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Long Term Care Medicine-2010


B34 - The CMS 5-Star Rating System is a Bumpy Road: How to Understand, Improve and Defend Your Quality Measure Score


Mar 12, 2010 11:00am ‐ Mar 12, 2010 12:00pm

Standard: $24.00

Description

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates
this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of 1 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
The CMS Quality Measures (QM) are part of a complex measurement system used to gauge the quality of care provided by nursing homes, but their use doesn't stop there. The QMs directly affect survey results, reimbursement levels and the cost of liability insurance. A subset of QMs are used to generate a CMS 5-star Quality Rating that is publicly reported to help consumers select a nursing home. A key question is whether the QMs are up to the challenge of fairly ranking nursing homes? This session will help medical director's understand how the QMs factor into the Overall 5-Star Ratings and will help to explain facility 5-Star Quality Rating to staff, residents, families, boards and the public in the context of resident populations. The speaker was selected by CMS to participate in a small stakeholder group to review and make recommendations to improve the accuracy of the Five Star Quality Rating system and will report on the progress of the dialogue and status of proposed improvements to the rating system.

Learning Objectives(s):

  • Recognize the importance of the QM/QIs to your facility and the value of educating more than just nursing staff about QM/QIs.
  • Evaluate and explain your facility 5-Star Quality Measure rating to staff, residents, families and the public in the context of your resident population.
  • Discuss the status of a small stakeholder group convened by CMS to conduct ongoing discussions related to potential short-term and long term improvements to the 5-Star Rating System.
  • Discuss a proactive facility-wide process for integrating QM data into ongoing QA processes that can help minimize future adverse outcomes, maximize reimbursement and make optimal use of scarce staffing resources.


Speakers(s):
Christie L. Teigland, PhD, MA

Disclosure(s):
Christie L. Teigland, PhD, MA has no disclosures to report.

References:
For the past 12 years Dr. Teigland has specialized in long term care quality measurement research. She has served as Principal Investigator for 8 large outcome studies, including a 4-year patient safety project funded by DHHS (AHRQ) that developed computerized predictive risk tools. In 2005, DHHS (HRSA) awarded a large nurse education grant to develop on-line education modules to provide much needed training in the new "nursing informatics"; skills now essential to support complex clinical decision making, including how to use computerized patient data to improve resident outcomes and quality of care. In 2006, Dr. Teigland received a grant from the Alzheimer';s Association to develop new quality of life measures for dementia residents, and in 2007 received a grant from the NYS Dementia Grants program to use technology to improve pain assessment in elderly residents with dementia. Christie is lead developer of a clinical informatics software designed to improve outcomes and quality of care and serves on several CMS expert panels including the MDS 3.0 Validation Panel, stakeholder group convened to discuss potential improvements to the 5-Star Rating System, RAND/Harvard panel to identify national patient safety indicators, and AHRQ panel to develop a national patient safety culture survey for long term care.

Speaker(s):

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