Qm reports - National Association of State Veterans Homes

January 15, 2018 | Author: Anonymous | Category: Science, Health Science, Pediatrics
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RUG and QM Reports Update Presented to State Veterans’ Homes Administrators Presented by Janet Barber National Program Manager, Data Mgmt. and Analytics Geriatrics and Extended Care Operations Department of Veterans Affairs

RAI/MDS  Resident Assessment Instrument/ Minimum Data Set  RAI/MDS was designed to facilitate achievement and maintenance of the resident’s highest practical level of wellbeing by identifying and documenting individual resident’s needs and strengths, and incorporating this information into the resident’s care plan

RUG REPORTS

What is a RUG?  Resource Utilization Group  This classification system uses information from the MDS assessment to classify nursing home residents into a series of groups representing the residents’ relative direct care resource requirements

RUG Basics1  SVH reports will utilize RUG IV  There are 66 RUGs in the RUG IV classification system

RUG Basics2  Eight major classification categories   

  

 

Rehab plus Extensive Services Rehabilitation Extensive Services Special Care High Special Care Low Clinically Complex Behavioral Symptoms & Cognitive Performance Reduced Physical Function

RUG report Facility: Any SVH Date Range:01-OCT-13 to 31-OCT-13 Creation Date:07-JAN-14 Average CMI Weight: 9.93 (Total CMI Weight / Total Assessments) Total Assessments: 171 Total CMI Weight: 1698.0

Number of assessments in this reporting month that were completed late. This is a count of late assessments for the reporting month, and may not have been used for the RUGS counts. Quarterlies : 0 Fulls : 0 Total : 0 RUG Model/Logic Version: 66/103 RUG Weight Set: MEDICARE RUGS Model 66 RURAL-FY2012 Reference: MDS 3.0 Users Manual

DOMAIN Assmt #Assmts with SubDomain RUG (ADL Range) ADL this RUG & ADL ------------------------------------------------------------------------1. REHAB PLUS EXTENSIVE SERVICES ULTRA HIGH INTENSITY RUX (11-16) RUL (2-10) VERY HIGH INTENSITY RVX (11-16) RVL (2-10) HIGH INTENSITY RHX (11-16) RHL (2-10) MEDIUM INTENSITY RMX (11-16) RML (2-10) LOW INTENSITY RLX (2-16) ----------------------------------------------------------Category SubTotal 0 0.0

CMI Weight this RUG

CMI Wt. Sub-Total

66.0 65.0

0.0 0.0

64.0 62.0

0.0 0.0

63.0 57.0

0.0 0.0

58.0 55.0

0.0 0.0

52.0

0.0

CMI  Each RUG group has a weighted value called Case Mix Index  Represents the relative use of resources for a resident  Case refers to nursing facility resident  Mix refers to the mixture of different types of residents cared for in the CLC

Things to consider1  How do your residents fall into the various RUG categories?  Would first pay attention to the residents in the Reduced Physical Function and the Behavioral Symptoms & Cognitive Performance categories  These residents may be served better in a different level of care 



They may be ready for assistive living or admission into your domiciliary They may be ready for discharge home with home health services

Things to consider2  You can determine the residents’ discharge goal by the coding in Section Q

QM REPORTS

What is a QM?  Quality Measure  One method for determining the quality of care in a nursing home is through the use of Quality Measures

What is a QM2  Quality Measures are derived from resident assessment data (RAI/MDS) routinely collected on the residents at specified intervals during their stay  Measures are valid and reliable - based on the best research currently available

What is a QM3?  Measures are not intended to be benchmarks, thresholds, guidelines, or standards of care 

Rather,  They are markers for facility trending and comparison  Allows facilities to monitor progress over time  They are pointers to potential problem areas/areas of possible weakness

 The SVHs will be receiving from the VA the Annual survey process report (also called Surveyors Report). It contains all of the quality measures plus the addition of 4 immunization measures.

