, money and quality? Tools exist that can help you collect solid data and measure staff stability in your long term community. Come learn more about these tools that are available for free to the participants of the collaborative. We will be demonstrating a selection of these available tools in this session. We will also discuss the causes of this never ending cycle, important things to consider when developing a performance improvement plan (PIP) to address it, and strategies for correcting turnover and instability in your home. If you are not already a participant of the collaborative, it is not too late to join!
Presenters:
Pamela Heckman, RN and Sarah Dudley
Pamela Heckman is a Quality Improvement Project Coordinator in Qualidigm’s New Hampshire office where she leads quality improvement initiatives for the long-term care setting under the New England Quality Innovation Network-Quality Improvement Organization (NE QIN-QIO) contract from the Centers for Medicare & Medicaid Services.
Ms. Heckman has seventeen years of experience in quality improvement in long term care and seventeen years of experience in home health care. Early in her career, Ms. Heckman was a supervisor for the Episcopal Long Term Home Health Care Program, and supervisor of the Episcopal AIDS Home Care Program in Buffalo, NY where she coordinated home care services. She also participated in the development of Benedict House, the first home in Western New York for people living with AIDS.
Prior to joining Qualidigm, Ms. Heckman worked for the Northeast Health Care Quality Foundation (NHCQF) where she served as a quality improvement specialist where she developed, implemented and provided training on quality improvement intervention projects aimed at improving care and patient safety in the long-term care setting. Ms. Heckman is a registered nurse in the states of Maine, New Hampshire and Vermont and holds a Bachelor of Science in Nursing from D’Youville College in Buffalo, NY.
Sarah Dudley is a Program Administrator at Healthcentric Advisors. Sarah has over 10 years of experience in long-term care. She currently leads a multi-disciplinary team providing education and technical assistance to nursing homes throughout Massachusetts and New England. Ms. Dudley’s work focuses on quality improvement methodology, staff stability, leadership, and improving satisfaction, process and outcome measures.
Planning a transition from paper to technology? Technology is only as good as the outcome it produces. This training is designed to help you succeed in implementing new technology systems in your facility. We will go through a step by step process on how to successfully prepare your staff before implementation, train them during implementation and finally how to support them after implementation.
We will also learn how technology can give you data that will help you produce positive patient outcomes, including how to gather and monitor data and use that information to create an environment for safe and effective care.
Presenter:
Julie Normand, RN
Bedford Nursing & Rehabilitation
I am the Director of Quality Assurance at Bedford Nursing & Rehabilitation Center, where I have worked for 15 years. I am passionate about the delivery of quality care to our residents. With the support of my Administrator, I built a successful QAPI program that took our 2 star quality measure rating to a 5 star rating. The QIO has recently designated BNRC as “peer coach” for the state of New Hampshire for our quality improvement programs. For me this honor is not about the title but about the recognition that we created an environment where our staff can work together to deliver effective patient-centered care.
A fun fact about me! My favorite past time is cooking and spending time with my family which includes 11 grandchildren!
Vitalize 360
Vitalize 360 combines an innovative, award-winning, person-directed approach to wellness coaching with the power of information derived from a scientifically grounded assessment system. The program engages, challenges and inspires
older adults to live full, healthy, vibrant lives and enables communities to demonstrate significant improvement in successful aging.
Vitalize 360 is a joint venture between two not-for-profits: Hebrew SeniorLife, a Harvard Medical School Affiliate and Kendal. Reflective, person-centered coaching is paramount to Vitalize 360. Meetings give participants opportunities to share what is most important, set goals and refocus on living more intentionally. Vitalize 360 supports individuals as they progress through stages of “activation” toward living their “best lives.” Participating communities receive bi-annual outcome reports which guide quality improvement activities for their organization.
Presenters:
Diana Cox
Executive Director, Vitalize 360
Diana Cox (RN, MSN, NHA) is the Executive Director for Vitalize 360, a wellness coaching and assessment system for older adults. Diana has a BSN and MS in Nursing from Russell Sage College, and an MS in Health Care Policy/Performance Improvement from Dartmouth College. Since 1998, she has been the Director of Resident Health Care Services at Kendal at Hanover in Hanover, New Hampshire. In addition to Cox’s expertise in health and well-being, she brings a variety of other strengths to her job including teaching, strategic thinking, organizational management and a passion for the work. Cox played a key role in the successful genesis and development of Vitalize 360 at Kendal at Hanover.
Rob Schreiber, MD, AGSF, CMD
Medical Director of Evidence based Programs at Hebrew SeniorLife, Harvard Medical School
Rob Schreiber, M.D is Medical Director of Evidence based Programs at Hebrew SeniorLife and Medical Director of the Healthy Living Center of Excellence (HLCE), an organization funded by the John A. Hartford Foundation and the Tufts Health Plan Foundation. The Center strives to promote the independence of older adults by empowering them and their families to take more active roles in their care by offering quality, proven interventions addressing issues including, but not limited to management of chronic illness, methods to prevent and manage fall and promote physical activity and proper nutrition.
