Marilyn Rantz on “Brad’s Bites”, Inside Mizzou Athletics interview regarding reducing hospitalizations.

Click HERE for the 10-minute interview!

Read More

Amy Vogelsmeier and Sue Shumate talk with Mason Rothert (Mediprocity) about NewPath Health Solutions.

Click HERE to listen to the episode!

Read More

OBJECTIVES: To measure the impact of advanced practice nurses (APRNs) on quality measures (QM) scores of nursing homes (NHs) in the CMS funded Missouri Quality Initiative (MOQI) that was designed to reduce avoidable hospitalizations of NH residents, improve quality of care, and reduce overall healthcare spending.

DESIGN: A four group comparative analysis of longitudinal data from September 2013 thru December 2019.

SETTING: NHs in the interventions of both Phases 1 (2012-2016) and 2 (2016-2020) of MOQI (n=16) in the St. Louis area; matched comparations in the same counties as MOQI NHs (n=27); selected Phase 2 payment intervention NHs in Missouri (n=24); NHs in the remainder of the state (n=406).

PARTICIPANTS: NHs in Missouri Intervention: Phase 1 of The Missouri Quality Initiative (MOQI), a Centers for Medicare and Medicaid (CMS) Innovations Center funded research initiative, was a multifaceted intervention in NHs in the Midwest, which embedded full-time APRNs in participating NHs to reduce hospitalizations and improve care of NH residents. Phase 2 extended the MOQI intervention in the original intervention NHs and added a CMS designed Payment Intervention; Phase 2 added a second group of NHs to receive the Payment. Intervention Only.

MEASUREMENTS: Eight QMs selected by CMS for the Initiative were falls, pressure ulcers, urinary tract infections, indwelling catheters, restraint use, activities of daily living, weight loss, and antipsychotic medication use. For each of the monthly QMs (2013 thru 2019) an unobserved components model (UCM) was fitted for comparison of groups.

RESULTS: The analysis of QMs reveals that that the MOQI Intervention + Payment group (group with the embedded APRNs) out-performed all comparison groups: matched comparison with neither intervention, Payment Intervention only, and remainder of the state.

CONCLUSION: These results confirm the QM analyses of Phase 1, that MOQI NHs with full-time APRNs are effective to improve quality of care.

Rantz, M., Petroski, G.F., Popejoy, L.L., Vogelsmeier, A.A., Canada, K.E., Galambos, C.L., Alexander, G.L., & Crecelius, C. (2021). Longitudinal impact of APRNs on nursing home quality measures in the Missouri Quality Initiative. Journal of Nutrition, Health, & Aging, 25, 1124–1130.

Read More

Eleven nursing homes, that participated in the Missouri Quality Initiative (MOQI) reduced potentially preventable hospitalizations for short- and long-stay residents by 58%, which saved payers more than $32 million from 2014 through 2019. The reduction in potentially preventable hospitalizations also improved revenue for the 11 nursing homes.

Hacker, T. (September 9, 2021). “Missouri Nursing Homes Participating In A Quality Initiative Cut Potentially Preventable Hospitalizations By 58%, Which Saved Payers $32 Million Over Six Years”, OPEN MINDS – Weekly News Wire, openminds.com/market-intelligence/news/.

Read More

Researchers say employing more fully trained staff members can also save lives and money.

Maynard, C. (August 17, 2021). “Detecting illnesses early in nursing homes helps prevent hospitalizations, study finds”, Consumer Affairs.

Read More

Skilled nursing operators can reduce costs and increase revenues, potentially by millions, by having staff members focus on detecting illnesses earlier to avoid hospitalization, according to a new study.

Brown, D. (August 18, 2021). “Nursing homes recapture $32 million after reducing hospitalizations: study”, McKnight’s Long-Term Care News.

Read More

MU study examines financial, clinical benefits of early illness detection.

Click HERE for the press release!

Consiglio, B. (August 17, 2021). “Missouri nursing homes saved $32 million by reducing avoidable hospitalizations”, MU News Bureau.

