Harmony Healthcare Blog

Quality Measure #8: One or More Falls with Major Injury - Long Stay (Part 2)

Posted by Kathy Monahan on Tue, Oct 11, 2016

C.A.R.E.

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


5 Steps to Develop a Fall Prevention Process 

In Part 1 of our Quality Measure #8 series, Harmony Healthcare International (HHI) discussed the Quality Measure Item Sets for triggering one or more falls with major injury.  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 clients at risk, as well as assist in strengthening the Development of a Fall Prevention Process.  

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Topics: Quality Measures, falls, Injurious Fall

Quality Measure #8: One or More Falls with Major Injury - Long Stay (Part 1)

Posted by Kathy Monahan on Thu, Oct 06, 2016

C.A.R.E.

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


Steps to Better Understand Major Falls with Injury


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 and the criteria for “Injurious Fall”. 

  • It is based on MDS Section J coded as one or more falls that result in major injury.
  • Major injury includes bone fractures, joint dislocations, closed head injuries with altered consciousness and subdural hematomas that occur as a direct result of the fall or are recognized after the fall that can be attributed to the fall

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Topics: Quality Measures, Injurious Fall

Quality Measure #11:  Pressure Ulcers/Injury - Long Stay (Part 2)

Posted by The Harmony Team on Thu, Sep 29, 2016

C.A.R.E.

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


Continued from the last post, lets tie all of the pieces together when coding Pressure Ulcers (Long Stay).  Understanding the RAI Guidelines for completion of Section M is the third and final key to assist with managing this Quality Measure. 

In order to ensure accurate coding and documentation, it is important to understand the intent of each area of Section M. Harmony Healthcare International (HHI) provides the following helpful tips to assist with this process: 

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Topics: Pressure Ulcer, Quality Measures, Long Stay

Quality Measure #11: Pressure Ulcers/Injury - Long Stay (Part 1)

Posted by The Harmony Team on Tue, Sep 27, 2016

C.A.R.E.

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


As discussed with the short stay Quality Measure for Pressure Ulcers/Injury, we have seen that it is all about understanding different ulcer types and staging, which directly impacts Documentation and MDS Accuracy. 

1)  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 Long Stay Quality Measure is calculated and used both in the Five Star reporting system and the Public Reporting Nursing Home Compare website. The measure specifically focuses on High Risk Residents who have Stage 2 up to Stage 4 Pressure Ulcers (Injuries). 

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Topics: Pressure Ulcer, Quality Measures, Long Stay

We’ve got a Physical Restraint!  Now what? 7 Steps to Assess

Posted by Kathy Monahan on Thu, Sep 22, 2016

C.A.R.E.

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


When the interdisciplinary team determines that the use of physical restraints is the appropriate course of action, and there is a signed physician order that gives the medical symptom supporting the use of the restraint, the least restrictive manual method or physical or mechanical device, material or equipment that will meet the resident’s needs must be selected.  Care planning must focus on preventing the adverse effects of physical restraint use.

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Topics: Quality Measures, physical restraints

Quality Measure: Physical Restraints - Long Stay (Section P)

Posted by Kathy Monahan on Tue, Sep 20, 2016

C.A.R.E.

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


The Physical Restraint Quality Measure is common on for error and miscoding.  This measure reports the percent of long-stay nursing facility residents who are physically restrained on a daily basis. Nursing facilities consistently strive to reduce unnecessary physical restraints and safeguard that residents are free of restraints unless deemed necessary and appropriate. Even though this is a continuous are of focus, it is beneficial for you and your staff to review the definition and intent of physical restraints.

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Topics: Quality Measures, physical restraints

"Sweet 16": Quality Measures and Your Five-Star

Posted by Kris Mastrangelo, OTR/L, LNHA, MBA on Fri, Sep 16, 2016

C.A.R.E.

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



Harmony Healthcare International (HHI) has created a numbering system for the “Sweet 16” Quality Measures.

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Topics: Five-Star, Quality Measures

Quality Measure: New or Worsening Pressure Ulcer - Short Stay

Posted by The Harmony Team on Tue, Sep 13, 2016

C.A.R.E.

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


Of the Harmony dubbed “Sweet 16 Quality Measures” that impact SNF Five-Star Rating, Pressure Ulcer falls on the list twice.  Once for long stay and once for short stay. Today’s blog will focus on the short stay measure. Many facilities become concerned when they note that their Quality Measures for Patients With New or Worsening Pressure Ulcer (Injury) is elevated above facility benchmarks or national averages.  This concern is justified and opens an excellent opportunity to investigate current facility practices for managing, coding and clinical operations. Harmony Healthcare International (HHI) offers the following guidelines to assist facilities:

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Topics: Pressure Ulcer, Quality Measures, MDS Short Stay

Quality Measure Improvement in Function: Top Two Questions about the Measure

Posted by The Harmony Team on Thu, Sep 08, 2016

C.A.R.E.

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


The new CMS Short Stay Quality Measure titled “Percentage of Short-Stay Residents Who Made Improvements in Function” was posted to Nursing Home Compare April 2016. Effective August 2016, this Quality Measure is integrated into the Five Star Rating System.

Currently, this measure will only be assigned half of its assigned point value (up to 50 Points of 1350) but will impact fully (100 points of 1600) in January 2017.  Many providers noted that although they have a strong rehabilitation program with obvious improvements (as evidenced by successful discharges home), the data shows they may have performed poorer than expected.  

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Topics: Quality Measures, MDS Short Stay, Improvement in Function

Quality Measures Related to Pain:  Understanding the Intent of the Pain Assessment

Posted by Melissa Fox on Tue, Sep 06, 2016

C.A.R.E.

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


Many facilities become concerned when they note that their long and short stay Quality Measures for Patients Who Self-Report Moderate to Severe Pain is elevated above facility benchmarks or national averages.  This concern is justified and opens an excellent opportunity to investigate current facility practices for pain control.

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Topics: Pain Assessment, Quality Measures, MDS 3.0 RAI Manual

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