C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

We continuously hear the story told by Kris Mastrangelo about her experience at the Boston MS clinic years ago when she was convinced she had Multiple Sclerosis.  The Physician asked her to walk down the hall 50 feet, turn around, and walk back as fast as she could.  She was perplexed by the request, but even more curious as to why the Physician displayed a stop watch high in the air indicating she was being timed.   Why?  After much thought and a little research, Kris surmised that “the slower you walk, the sooner you die.” 

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

Interview with Mark Parkinson, President and CEO of AHCA

Kris Mastrangelo, President of Harmony Healthcare International (HHI) interviews Mark Parkinson, President of the American Health Care Association (AHCA), in the 2017 AHCA Provider Lounge. Governor Parkinson assures providers that despite the new regulations and census issues facing providers this year, there is light at the end of the tunnel.   (Audio transcription below).

Interview with Brendan Williams, President - New Hampshire Health Care Association

Kris Mastrangelo, President of Harmony Healthcare International (HHI) interviews Brendan Williams, President and CEO of the New Hampshire Healthcare Association (NHHCA), in the AHCA Provider Lounge.  Brendan discusses the staff crisis facing skilled nursing homes.  Not only does Brendan strive to make caregiving an attractive profession to the current generation, he argues that "we can't have people getting poor for taking care of the poor."  (Audio transcription below).

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

With the nationwide focus on antipsychotic drug reduction, providers are seeing an increase in behaviors, especially with the dementia population.  Thus, this Quality Measure is being impacted in facilities with a large dementia population.  Many facilities are updating behavior management techniques and procedures to meet the increasing number of residents with dementia and behaviors.  Surveyors are taking notice and are looking to see how facilities are managing challenging behaviors. 

All the patients that triggered for this Quality Measure in the facility have a dementia diagnosis. 

So, let’s take a deeper dive into the Measure Specification for this Quality Measure.  This measure reports the percentage of long-stay residents who have behavior symptoms that affect others during the target period.

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

This blog will be short. It is meant to give you an “aha” moment. 

It has been one heck of a ride these last three years. We keep studying, we keep reading and we keep pulling “all-nighters” just to keep abreast of the nonstop regulatory and reimbursement changes.  I have whiplash from the dinging, pinging and buzzing on my multiple devices. The days are consumed with massive amounts of questions and discussions from top level CEO’s, Executives, and Clinical Management Teams across the country all with a unified goal of deciphering and simplifying Value Based Purchasing (VBP), Bundled Payments and the Quality Reporting Program (QRP). 

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

As we plow through the medical records, there are many factors contributing to Quality Measure misrepresentation. One of the recent findings is the (unfortunate or fortunate depending on how you see it) auto populate function of the diagnoses throughout the record and specifically on the “Face Sheet.” 

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

Every night Kris Mastrangelo and I talk about the day’s events and the hot topics infiltrating the industry.  These days, our conversations jump subject to subject given the volume of regulatory changes impacting the healthcare industry. Most recently, the topic that is recurring  is Pain. Kris mentioned in her last 3 speaking engagements, the subject of pain is a common discussion item for industry leaders, and I, with my daily audits in facilities from Hawaii to New York, also see pain as a quality measure raising the most questions and concerns.  Our process includes a review of the “Sweet 16” Quality Measures that impact the Five Star Quality Rating System. A deep dive into the facility specific areas of opportunity (area of Pain), are worth sharing to help you improve your process and ultimately your Quality Rating. 

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

Harmony Healthcare International (HHI) has noted an increase in facilities who wish to improve their measure of this quality indicator on their facility Quality Measure (QM) report. It is important to remember that high ratings may not be an indicator of substandard patient care. Substandard care is not the presence of incontinent residents in your facility. Substandard care is the lack of competent assessment, inappropriate treatment or management of incontinence, and lack of adjustments to clinical care that preserve the dignity of residents who are incontinent. 

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

Steps to Develop a Behavior Monitoring Process 

In Part 1 of our Quality Measure #16 series, Harmony Healthcare International (HHI) discussed the Quality Measure Item Sets for Triggering Residents who received an Antipsychotic Medications. After identifying a resident that has triggered for this quality measure what is the next step? The Harmony HealthCARE Specialists work alongside their clients to identify the residents at risk, as well as assist in strengthening the development of a Behavioral Root Cause Analysis Process. 

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

Root Cause Analysis 

The first step in drilling down to the root cause of this Quality Measure is to understand how the measure is calculated.  This measure reports the percentage of long-stay residents who are receiving antipsychotic drugs within the target period.