In this interview, we sit down with Real Time Medical Systems (Real Time) Clinical Account Specialist Michele Self, MA, CCC SLP, CMA, Clinical Program Director Kathy Derleth, RN, BSN, and Clinical Account Specialist Cheryl Scalzo, RN, to discuss what SNFs can do to prepare for state surveyors.
Michele, Kathy, and Cheryl will discuss three key areas that are most cited amongst surveyors, including the importance of having a comprehensive care plan, ensuring quality care, managing Infection Prevention and Control (IPC) efforts, and how data driven technology solutions can improve patient outcomes while ensuring SNFs are prepared for survey teams.
COMPREHENSIVE CARE PLAN – TAG F655
Real Time: How does the Minimum Data Set (MDS) impact SNF surveys?
Self: The MDS is used as the starting point for the survey. Surveyors obtain vital information regarding the patients in a facility prior to them even coming through the door. They can see all the data that has been submitted on the MDS. The accuracy of each item set is critical, and it is not just about the items that impact billing. The MDS provides information regarding the patient’s needs and capabilities. Those needs and capabilities all connect to the patient’s care and comprehensive plan. It is important for SNFs to utilize their own live data to know exactly who the survey teams will be looking at.
Real Time: One of the top ten survey tags is Care Planning, why is that?
Self: The correlation between the patient assessment and their care needs is powerful. It is easy to pull the MDS and care plan, put them side by side and determine if they support each other and represent the patient’s needs. With collaboration amongst the entire team on a patient’s care plan, allows for the best coordinated provision of care and improved outcomes. Also, when looking at other top tags, each have a connection to care planning, like quality care and infection control to name a few.
QUALITY OF CARE – TAG F684
Real Time: What are some areas of Quality of Care that surveyors evaluate?
Derleth: Under the quality of care deficient area, surveyors are focusing on key areas that can be seen as harming a patient. Areas like accidents (falls, medication errors, elopements, or Adverse Drug Events) or patient care areas like pressure ulcers or weight loss. Therefore, care providers must be cautious in implementing deep clinical evaluations each day. Below are key areas SNFs can focus on to improve quality of care:
- Avoid preventable accidents and rehospitalizations through recognition of early subtle changes in patient behavior, condition, and intervening with clinical actions that are aligned with a patient’s Advance Care Plan (ACP) and corresponding treatment.
- Reinforce safeguards against redundant medications by identifying potential side effects, interactions, and psychotic condition treatment. This allows the SNF to safely administer medications while minimizing the possible negative impacts to the patient.
- Provision of quality of care is achieved by implementing the highest possible clinical standards, and through industry approved suggested interventions based on disease or condition. The inclusive psychosocial plan of care involves the patient, the family, and the staff to provide the best mental and physical care possible.
Real Time: In looking at Quality of Care tags, what are some specifics the facility should view regularly?
Derleth: One of the main challenges for care providers is the inability to have one-on-one, 24/7 contact with each patient. Therefore, sometimes patient accidents occur such as falls, wandering without safety awareness, or poor wound healing – these are more common than one would think. The staff need to be vigilant every day with incident investigation, as well as patient specific interventions based on the root cause of the accident. Care plans should also be updated to reflect the adjustments made. However, providers cannot stop at the first step of the incident report completion, they must follow all points with a final check evaluating if the new intervention is working, and that the patient has no further incidents.
INFECTION PREVENTION & CONTROL – TAG F880
Real Time: With the Public Health Emergency (PHE) officially over and facilities moving beyond COVID-19, why does Infection Control remain among the top cited deficiencies?
Scalzo: Now more than ever, facilities have the task of maintaining strong IPC programs. And with IPC being two of the top three cited areas for SNFs, the heightened oversight and enforcement of regulations will likely remain in place for the foreseeable future. Breeches in IPC efforts can and have resulted in development of Healthcare Associated Infections (HAIs), increased Methicillin-resistant Staphylococcus aureus (MRSA), development of new multi-drug resistant organism (MDROs), and central line-associated bloodstream infections (CLABSI). Additionally, care providers are now realizing the accountability of the Phase 3 Requirements that were initiated before the PHE and have since been revised. This guidance includes Antibiotic Stewardship programs, and the defined role of an Infection Preventionist.
Real Time: As facilities strive to improve their IPC efforts, where should they focus their attention?
Scalzo: The answer here is quite simple, prevention. The term “prevention” or forms of the word, such as preventionist, preventative, etc., is not only in the title of IPC programs, but is intentionally used with care providers guidance. Through a myriad of requirements and structed methods, successful IPC efforts work to prevent the spread of infections, the development of HAI’s and MDRO’s, adverse effects related to unnecessary antimicrobial therapy, and many more.
Get Survey Ready with Real Time
By utilizing data analytics, SNFs now have the ability to always be ready for state surveyors. With live data analytics solutions, like Real Time, providers can identify the areas that either need new or updated comprehensive care plans, ensure quality care, and better manage IPC efforts. By analyzing live data from the post-acute EHR, care teams can identify early medication prescribing, potential side effects, and provide appropriate medication management for patients. This is an area where Real Time’s Interventional Analytics solution can help SNFs highlight early and subtle changes in patient conditions, allowing care teams to assess, treat, and manage those at high-risk and intervene in care prior to an adverse event occurring. Real Time’s Infection Control dashboard can also assist SNFs in their efforts to reduce HAIs, and ensure prevention measures are in place, including tracking, trending, and managing antibiotic usage. With live data analytics, SNFs can make certain that their facility is always survey ready.
To learn more about Real Time’s Interventional Analytics solution and the ways Real Time can help, contact us today.