Quality Virtual Conference Recording Bundle

Quality Measures Unveiled – A Crash Course | Stacy Grondel RN, BSN, RAC-MT, CMAC, QCP, Brickyard Healthcare

Understanding the basics of Quality Measures (QMs) can be a tricky road to navigate. During this session, the speaker will take you on a crash course of the fundamentals of QMs, review how the data is collected, and cover what is impacted by the QMs. These core concepts are essential for healthcare professionals seeking to deepen their understanding of QMs and improve quality outcomes. Following this session, you’ll be able to:

• Understand basic QM key concepts and their purpose
• Identify basic QM data collection and reporting
• Recognize the impact of QMs in nursing homes

MDS Coding as It Impacts the Quality Measures | Carol Maher, RN, GERO-BC, RAC-MT, RAC-MTA, CPC, Hansen Hunter & Co

There are five Quality Measures (QMs) that are often impacted by MDS coding errors: Falls with Major Injury (LS), Urinary Tract Infection (LS), Significant Weight Loss (LS), Antipsychotic Med Use (SS), and Pressure Ulcer Worsening (SS). In this session, the speaker will briefly explain how MDS assessments trigger QMs, provide a review of the five QMs that are impacted by MDS coding, discuss the difference between look-back scan measures and other measures, explain the differences between percentages and percentiles, and highlight the types of MDSs that can trigger QMs. Following this session, you’ll be able to:

• Recognize the most common coding errors impacting the Significant Weight Loss measure
• Identify the two criteria that must be met before coding Urinary Tract Infection
• Recall the four “major” injuries that impact the Falls with Major Injury QM
• Understand the requirements that must be met to code the diagnosis of Schizophrenia and how the diagnosis impacts the Antipsychotic Med Use QM
• Review the many instructions regarding “present on admission” for coding pressure ulcers that impact the Short Stay Pressure Ulcer Worsening QM

The Role of Diagnosis and ICD-10-CM Coding in Quality Measures | Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, AAPACN

Resident diagnoses and ICD-10-CM coding play a pivotal role in quality measurement and reporting for skilled nursing facilities (SNFs). In this session, you will explore how ICD-10-CM codes affect SNF Quality Measures (QMs), including the methodologies for triggering measures and calculation of exclusions and risk adjustment. Following this session, you’ll be able to:

• Understand the relationship between ICD-10-CM coding and QMs
• Refine ICD-10-CM coding practices
• Identify specific diagnoses that impact QMs

Five-Star – A Focus on the Quality Measure Domain | Tammy Cassidy RN, BSN, LNHA, RAC-MT, Engage Consulting

Are your stars in alignment with the quality of care your community provides? Understanding recent changes to the Quality Measures (QMs), and definitions of each element, is critical to the success of any organization. The QMs are not only a major component of the Five-Star Quality Rating System, but they also impact state and federal survey samples, influence participation in managed care programs and preferred provider listings, and drive how consumers view communities. This session will guide you through the QM domain and will detail the qualifications and impact of each measure. You will learn best practices and strategies to ensure the information reported to the Centers for Medicare and Medicaid Services (CMS) accurately represents the residents and the care they receive. Following this session, you’ll be able to:

• Understand how the QMs impact the overall Five-Star score
• Discuss specific ways to ensure accuracy of the QMs
• Identify common QM errors and ways to reduce their occurrence

Discharge Function Score | Judy Wilhide Brandt, RN, BA, RAC-MTA, RAC-MT, DNS-CT, QCP, CPC, Wilhide Consulting

Learn how one of the most important Quality Measures (QMs) is calculated — the Discharge Function Score measure. During this session, the speaker will explain terms like imputation, logistical regression, and use of covariates in plain language, as well as walk you through how the measure is constructed and what it means. You will come away with the knowledge to explain this measure to your colleagues and have a clear understanding of how to approach improvement efforts. Following this session, you’ll be able to:

• Understand the calculation and risk adjustments used in the MDS-based QM and the Discharge Function score
• Identify the QM programs for which this measure has been approved and how it will be used
• Know important risk adjustment terms, their meaning, and how they are used in this measure: statistical imputation, specific covariates, logistical regression
• Recognize what this QM measures and why it’s important

