Everyone has been working hard on the Quality Initiative
goals: 1) safely reduce hospital
readmissions; 2) increase staff stability; 3) increase customer satisfaction;
and 4) safely reduce the off-label use of antipsychotics. We have seen many examples of success – this
is great and continued improvements are important because of changes we are
going to experience beginning in 2015.
What are the changes and what do the Quality Initiative goals have to do
with them?
Five-Star: (a) Antipsychotic use will be added to the
Quality Measure (QM) domain early in 2015; (b) measures for return to hospital
and discharge to community will be added to the QM domain later in the year;
(c) submission of electronic payroll data will begin on a voluntary basis in
2015; (d) CMS will implement other processes to validate reported staffing
information.
IMPACT Act: Data about quality measures, hospitalizations,
rehospitalizations, and discharge to community must be reported publicly and
made available to consumers when transitioning to long term care. This data reporting is phased in between
October 2017 and October 2019. Penalties
for not meeting the reporting requirements begin in October 2019 and will be a
market basket payment penalty of 2 percent.
Value-Based Purchasing: Beginning in October 2018, Medicare
payment rates will be based in part on a nursing centers’ performance scores
related to an all-condition hospital readmission measure. This measure must be developed by October
2015. And by October 2016, an
all-condition risk-adjusted potentially preventable hospital readmission rate
will be developed.
These are just three examples of the value of embracing the Quality Initiative and striving to achieve and sustain the goals.
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