Dr. Schreiber is also now working as a geriatric consultant in a Patient Centered Medical Home for an Accountable Care Organization to develop a systems approach to managing the high risk elder population. He has developed a comanagment model of complex care management that is now being replicated in this large ACO In particular, his practice focuses on patients with cognitive impairment and dementia, palliative care and multiple morbidities.
Dr, Schreiber served as Physician-in-Chief and CMO of Hebrew SeniorLife in Boston, MA from 2004 to 2012. He helped to develop the strategic direction of Hebrew SeniorLife (HSL) Medical Group in home and community based services, long-term care and post acute care. He has been a faculty member of the Institute for Aging Research at Hebrew SeniorLife and is working to connect research to health care systems clinical venues. He serves on the faculty at Harvard Medical School and is a Senior Leader of the Practice Change Leaders Program which mentors physicians, nurses and social workers improve the care of older adults in their health systems
Prior to Hebrew SeniorLife, he served as the Department Chairman at Lahey Clinic in Burlington, Massachusetts where he developed innovative geriatric evaluation and management units in skilled nursing facilities that resulted in improved population health outcomes at lower costs. In addition, he led the development and implementation of a care management program that was highly successful in managing the most complex older adults in a Medicare HMO program
Dr. Schreiber is a national consultant for the National Association of Area Agencies on Aging’s “Aging and Disability Institute” which is helping community based organizations develop the business acumen to engage with health care providers, healthcare systems and insurers. He was awarded the American Medical Director’s Physician of the Year Award for 2010.
Jimmo V. Sebelius
The False Improvement Standard
The speaker will present about the Jimmo v. Sebelius class action (Jimmo) and continuing efforts to implement the settlement. The Jimmo settlement of 2013 called for the Centers for Medicare and Medicaid Service (CMS) to clarify that the correct legal standard for coverage of therapies and nursing does not depend on a person’s ability to improve or make progress, but rather on the person’s individualized need for skilled care. Skilled Care may have the goal of maintaining or preventing deterioration. Unfortunately, the “Improvement Standard” continues to be inappropriately applied, depriving many Medicare beneficiaries of needed care. This presentation will discuss continued barriers to implementation of Jimmo, including CMS proposals and reforms that may include improvement as a metric (such as Value-Based Purchasing and Star Ratings). The presenter will provide an overview of Medicare Entitlement, Eligibility and Coverage Criteria supporting the Jimmo v. Sebelius Settlement Agreement. Practical application of Medicare Coverage Criteria for Medicare Part A and B with discussion of key documentation points for Nursing and Rehabilitation Services.
Objectives
1. Discuss key points of the Jimmo v. Sebelius Settlement.
2. Explain the correct standard for Medicare coverage of nursing and therapy, including maintenance
3. Identify strategies for practical application of Skilled Coverage for Medicare Part A and B
This program will enable healthcare providers to practically apply and document Medicare Part A and Part B Coverage Criteria related to the Medicare Improvement Standard, Jimmo v. Sebelius Settlement.
Presenter:
Kris Mastrangelo, OTR/L, LNHA, MBA
President & CEO, Harmony Healthcare International
Kris has more than 24 years of experience in the Health Care industry with a specialty in the Long-Term and Post-Acute Care Arena. An Occupational Therapist degree from Tufts University followed by a Master's in Business Administration from Salem State University coupled with a Nursing Home Administrator's License affords Kris an in-depth perspective into the nursing home industry.
Initially providing direct care as an Occupational Therapist, Kris became familiar with the Medicare, Medicaid and HMO reimbursement systems. Her position evolved into the management of rehabilitation programs to Vice President of Operations for a national consulting company to Vice President of Reimbursement. Her experience includes the development and presentation of training modules (C.A.R.E.- Compliance, Audit, Analysis, Reimbursement and Regulatory an Efficiency) for independent owners to national organizations. Kris has owned and operated Harmony Healthcare international (HHI) for over 15 years. She proclaims that "Our on-site and off-site medical record review process is the platform for C.A.R.E. optimization and systems improvement."
Kris and her team of HealthCARE Specialists are integral players in Payment Reform with significant contributions to the policy process. The inordinate amount of regulatory change is nearly impossible to digest and implement in the required timeframes. This changing regulatory climate was a driving force in Harmony Healthcare International's (HHI) mission of to distill, synthesize and educate owners and caregivers which in turn facilitates high quality outcomes and optimal care.
Kris was appointed to and serves on the American Health Care Association (AHCA) Clinical Practice Committee (CPC).