Growing Together with the SNF QRP | Joel VanEaton, BSN, RN, RAC-CT, RAC-CTA, MT, MTA, Broad River Rehab

The Skilled Nursing Facility Quality Reporting Program (SNF QRP) continues to grow in importance and influence on SNFs. With the fiscal year (FY) 2024 and 2025 final rules firmly establishing SNF QRP expansion, providers should be aware of the scope and variety of measures with reporting requirements that could impact their Prospective Payment System (PPS) payment rates. This session will help you gain a deeper understanding of the SNF QRP, measure specifications, reporting requirements, and the validation process. Following this session, you’ll be able to:

• Describe the SNF QRP and recognize the SNF QRP measures
• Appreciate the complexity of the MDS-based technical specifications
• Identify the SNF QRP reporting requirements
• Understand the SNF QRP Validation Requirement
• Apply an understanding of the SNF QRP to daily practice

Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Expansion | Robin L. Hillier, CPA, LNHA, RAC-MT, RAC-CTA, RLH Consulting

The Centers for Medicare and Medicaid Services (CMS) Value-Based Purchasing (VBP) program is expanding over the next several years to include four new measures, replace the current single rehospitalization measure used, and introduce a health equity adjustment to the scoring methodology that generates the annual incentive multiplier that adjusts each center’s Medicare rates. In this session, you will review the changes and implementation timeline so facility staff can be prepared. Following this session, you’ll be able to:

• List the specific measures that will be used in SNF VBP in the next four years
• Define the health equity adjustment to be incorporated into the SNF VBP
• Describe CMS’s plans to validate claims, the Payroll Based Journal reporting, and MDS coding that generate SNF VBP measures

VBP Road Map: Clear Directions to Health Equity Adjustment | Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, AAPACN

Starting in fiscal year (FY) 2027, the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program will change to a variable distribution to allow for the health equity adjustment (HEA). During this session, the speaker will map out how dual eligibility status and Quality Measure (QM) performance will be used to determine bonus points and potentially a higher VBP incentive payment. Following this session, you’ll be able to:

• Identify QMs that will be used in the HEA
• Calculate the underserved multiplier based on the proportion of residents with dual eligibility status
• Determine the HEA bonus points based on facility case-study performances

Discharge Planning: A Care Plan for Home  | Maureen McCarthy, RN, BS, RAC-MT, QCP-MT, DNS-MT, RAC-MTA, Celtic Consulting

Get ready to elevate the discharge planning process! Comprehensive discharge plans have been recognized to improve resident outcomes post-discharge, reducing skilled nursing facility (SNF) readmission measures and optimizing outcomes in quality programs. This session will dive into the essential regulations that guide discharge planning, explore the critical impacts of the SNF Value-Based Purchasing (VBP) program and SNF Quality Reporting Program (QRP). Learn how to transform the team’s approach from working in silos to a collaborative, unified effort that drives better resident outcomes and compliance. Following this session, you’ll be able to:

• Build a comprehensive discharge plan, including considerations for community services, transportation, health literacy, and language
• Utilize an interdisciplinary approach during the discharge planning process
• Understand the impact on SNF VBP and SNF QRP

QAPI in the SNF: Using QM Data in Your QAPI Program | Beckie Dow, RN, RAC-MT, CHC, CPC-A, Maine Veterans’ Homes

The Quality Assurance and Performance Improvement (QAPI) team has a unique perspective on opportunities for improvement in the skilled nursing facility (SNF). When comprised of the right members and when focused on the right goals, this team is unstoppable! During this session, you will learn the Five Elements of a QAPI program with a focus on how the team can use their Quality Measure (QM) data to drive QAPI initiatives and improve the resident’s experience of care. Following this session, you’ll be able to:

• Name the Five Elements of QAPI
• Identify tools to guide the development of a QAPI program
• Recognize key personnel to include in Performance Improvement Projects (PIPs)
• Understand how to use QM data, as well as other sources of data already collected, to evaluate progress toward goals and when to set new goals