Provider Evaluation

Provider Evaluation

HAS 315

Provider Evaluation

In today’s health care society, there are a number of acute care and long-term care facilities that face daily competition within their region. Each health care facility is constantly looking for ways to improve the quality of health care they provide to each patient. They are also looking for ways to beat out the local competition. Some health care facilities struggle to keep in compliance in terms of quality of care and safety measures. Sometimes all they need is a little bit of guidance on ways to improve the quality of care they give to their patients. In this paper, the health care provider that will be discussed is The Grand Rehabilitation and Nursing At Rome. Measures of safety, quality and evidence-informed health care will be discussed. Recommendations for improvements will also be detailed.

The Grand Rehabilitation and Nursing At Rome is long-term care facility located in Rome, NY. They have several nursing homes under The Grand brand. They are a 160 licensed bed facility that houses both short-term rehabilitation residents and long-term care residents. Each year quality and safety are measured by a health inspection from the New York State Department of Health and is measured at least once a year. (https://profiles.health.ny.gov/nursing_home/pages/about_performance). The Grand had a rating of three out of five stars for quality of care which is ranked at average in their 2018 inspection. Two nursing homes in the region that a comparison was done with are Trustees of Eastern Star Hall and Home of NYS which has 86 licensed beds ranked at four out of five stars for quality of care which is above average, and Betsy Ross Rehabilitation Center, INC which has 120 licensed beds ranked at four out of five stars for quality of care. In terms of quality measures, The Grand is a little below level.

(https://www.medicare.gov/NursingHomeCompare/compare.html#cmprTab=0&cmprID=335589%2C335727%2C335497&cmprDist=0.5%2C1.1%2C8.7&loc=13440&lat=43.2212399&lng=-75.4577775https://www.medicare.gov/NursingHomeCompare/compare.html#cmprTab=0&cmprID=335589%2C335727%2C335497&cmprDist=0.5%2C1.1%2C8.7&loc=13440&lat=43.2212399&lng=-75.4577775).

A goal of any health care facility is to have little to no hospital readmissions after health care has been received. The lower the number is means that all necessary assessments were done on each patient to take care of their illness the first time around. It also ensures that there will be lower costs for not only the patient but for the health care facility as well. For short-term residents The Grand had a hospital readmission rate of 16.6 percent after a nursing home admission. Eastern Star had a hospital readmission rate of 16.4 percent. Betsy Ross had a readmission rate of 19.1 percent. For long-term residents The Grand had a hospital readmission rate of 1.74 percent. Eastern Star had a rate of 3.31 percent. Betsy Ross had a rate of 0.85 percent. These numbers were much lower than the readmission rate of those who were only in each health care facility for a short period of time. (https://www.medicare.gov/NursingHomeCompare/profile.html#profTab=4&ID=335589&cmprTab=4&measureID=S_004_01_PPR_PD_COMP_PERF&cmprID=335589%2C335727%2C335497&cmprDist=0.5%2C1.1%2C8.7&loc=13440&lat=43.2212399&lng=-75.4577775%20class%3Dhttps://www.medicare.gov/NursingHomeCompare/profile.html#profTab=4&ID=335589&cmprTab=4&measureID=S_004_01_PPR_PD_COMP_PERF&cmprID=335589%2C335727%2C335497&cmprDist=0.5%2C1.1%2C8.7&loc=13440&lat=43.2212399&lng=-75.4577775%20class%3D).