Read More

The MOQI seeks to reduce avoidable hospitalization among nursing home residents by placing an advanced practice registered nurse (APRN) within the care team with the goal of early identification of resident decline. In addition to the APRN, the MOQI involves nursing home teams focused on use of tools to better detect acute changes in resident status, smoother transitions between hospitals and nursing homes, end-of-life care, and use of health information technology to facilitate communication with peers. As a result of the innovation, resident hospitalizations declined. Funding for this innovation was originally provided to the University of Missouri via a Centers for Medicare & Medicaid Services (CMS) demonstration grant. Given the success of the innovation, when the grant funding expired, the model and lessons learned from the initiative were transferred to NewPath Health Solutions, LLC, to ensure continued dissemination.

Read the article HERE!!

Read More

Objectives: 1) Explain the financial benefit of potential revenue recapture (PRR) for non-billable days due to hospitalizations of nursing home (NH) residents using a six-year longitudinal analysis of 11 of 16 NHs participating in the Missouri Quality Initiative (MOQI); and 2) Discuss the work-flow benefits of early detection of changes in health status using qualitative data from all MOQI homes.

Design: A CMS funded demonstration project with full-time advanced practice registered nurses (APRN) and operations support team focused on reducing avoidable hospitalizations for long stay NH residents (2012–2020).

Setting and Participants: Setting was a sample of 11 of 16 US NHs participating in the CMS project. The NHs ranged in size between 121 and 321 beds located in urban and rural areas in one midwestern geographic region.

Methods: Financial and occupancy data were analyzed using descriptive methods. Data are readily available from most NH financial systems and include information about short and long stay residents to calculate non-billable days due to hospitalizations. Average hospital transfer rates per 1000 resident days were used. Qualitative data collected in MOQI informed the work-flow benefits analysis.

Results: There was over $2.6 million in actual revenue recapture due to hospitalization of long stay residents in the 11 participating NHs during five years, 2015–2019, with 2014 as baseline; savings to payers was more than $31 million during those same years. The PRR for both short and long stay residents combined totaled $32.5 million for six years (2014–2019); for each NH this ranged from $590,000 to over $5 million. On average, an additional $500,000 of revenue each year per 200 beds could have been recaptured by further reducing hospitalizations. Workflow improved for nurses and nursing assistants using INTERACT and focusing on early detection of health changes.

Conclusions: Reducing avoidable hospitalizations reduces costs to payers and increases revenue by substantially recapturing revenue lost each day of hospitalization.

Implications: Focusing nursing staff on early illness recognition and management of condition changes within NHs has benefits for residents as the stress of hospital transfer and resulting functional decline is avoided. Nurses and nursing assistants benefit from workflow improvements by focusing on early illness detection, managing most condition changes within NHs. NHs benefit financially from increased revenue by reducing empty bed days.

Rantz, M., Vogelsmeier, A., Popejoy, L., Canada, K., Galambos, C., Crecelius, C., & Alexander, G.L. (2021). Financial and work-flow benefits of reducing avoidable hospitalizations of nursing home residents. Journal of Nutrition, Health, & Aging, 25, 971–978.

Read More

Social network analysis (SNA) uses quantitative methods to analyze relationships between people. In the current study, SNA was applied in two nursing homes (NHs) to describe how health care teams interact via text messages. Two data sources were used: (a) a Qualtrics® survey completed by advanced practice RNs containing resident transfer data, and (b) text messages from a secure platform called Mediprocity™. SNA software was used to generate a visual representation of the social networks and calculate quantitative measures of network structure, including density, clustering coefficient, hierarchy, and centralization. Differences were found in the low and high transfer rate NHs for all SNA measures. Staff in the NH with low transfer rate had greater decision-making interactions, higher information exchange rates, and more individuals communicating with each other compared to the high transfer rate NH. SNA can be applied to examine communication patterns found in text messages occurring around the time of NH resident transfers.

Powell, K.R., Popescu, M., & Alexander, G.L. (2021). Examining social networks in text messages about nursing home resident health status. Journal of Gerontological Nursing, 47(7), 16-22.

Read More