Notifications From CORHIO Can Help Skilled Nursing Facilities with New Star Rating MeasuresDate: May 21st, 2019Category: CORHIO e-NewsletterTopics: SNF, Value-Based Care, Hospital Readmissions, Long-Term Care, Notifications
With recent changes released by CMS, skilled nursing facilities are faced with an increasing challenge to keep track of patients when they leave their care.
The Centers for Medicare and Medicaid Services (CMS) recently released major changes to the Five-Star Quality Rating System that skilled nursing facilities rely on to show their quality to hospital referral partners and the public. The Nursing Home Compare website “has detailed information about every Medicare- and Medicaid-certified nursing home in the country,” according to the site.
These quality rating system changes affect all three of the program’s domains: Health Inspection, Staffing and Quality Measures. According to a CMS statement:
“CMS is introducing separate ratings for short- and long-stay measures to reflect the level of quality provided for these two subpopulations in nursing homes. We are also revising the thresholds for ratings, adding a system for regular updates to thresholds every six months, and weighting and scoring individual QMs differently. Additionally, we are adding the long-stay hospitalization measure and a measure of long-stay emergency department (ED) transfers to the rating system.”
CORHIO Notifications for Patient Tracking
CORHIO has a Notifications solution that allows skilled nursing facilities to track patients recently discharged. CORHIO will match a patient list to our database of most major hospitals in the state and send real-time notifications of a hospital admission or discharge or emergency department visit. This allows skilled nursing facilities to stay informed about patient activities outside of their system and not rely on hospitals for direct and timely notification.
There is currently funding available for skilled nursing facilities to join the CORHIO network called the Colorado Care Connections Program. Through this program, implementation fees ($6,000-$10,000) are waived for any organization that has a referral relationship with a Meaningful Use eligible provider or hospital.
The area with the most changes is the Quality Measures Domain, which is particularly important to hospitals who use this data when evaluating referral partners. In addition to tracking rates of pressure ulcers, urinary tract infections, flu, pneumonia, mobility improvements, etc, there are quality measures specific to hospital readmissions and emergency department visits. These can be difficult measures for skilled nursing facilities to keep track of because these encounters could happen after the patient has left their care.
Specific quality measures include two for short-stay residents (under 100 days):
- Percentage of short-stay residents who were re-hospitalized after a nursing home admission
- Percentage of short-stay residents who had an outpatient emergency department visit
As well as two for long-stay residents (over 100 days):
- Number of hospitalizations per 1,000 long-stay resident days
- Number of outpatient emergency department visits per 1,000 long-stay resident days
For more details on the Five Star Quality Ratings System changes: