January 17, 2019

Nursing Facility Quality Review Begins January 2019

HHSC has contracted with The University of Texas at Austin School of Nursing Center for Excellence in Aging Services and Long-Term Care for the NFQR 2019 data collection. Nurse quality reviewers from the Center will visit 400 Medicaid-certified nursing facilities across the state, using a structured survey tool to collect data. The NFQR will also expand to include residents in a random sample of 35 assisted living facilities. The onsite reviews will run from January to December 2019.

During the on-site visits, the nurse quality reviewers will review the medical records of residents selected for the survey, and evaluate the quality of care provided in several clinical areas, such as continence promotion, and pain and pressure injuries. The reviewers will interview the residents to determine their satisfaction with the care they receive and with their quality of life in the facility.

The nurse quality reviewers represent HHSC under the contract with the Center. The purpose of their visit is data collection only. Your facility is required to provide the nurse reviewers access to the resident records and to the residents themselves. You will be notified in advance of any visit scheduled to your facility and will be provided with the name of the nurse reviewer as well as a list of the documents required.

For detailed information about how the NFQR works, please visit the nursing facility quality review page.

Email questions about the NFQR process to QMP@hhsc.state.tx.us. If you have questions about scheduling of on-site visits or about a nurse reviewer, contact Dr. Tracie Harrison, 512-471-9085

New CMP Project Coming Soon – Providing Advanced Practice Nurse Services in NFs

HHSC has received Civil Monetary Penalty funds for the Providing Advanced Practice Registered Nurse Services in Nursing Facilities program and is contracting with The University of Texas at Austin School of Nursing Center for Excellence in Aging Services and Long-Term Care to administer the program.

APRNs will be placed in NFs selected by HHSC. During the first year of the program, the APRN salaries will be paid through CMP funds when the Center will work with the NFs to establish billing systems to sustain the program in and through the second year. The goal of the program is to determine if employment of full-time, salaried APRNs, as part of an NF care team, reduces the rates of adverse events and improves the quality of care for NF residents.

Nominations open in January 2019 and are limited to facilities in Travis county and the surrounding counties (Region 7 and northern areas of Region 8). NFs will participate in a progressive screening process with HHSC that will include interviews with facility leadership and other activities.

More information about the nomination process and specific requirements for participation will be released soon.

Questions can be emailed to QMP@hhsc.state.tx.us.

Texas OASIS Dementia Care Training for HCBS – Update Your Bookmarks

The link to the on-line Texas Oasis HCBS Dementia Training Academy course has changed. Please update your bookmarks.

This web-based course has the same information taught in the regional trainings, including:

  • Self-paced lessons for all levels of experience
  • Warm-up exercises at the beginning of each lesson
  • Wrap-up sections at the end of each lesson
  • Information to satisfy legislative staffing requirements for facilities that provide care to people with Alzheimer ’s disease and dementia
  • Innovative methods to care for people with Alzheimer’s disease and dementia, enabling them to remain in the community

Email questions to QMP@hhsc.state.tx.us.

Flu Season - Influenza is Increasing Across the State. Are You Prepared?

The flu is a highly contagious respiratory illness caused by influenza viruses. It can be mild to severe, and can result in serious outcomes such as hospitalization or death. Older adults, young children and people with compromised immune systems are at a higher risk for serious complications from flu. Now is the time to review your plan for preventing an outbreak in your facility.

Health care workers can transmit the flu directly to residents, even before they exhibit symptoms. The best way to prevent the flu is for you, your residents and all employees to get vaccinated each year.

It’s best to get flu shots between September and November, before the flu season starts. This gives your body plenty of time to respond and become fully protected. However, it’s better to receive a flu shot in January than not at all.

For a summary of current immunization recommendations and available vaccines, visit the CDC website.
Visit the CDC website for specific recommendations on managing an outbreak.
Below are a few things to consider:

  • For facilities experiencing an outbreak, containing the flu begins with infection control. Have adequate supplies on hand for workers, such as soap, hand sanitizer with at least 60% alcohol content, tissues, trash baskets, disposable facemasks and extra disposable gloves.
  • Ensure high touch surfaces are cleaned and disinfected frequently.
  • All residents with suspected or confirmed flu should receive antiviral treatment immediately. Antiviral drugs work best when they are started within two days of getting sick. However, starting them later can still be beneficial, especially if the sick person is at high risk of serious flu complications or is in the hospital with a more severe illness.
  • During an outbreak, antiviral treatment is recommended for residents who are not ill, regardless of their vaccination status. More information about the use of antivirals is available from the CDC website.
  • Residents with symptoms should remain in their own rooms as much as possible. The facility may consider limiting large group activities, if the outbreak is widespread across units.
  • Monitor staff absenteeism due to respiratory symptoms. Those with symptoms should be excluded from work for 24 hours or more after fever is normal.
  • Exclude visitation from people who are ill.
  • Staff should use personal protective equipment and conduct hand hygiene frequently.

Per Title 25, Part 1, Chapter 97 in the Texas Administrative Code all outbreaks must be reported to your local health department, regardless of your facility type. Contact information for your local health department, can be found on the following DSHS website.

  • Nursing facilities have additional reporting requirements per 40 TAC §19.1923(b)(1)-(2). More information is available on the HHSC website.

Questions can be emailed to QMP@hhsc.state.tx.us.

Medicare Learning Network Dementia Care & Psychotropic Medication Tracking Tool Call

During this call, participants will:

  • Gain insight on the free, publicly traded Dementia Care & Psychotropic Medication Tracking Tool which provides an organized approach to tracking preference-based care and psychotropic medication use among residents living with dementia.
  • Learn about a recently released Nursing Home Staff Competency Assessment toolkit.
  • Receive CMS updates on the Phase 3 Requirements for Participation from the Reform of Requirements for Long-Term Care Facilities final rule, and the progress of the National Partnership to Improve Dementia Care in Nursing Homes.
  • A question and answer session will follow the presentations.

Fall and Winter 2019 - Quality Assurance, Performance Improvement and Resident Safety Training

This free two-day training will be offered in eight regional locations across the state, beginning in the fall of 2019. It will provide NF staff with the knowledge and skills required to develop, initiate and evaluate different approaches to quality assurance, performance improvement and resident safety.

Topics include:

  • Definitions of quality
  • Regulations and standards related to quality management in long-term care
  • Quality management tools
  • Patient safety and infection control
  • Change and organizational culture
  • Evidence-based practices, and integrated approaches to quality programs

After completing the training, participants will be able to initiate new quality processes in their facility, or build upon current quality processes, and teach the curriculum to other staff members. HHS will also offer an in-depth evaluation of new or existing NF quality processes.

More information will be coming soon. Questions can be emailed to QMP@hhsc.state.tx.us.

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