Addressing Your Dementia Care Challenges

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1 dementia capable care Addressing Your Dementia Care Challenges Implementing Dementia Capable Care training techniques and principles helps you address challenges related to revenue, regulations, staff turnover, safety risks, and more. This document summarizes how we can empower your organization to improve quality of care and quality of life for those you serve. Your Challenges Revenue Related to Census Our Solutions Quality care sells. Apply for our Facility Distinguished Provider Recognition Award and Individual Recognition Awards to demonstrate your commitment to excellence. Revenue Related to Ancillary Services Proactive therapy intervention for all those living with ADRD, which is a very underserved population. Revenue Related to Reductions in Medicare Funding for Therapy Make up for cuts in reimbursement with an increase in therapy client volume and an increase in minutes per session and length of stay. Cost Reductions Minimize direct and indirect costs related to excess disability, supplement use, staff replacement costs, and behaviors. Reducing Hospitalizations and Premature Discharge to New Level of Care Those with dementia are hospitalized 3x more often than others of the same age. Reduce by maintaining health and safety at each dementia stage as facilitated by the IDT using Dementia Capable Care training principles. Residents with dementia remained in a facility 209 fewer days at the median than residents without dementia. After adjustment for other variables, lack of treatment for dementia was the primary reason. (Source: Journal of the American Geriatric Society, 2007) Primarily due to increasing care needs, most residents in the specialized ALF relocated to a nursing home after a median stay of 10.9 months. Depression, falling, and wandering were significant predictors to the transition. (Source: International Journal of Geriatric Psychiatry, 2000) Dementia Capable Care trainings will provide care to maximize health, function, and QOL to minimize risk of discharge. Regulatory Compliance Person-Centered Care F-Tags F , 310 have been revised for surveyors. Instances of citations related to quality of life and dignity are increasing. Demonstrate your focus to delivering PCC and increasing quality of life with implementation of Dementia Capable Care trainings. Sustain Dementia Training and Implementation Over Time Take advantage of our experienced Dementia Care Specialists training team, who can deliver on-site programs and facilitate public programs in various national locations. Also, we use a variety of training methods including Instructor Certification and elearning. 1

2 Your Challenges Learning Transfer for Maximum Return on Investment and Return on Information Our Solutions Our trainings are designed by adult learning experts with multiple methods to learn and apply the information throughout the program. Moving Through a CCC Appropriately and Effectively Define and implement clear admit, d/c, and transfer requirements for all levels of care (IL, AL, Memory Care, SNF) through dementia staging as introduced in our Dementia Capable Care trainings. Quality Indicator Results Falls Weight Loss Low Activity Participation Aggressive Behaviors Root Cause Analysis: An identified reason for the presence of a defect or problem. The most basic reason, which if eliminated, would prevent recurrence. Studies show that dementia is a key risk factor for these QI challenges. Dementia Capable Care interventions and trainings can mitigate the dementia impact and create improved outcomes. Example benefit: Supplements. Because food is available and staff use alternative interventions, weight loss should be less than 1% (average savings of $3 per day per targeted resident). MDS Recent MDS 3.0 changes still present a struggle for MDS coordinators. The most notable is difficulty with the interviewing process. 75% or more of residents in SNFs have some form and degree of dementia. Staff who are interviewing and do not have adequate dementia training will produce poor results with a person-centered care focus tool. Staff Burnout and Turnover Most experts believe the cost to recruit, hire, and train a new employee is between $1,800 and $3,500 each. Dementia Capable Care trainings reduce resident agitation and refusals and improve staff job satisfaction to reduce staff burnout and turnover. Inspire staff to learn through our passion and positive paradigm, and use our recognition programs to fit your clinical laddering programs. Risk Management Discover the dementia stage, which reveals the areas of risk, and implement proactive methods to prevent/reduce the risk from becoming a reality. Accountable Care Organizations New federal initiative to control costs. SNFs and ALFs are able to join ACOs. Organizations demonstrating quality, cost-effective care are eligible. Dementia Capable Care trainings put organizations on the cutting edge of present and future quality measures. 2

3 Company A Data provided by a national health care company that tracked the impact of our training program in 10 of their buildings. # of dementia patients on caseload % increase in ADRD caseload for 10 facilities in 3 months increase in billable units for ADRD 1,184 1, ,476 3,197 3, ,686 Extrapolated revenue increase based on $25/unit $29,602 $31,065 $1,241 $61,908 $79,925 $83,875 $3,350 $167,150 Revenue increase over 3 months after Dementia Capable Care training for 10 facilities: 170% $105,242 3

4 Company B Data provided by a national health care company that tracked the impact of our training program on its therapy revenue. Data Number of patients tracked: 930 Number of Med A patients: 562 (60%) Number of Med B patients: 331 (35%) Other patients: 37 (5%) Therapists indicated that 284 patients (~30%) were identified for treatment based on the Allen training. Therapists reported that these patients would not have been placed on caseload without the training. Average length of stay was 29 days. 805 patients received services (87% of the 930 patients tracked) 606 received services (65% of the 930 patients tracked) 239 received ST services (26% of the 930 patients tracked) Allen Cognitive Level B reakdown Allen Cognitive Level Number of Patients Percentage of total 0.0 to % 2.0 to % 3.0 to % 4.0 to % 5.0 to % This data shows that the often-neglected middle-stage resident was given much more therapy time. Client Stated: Average LOS was 29 days (4 weeks) and the average frequency was 4x per week (evenly split between 3x and 5x). Based on an estimate of billable time per visit, we could estimate revenue. Estimated increase of revenue due to two-day dementia training course: $470,158 4

5 Company C Data provided by a 125-bed community designed for people with Alzheimer s and related dementias. Licensed as a skilled nursing facility; however, about 40 of the beds were marketed as an assisted living lifestyle. The community served all stages of dementia from the early stage to end stage and very medically complex. Kim Warchol installed her best abilities social model program (previously called Forget-Me-Not ) in which all residents had an Allen level identified with maintenance programs designed to enhance maximum ability to function. Every team member received education about the stages and appropriate interventions from housekeeping to activities, CNAs, nursing, and management. The therapy team was proficient in the administration and use of the Cognitive Disabilities Model designed by Claudia Allen. Year 1 Outcomes Weight loss 1% to 3%. Supplement use 3% to 5%. Excellent staff retention 75% of initial staff retained. Reduction in sundowning. High level of activity involvement; excluding ADLs, activity participation averaged 8 to 10 activities per day, per resident. Health Maintenance: No developed pressure sores. No developed contractures. Two hospitalizations due to unmanageable behaviors in the first year. Marketability and Recognitions: The facility filled within one year in a market that averages 75% capacity. The community continues to run at full census. The facility won the 2004 St. Louis Business Journal Health Care Innovation Award. Industry Averages (Benchmark) Post-Training Statistics Training Results Resident weight loss 7.9% 4% down 3.9% Supplement use 26.7% 4% down 22.7% Development of pressure sores 26% 0% down 26% Development of contractures 0% Behavioral or emotional patterns that affect others 17.1% 2% down 15.1% Sundowning/wandering 3.5% 0% down 3.5% Activity involvement, excluding ADLs 8 10 activities per day, per resident Staff turnover 115% 25% down 90% Census 75% 100% up 25% Crisis Prevention Institute: W. Park Place, Suite 600, Milwaukee, WI USA TTY (Deaf, hard of hearing, or speech impaired) dcs@crisisprevention.com crisisprevention.com 5 YFORM DCC-HND / CPI (reprinted 2015). All rights reserved.