Division of Quality Assurance. Updates
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- Neal Haynes
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1 Updates Otis L. Woods, MBA, Administrator
2 Nursing Home Update CMS Updates DQA Updates Survey Statistics AGENDA
3 CMS Update Partnership to Improve Dementia Care in Nursing Homes Antipsychotic use MDS Staffing level focused surveys Improvements in dementia care continue New goals for antipsychotic reduction Focus care on person directed WI QIO continues to be underutilized
4 Antipsychotic Use CMS Update o WI rate decline is 25.3% o WI 3rd best in nation o New Goals 25% reduction % reduction 2016
5 CMS Update
6 CMS Update MDS/Staffing level focused surveys WI in Phase I Surveyors identified and trained 10 facilities to be surveyed Start May 13, 2015
7 DQA Updates Antimicrobial Stewardship Dementia Training M&M, Phase III application Overuse of Antibiotics Whose Resident is it?
8 DQA Update Dementia Training DLTC Applying for CMP Train Crisis Response Dementia Generalist; Dementia Specialist; Challenging Behaviors
9 DQA Updates Music and Memory Phase III application Another 150 facilities on board
10 DQA Updates
11 Immediate Jeopardy Trends 100 Immediate Jeopardy Citations # IJ citations # facilities with IJ # facilities with multiple IJs
12 Immediate Jeopardy Rank Rank 2014 Tag 1 1 F (tied) F157 Description of Regulation Care and services to attain/maintain highest practicable level of well-being Facility immediately consults with a physician when a resident has a significant change in condition Number of IJ Citations F314 Services and treatment to prevent and/or to heal pressure ulcers F323 Facility is free of hazardous environment/supervision and assistive devices to prevent accidents (tied) 6 (tied) F441 Infection control program designed to prevent the development and control the spread of infection F327 Sufficient fluids to maintain adequate hydration and health F281 Services provided meet professional standards of quality (tied) 6 (tied) 6 (tied) F329 Each resident s drug regimen is free of unnecessary drugs 3 F225 Report and investigate allegations of abuse, mistreatment, neglect and misappropriation 2 9 (tied) 6 (tied) F226 Develop and implement policies and procedures prohibiting abuse, mistreatment, neglect and misappropriation 2 9 (tied) 6 (tied) F490 Facility administered in a manner that promotes each resident's health and well-being 2
13 TOP TEN CITES TOP TEN FEDERAL HEALTH CITATIONS NATION, STATE, REGIONAL OFFICE 2015 Nation F323 - supervision to prevent accidents (6106) F441 - infection control (5877) State F441 - infection control (213) F323 - supervision to prevent accidents (205) Southern (Madison) F323 - supervision to prevent accidents (42) F225 - investigate allegations of abuse (37) Southeastern (Milwaukee) F323 - supervision to prevent accidents (69) F225 - investigate allegations of abuse (60) Northeastern Western (Eau Northern (Rhinelander) (Green Bay) Claire) F314 - prevention of pressure F441 - infection control (30) F280 - periodically review ulcers (57) and revise the plan of care F371 - store, prepare, and (47) F441 - infection control (56) serve food under sanitary conditions (30) F441 - infection control (46) F309 - care promotes highest level of well-being (5186) F371 - store, prepare, and serve food under sanitary conditions (5180) F314 - prevention of pressure ulcers (181) F225 - investigate allegations of abuse (177) F441 - infection control (36) F157 - promptly consult with MD after significant condition change (33) F309 - care promotes highest level of well-being (54) F314 - prevention of pressure ulcers (48) F225 - investigate allegations of abuse (41) F315 - services to restore normal bladder function and prevent infection (39) F309 - care promotes highest level of well-being (25) F315 - services to restore normal bladder function and prevent infection (25) F323 - supervision to prevent accidents (40) F371 - store, prepare, and serve food under sanitary conditions (37) F279 - develop comprehensive care plan (3365) F329 - drug regimen is free of unnecessary drugs (3300) F371 - store, prepare, and serve food under sanitary conditions (158) F309 - care promotes highest level of well- being (156) F329 - drug regimen is free of unnecessary drugs (33) F425 - medication system assures accurate receipt and administration (33) F441 - infection control (45) F329 - drug regimen is free of unnecessary drugs (32) F371 - store, prepare, and serve food under sanitary conditions (38) F425 - medication system assures accurate receipt and administration (36) F329 - drug regimen is free of unnecessary drugs (23) F314 - prevention of pressure ulcers (22) F282 - care in accordance with care plan (36) F309 - care promotes highest level of well-being (33) F431 - labeling of drugs and biological (3235) F514 - documentation (3032) F241 resident dignity (2577) F282 - care in accordance with care plan (2506) F329 - drug regimen is free of unnecessary drugs (139) F425 - MEDICATION SYSTEM ASSURES ACCURATE RECEIPT AND ADMINISTRATION (129) F315 - services to restore normal bladder function and prevent infection (127) F157 - PROMPTLY CONSULT WITH MD AFTER SIGNIFICANT CONDITION CHANGE (105) F314 - prevention of pressure ulcers (30) F371 - store, prepare, and serve food under sanitary conditions (27) F282 - care in accordance with care plan (26) F309 - CARE PROMOTES HIGHEST LEVEL OF WELL- BEING (26) F425 - medication system assures accurate receipt and administration (30) F514 - documentation (30) F279 - develop comprehensive care plan (29) F157 - PROMPTLY CONSULT WITH MD AFTER SIGNIFICANT CONDITION CHANGE (28) F323 - supervision to prevent accidents (35) F156 - Provision of information regarding rights, rules, services, and charges (26) F226 DEVELOP AND IMPLEMENT POLICIES AND PROCEDURES PROHIBITING ABUSE (25) F329 - drug regimen is free of unnecessary drugs (25) F323 - supervision to prevent accidents (19) F279 - develop comprehensive plan of care (13) F425 - MEDICATION SYSTEM ASSURES ACCURATE RECEIPT AND ADMINISTRATION (13) F225 - INVESTIGATE ALLEGATIONS OF ABUSE (12) F282 - care in accordance with care plan (12) F225 - INVESTIGATE ALLEGATIONS OF ABUSE (27) F329 - drug regimen is free of unnecessary drugs (27) F314 - prevention of pressure ulcers (24) F279 - develop comprehensive care plan (23) ITALICS not in State s Top Ten BLUE/SMALL CAPS - new to Top Ten compared to entity s 2014 data
14 CMS Other Updates o ESRD Services In Nursing Homes o Quality Assurance and Improvement Committee (QAIC) - CMP o Strict Liability anticipated CMS memo o QAPI o Federal OIG 2015 anticipated work o CMP projects MDS and Staffing
15 State Other Updates o Legislative updates o Ch. 50 ideas o Regional Quality Forums o Pain management focus interest
16 Wisconsin Population Changes
17 Wisconsin Population Changes
18 AL vs. LTC Facilities 4000 Trend in Number of Facilities Number of Facilities AL LTC
19 AL vs. LTC Capacity Trend in Capacity for Residents Capacity LTC AL
20 Wisconsin Working to Protect - Promote - Provide Quality in Wisconsin's Health Care Facilities QUESTIONS?
Wisconsin Top Ten Federal Health Citations 1/1 11/27/2017
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