Quality healthcare services are important at all types of care facilities, but one of the top areas of concern for healthcare quality is in the skilled nursing facility (SNF). It is imperative to individuals that their loved ones receive attention and care at these facilities where healthcare practices are not always transparent or visible.
Quality improvement in nursing is about maintaining patient safety. To drive change in the nursing industry, CMS developed quality measures that score providers based on patient outcomes, rewarding providers that take the time to appropriately treat individual patient needs and steer clear of process-driven nursing traditions. Nursing facilities that do not comply with these quality measures may be fined by CMS.
With specific, quantifiable goals in mind, nursing facilities can measure their success and consequent growth as quality healthcare providers.
How is nursing quality measured?
In November 2002, CMS began the nationwide Nursing Home Quality Initiative (NHQI). The purposes of this initiative and its quality measures are as follows:
Make information regarding the current level of quality care given at a nursing facility publicly available
Facilitate discussion with nursing staff about quality of care and how to improve it
Provide hard data to aid in quality improvements
Skilled nursing home quality measures are based on routine resident assessment data gathered by the nursing facilities themselves. These measures take into consideration a resident’s physical and clinical conditions, as well as personal preferences and life care desires.
Skilled nursing quality measures are defined through two categories: short stay and long stay. Short stay quality measures are based on patients who stay in a nursing facility for 100 days or less, while long stay quality measures are based on patients who stay in a nursing facility for 101 days or more.
Which quality measures CMS chooses to hold provider facilities accountable for can change over time based on feedback and further industry research.
Skilled Nursing Facilities ranked by Net Patient Revenue and Quality Rating
Skilled Nursing Facility Name
Net Patient Revenue
Twin Fountains Home
The Plaza Rehabilitation & Nursing Center
Hebrew Home at Riverdale
Masonic Village at Elizabethtown Skilled Nursing
Boro Park Center
Cold Spring Hills Center for Nursing and Rehabilitation
Kings Harbor Multicare Center
Erickson Living - Greenspring Village Skilled Nursing
Upper East Side Rehabilitation and Nursing Center
Fig. 1 Data from the Definitive Healthcare Long Term Care database (accessed June 2020). Annual Medicare Data is from the Centers for Medicare and Medicaid Services (CMS) Medicare Standard Analytical Files (SAF). The most recent annual Medicare data is from calendar year 2018; 2019 data is scheduled to be released in fall 2020.
How can nursing quality be improved?
There are many different ways SNFs can improve care quality. Nurses can start by being aware of the most common avoidable conditions that regularly plague patients and reduce facility quality scores:
Another way nurses can improve patient safety is by taking extra precautions during patient handoffs. Clear communication when transferring essential information and patients between healthcare professional should always be prioritized.
Improved work conditions mean improved quality
A critical point to consider when discussing how to improve SNF care quality is nursing fatigue. Nurses tend to work long hours over consecutive shifts in an already demanding work environment. Facility administrators need to be mindful of the danger that comes with a fatigued nursing staff.
Not only has high turnover become standard for nursing jobs, patient safety also declines as staff become exhausted and burned out. Nursing workloads must be managed attentively and spread evenly among an appropriate number of staff members.
If you’re looking for more information on how to break into the mindset of a long-term care facility, watch this Definitive Healthcare webinar replay: Selling to Long-Term Care Facilities
In the webinar, you will learn about:
The current state of the healthcare market
The biggest challenges in selling to this complex and challenging marketplace
The relationships between long term care (SNF, HHA and Hospice) with other provider types