Quality Care – Right for Your Residents and Your Bottom Line

One of our goals at LTCQ, Inc. is to improve the quality of care for residents in long term care.

Early on, we realized that providing quality of care isn’t just the “right thing to do”, it is also the “smart thing to do”. Why? Quality pays!

For more than a decade we have been preparing Return on Investment analysis reports (example) for our clients. We have shown, in real numbers, where our services improved quality of care, plus increased reimbursement. This increased reimbursement, coupled with decreased fines, deficiencies and risk for claims easily provides a 2x to 4x Return on Investment.

Added Bonus - Lower Insurance Premiums

Insurance carriers are offering LTCQ clients lower liability premiums because they recognize the link between high quality of care and lower risk. When was the last time your insurance premium went down? Find out more about our RiskRx™ (Acrobat required to view) program.

How Do We Help our Clients Improve Quality?

Our approach to quality is different from other companies. We know that good decisions are based on good data and so the first step in our quality improvement plan is to accurately assess each resident. Our patented Data Integrity Audit™ (Acrobat required to view) is a Web-based tool that ensures this accuracy with instant prompts for improving assessment and documentation prior to state submission. Front line staff receive online feedback that provides standard best practices and current CMS guidelines appropriate for each resident’s unique needs. Other quality plans that don’t include a data integrity piece base their analysis and recommendations on flawed data resulting in “Garbage in, garbage out”.

Building on a Strong Foundation

Once the data is clean, we then benchmark our client’s performance against internal, local and national peers. This is an important part of LTCQ’s Performance Portfolio™ (PDF: Acrobat required to view) which is our premiere quality measurement and improvement program. It takes a “snapshot” of the facility and then measures changes over time.

We track QM/QIs, and our own 16 risk-adjusted incidence-based measures that remove the penalty for treating sicker residents. Online reports are updated with every MDS submission so providers can immediately respond to a resident at risk. Easy-to-use reports focus attention where it is needed most and offer drill down capabilities from the corporate level to the bedside. Trending graphs track changes over 24 months and verify if policies and procedures are being implemented and, more importantly, if they are making a difference.

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False Sense of Security

At the 2005 American College of Healthcare Administrators (ACHCA) conference, LTCQ conducted a survey that showed that 82% of responding administrators were “very confident” in the accuracy of their MDS assessments.

Their opinion doesn’t match empirical data collected in LTCQ’s six-month study of more than five million MDS assessments submitted to the state. This study showed that 75% of assessments had data integrity issues.

What is a data integrity issue? A data integrity issue is something that doesn’t make sense either clinically or logically and may raise questions from surveyors and FIs. These issues have enormous impact because care planning is compromised and reimbursement is effected, usually negatively. Perhaps the most disturbing finding was the impact data integrity issues had on the facility’s CMS Quality Measures. The table below illustrates the findings.

CMS QM/QI - Chronic	Percentage of Facilities
ADL Decline	39.5%
Urinary Tract Infections	41.2%
Mood (decline)	53.5%
Low Risk Pressure Ulcer	29.9%
CMS Quality Measure – Post Acute	Percentage
Pain	12.3%
Delirium	15.9%
Pressure Ulcer Decline	37.9%

Pay for Performance

Senator Ron Wyden (D-OR) and Rep. Phil English (R-PA) each introduced legislation that would reward nursing homes for providing excellent care and penalize those that fall short of performance targets.

Rep. Marcy Kaptur (D-OH) also introduced legislation that would tie Medicare payment rates to nursing home performance. Given the spiraling costs of resident care, the decline in Medicare and Medicaid reimbursement, along with low public opinion of quality in nursing homes it is only a matter of time before these types of legislation pass.

The recently merged QM/QIs will serve as the basis for measuring quality. Given the dubious accuracy of MDS assessments that are the foundation of QMs/QIs, this type of legislation could have a devastating impact on reimbursement rates for the majority of providers.

Get Ahead of the Curve

Contact LTCQ today for an online demonstration of our comprehensive services!

Read Success Stories from our clients.

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