Short Stay vs. Long Stay  Short Stay Quality Measures: 

Include all residents in an episode whose cumulative days in the facility is less than or equal to 100 days at the end of the target period

 Long Stay Quality Measures: 

Include all residents in an episode whose cumulative days in the facility is greater than or equal to 101 days at the end of the target period

Short Stay Measures  Percent of Residents who Self-Report Moderate to Severe Pain  Percent of Residents with Pressure Ulcers that are New or Worsened  Percent of Short-Stay Residents Who Newly Received an Antipsychotic Medication  Percent of Residents who were Assessed and Appropriately Given the Seasonal Influenza Vaccine  Percent of Residents Assessed and Appropriately Given the Pneumococcal Vaccine

Long Stay Measures1  Prevalence of Falls  Percent of Residents Experiencing One or More Falls with Major Injury  Percent of Residents who Self-Report Moderate to Severe Pain  Percent of High-Risk Residents with Pressure Ulcers  Percent of Long-stay Residents with a Urinary Tract Infection

Long Stay Measures2  Percent of Low-Risk Residents Who Lose Control of their Bowels or Bladder  Residents Who Have/Had a Catheter Inserted and Left in Their Bladder  Percent of Residents Who Were Physically Restrained  Percent of Residents Whose Need for Help with Activities of Daily Living Has Increased

Long Stay Measures3  Percent of Long-stay Residents Who Lose Too Much Weight  Percent of Residents Who have Depressive Symptoms  Prevalence of Antianxiety/Hypnotic Use  Percent of Long-Stay Residents Who Received An Antipsychotic Medication

Long Stay Measures4  Prevalence of Behavior Symptoms Affecting Others  Percent of Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine  Percent of Residents Assessed and Appropriately Given the Pneumococcal Vaccine

QM Report Description ----------Self-Report Moderate to Severe Pain[S] With Pressure Ulcers New or Worsened[S] Assessd + Appr Givn Seasonal Influenza Vaccine[S] Assessd + Appr Given the Pneumococcal Vaccine[S] Shrt Stay Who Newly Received an Antipsych Med[S] Expr One or More Falls with Major Injury[L] Self-Report Moderate to Severe Pain[L] High-Risk With Pressure Ulcers[L] Assessd + Appr Givn Seasonl Influenza Vaccine[L] Assessd + Appr Given Pneumococcal Vaccine[L] With a Urinary Tract Infection[L] Low Risk Who Lose Control of Bowel or Bladder[L] Have/Had a Catheter Insertd + Left in Bladder[L] Were Physically Restrained[L] Need for Help w/ Activities Daily Living Incr[L] Lose Too Much Weight[L] Have Depressive Symptoms[L] Received An Antipsychotic Medication[L] Had a Fall During their Episode of Care[L] AntianxietyOrHypntcMed+noEvidPsychotcOrRltdTrgtPrd[L] Behavr Symptoms Affect Others for Trgt Prd[L]

MsmtID -----N001.01 N002.01 N003.01 N007.01 N011.01 N013.01 N014.01 N015.01 N016.01 N020.01 N024.01 N025.01 N026.01 N027.01 N028.01 N029.01 N030.01 N031.02 N032.01 N033.01 N034.01

Num ---3 38 15 40 2 8 6 3 203 208 8 1 1 0 18 16 1 70 131 0 28

Denom -----20 38 15 40 7 207 148 109 203 208 208 2 171 208 138 208 187 208 207 75 188

FAC Obs ------15.0% 100.0% 100.0% 100.0% 28.6% 03.9% 04.1% 02.8% 100.0% 100.0% 03.8% 50.0% 00.6% 00.0% 13.0% 07.7% 00.5% 33.7% 63.3% 00.0% 14.9%

FAC Adj ------100.0% 55.1% 52.8% -

StatAvg ------17.8% 96.6% 88.5% 94.4% 17.8% 03.7% 10.8% 02.2% 99.2% 98.9% 03.7% 50.5% 04.0% 00.0% 12.8% 07.5% 05.3% 29.5% 60.2% 00.0% 23.9%

VISNAvg ------18.0% 94.1% 92.6% 92.5% 11.6% 03.7% 10.2% 04.8% 99.3% 98.5% 05.3% 55.4% 04.2% 00.5% 14.2% 08.2% 05.6% 30.8% 58.4% 00.0% 26.9%

NatlAvg ------22.4% 90.7% 83.6% 83.7% 05.5% 03.5% 10.3% 06.1% 94.1% 96.1% 05.3% 59.5% 05.3% 01.6% 14.7% 07.6% 04.9% 25.8% 53.6% 00.0% 28.0%

NatPctl ------100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 00.0% 100.0% 100.0% 100.0% 100.0% 100.0% 00.0% 100.0%

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