In order to ensure patient safety, the department of health focuses on rate of infection and also the rate of preventative care such as flu shots. The rate of bed sores, ulcers and infections that were new or worsened for The Grand for short term residents was 1.1 percent. Eastern Star had a rate of 1.5 percent. Betsy Ross had a rate of 2.5 percent. For long term residents the rate of ulcers, infections and bed sores that were new or worsened for The Grand was 8.5 percent. Eastern Star was 5.4 percent. Betsy Ross was 11.0 percent. In terms safety in regard to bed sores, ulcers and infections, the rates were much higher for long term residents than they were for short term residents. This could be because short term residents are generally independent, so they do not need assistance in repositioning. In preventative care measures The Grand had a rate of 71.7 percent of short-term residents who opted to receive the seasonal flu shot. Eastern Star had a rate of 95.7 percent for short- term residents. Betsy Ross had a rate of 89.4 percent for short- term residents. For the long-term residents, The Grand had a rate of 97.6 percent who opted to receive the flu shot. Eastern Star had a rate of 99.2 percent. Betsy Ross had a rate of 99.5 percent. By each nursing home providing residents with their vaccines, it lowered their chances of being hospitalized for the flu or pneumonia. (https://www.medicare.gov/NursingHomeCompare/profile.html#profTab=4&ID=335589&cmprTab=4&measureID=S_004_01_PPR_PD_COMP_PfERF&cmprID=335589%2C335727%2C335497&cmprDist=0.5%2C1.1%2C8.7&loc=13440&lat=43.2212399&lng=-75.4577775%20class%3Dhttps://www.medicare.gov/NursingHomeCompare/profile.html#profTab=4&ID=335589&cmprTab=4&measureID=S_004_01_PPR_PD_COMP_PfERF&cmprID=335589%2C335727%2C335497&cmprDist=0.5%2C1.1%2C8.7&loc=13440&lat=43.2212399&lng=-75.4577775%20class%3D).

Based on the reports of The Grand as of where they stand right now the rate of them being a contender to obtain population health contracts on a scale of 1 to 5, would be a one. Although they had some decent rates when it came to preventative care measures such as the flu shot, they lacked in areas such as bed sores, infections, skin ulcers just for an example. The overall rating for The Grand was 1 out of 5 which is much below average. The report results would also make them an undesirable member of a health care organization. In order to be a contender for obtaining population health contracts or to be a desired member of a health care organization, overall quality of care needs to be at above average or higher. Most people would not want to be a resident of a health care facility where the quality of care they receive is below average. Patients want to receive the quality of health care that they are spending their money on. When a person goes to a health care facility, they want to ensure that their illness will be resolved the first time. They also want to make sure that they aren’t leaving with an illness they did not come in there with.

Based on the measures that were reported, The Grand needs to address a few areas. The first area they need to focus on would be patient safety in regard to long term residents who have new or worsened bed sores or ulcers. They need to make sure that it is charted in each patient’s plan of care that they are to be repositioned every two hours whether they are in bed or in a chair. This will prevent the patients from getting bed sores. Nurses also need to make sure that they are properly cleaning and dressing the patient’s bed sores so that they heal properly. The next area The Grand should focus on would be the hospital readmission rates of those who are in the facility short term. The lower the rate, the lower the costs for the nursing home and the patients. They should focus on fully assessing the patients, diagnosing the illness and beginning treatment as soon as possible.

In order for The Grand to improve on their outcomes, they should make sure that each patient health care plan is accurate and up to date. This will ensure that each patient is receiving the proper care. Patients receiving adequate care also lowers the number of hospital admissions and readmissions. This will help the facility with keeping costs low. They also need to make sure that they have the proper staff to patient ratio. When you are short staffed things tend to get missed and missing parts of patient care could be the difference between life and death of the patient. Improving upon staff to patient ratios will increase the quality of care each patient receives, it will also increase the overall rating of the facility which will in turn make them a desirable member of a system of providers. Word of mouth is the best form of advertisement. If the patients have a bad experience, they will make it known. The Grand should always make sure that each patient whether short term or long term has the best experience possible. This will keep loyal patients and also bring in new patients which will increase revenue for the facility which may allow them to branch out further into the health care community beyond nursing home facilities.

Resource

https://www.medicare.gov/NursingHomeCompare/compare.html#cmprTab=4&cmprID=335589%2C335727%2C335497&cmprDist=0.5%2C1.1%2C8.7&loc=13440&lat=43.2212399&lng=-75.4577775https://www.medicare.gov/NursingHomeCompare/compare.html#cmprTab=4&cmprID=335589%2C335727%2C335497&cmprDist=0.5%2C1.1%2C8.7&loc=13440&lat=43.2212399&lng=-75.4577775

https://profiles.health.ny.gov/nursing_home/pages/about_performance