Long-Term Care Quality Matters
Prior to beginning work on this assignment, read the Section 2: Long Stay Quality Measures in the MDS 3.0 Quality Measures User’s Manual v8.0 (Links to an external site.).
The Sun Top Nursing Home is currently a 100-bed facility located in a two-story building. Due to demand, two additional two-story buildings will be opening within the next two years. When completed, the units will be 1 North, 2 North, 1 East, 2 East, 1 West, and 2 West.
The Centers for Medicare & Medicaid Services (CMS) implements quality initiatives to assure quality health care for Medicare beneficiaries through accountability and public disclosure. CMS uses quality measures in its various quality initiatives that include quality improvement, pay for reporting, and public reporting. Quality measures are tools that help us measure or quantify healthcare processes, outcomes, patient perceptions, and organizational structure and/or systems that are associated with the ability to provide high-quality health care and/or that relate to one or more quality goals for health care. These goals include effective, safe, efficient, patient-centered, equitable, and timely care.
Long Stay Quality Measures
- Percent of Residents Experiencing One or More Falls with Major Injury (Long Stay)
- Percent of Residents who Self-Report Moderate to Severe Pain (Long Stay)
- Percent of High-Risk Residents with Pressure Ulcers (Long Stay)
- Percent of Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine (Long Stay)
- Percent of Residents Assessed and Appropriately Given the Pneumococcal Vaccine (Long Stay)
- Percent of Residents with a Urinary Tract Infection (Long Stay)
- Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder (Long Stay)
- Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder (Long Stay)
- Percent of Residents Who Were Physically Restrained (Long Stay)
- Percent of Residents Whose Need for Help with Activities of Daily Living Has Increased (Long Stay)
- Percent of Residents Who Lose Too Much Weight (Long Stay)
- Percent of Residents Who Have Depressive Symptoms (Long Stay)
- Percent of Long-Stay Residents Who Received An Antipsychotic Medication. (RTI International, 2019)
The Chief Nursing Officer/Director of Quality Improvement is concerned that as the facility expands, the Centers for Medicare & Medicaid Services (CMS) Long Stay Quality Measures results will reflect negatively upon the facility. The quality of care of the facility is good, but documentation in the MDS 3.0 is often with errors or omissions. The Chief Nursing Officer requested assistance in comparing the MDS 3.0 documentation with information abstracted after the resident’s discharge in preparation to a new training initiative for the staff hiring anticipated with the building expansion. For this assignment,
- Review the quality indicators and select two of the quality measures.
- Create a proposal to compare and contrast the MDS 3.0 findings with the information abstracted after the resident’s discharge.
- Determine the number of resident cases to be used in the study.
- Identify the codes abstracted from the residents’ health records related to each selected quality measure.
- Identify data that is not currently abstracted from the health records related to each selected quality measure.
- Outline the end of study report format.
The Long-Term Care Quality Matters assignment
- Must be two to three double-spaced pages in length (not including title and reference pages) and formatted according to APA style as outlined in the University of Arizona Global Campus Writing Center’s APA Style (Links to an external site.) resource.
- Must include a separate title page with the following:
- Title of paper in bold font
- Space should appear between the title and the rest of the information on the title page.
- Student’s name
- Name of institution (The University of Arizona Global Campus)
- Course name and number
- Instructor’s name
- Due date
- Title of paper in bold font
For further assistance with the formatting and the title page, refer to APA Formatting for Word (Links to an external site.) resource.
- Must utilize academic voice. See the Academic Voice (Links to an external site.) resource for additional guidance.
- Must include an introduction and conclusion paragraph. Your introduction paragraph needs to end with a clear thesis statement that indicates the purpose of your paper.
- For assistance on writing Introductions & Conclusions (Links to an external site.) as well as Writing a Thesis Statement (Links to an external site.), refer to the University of Arizona Global Campus Writing Center resources.
- Must use at least two scholarly and/or credible sources in addition to the course text.
- The Scholarly, Peer-Reviewed, and Other Credible Sources (Links to an external site.) table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment.
- To assist you in completing the research required for this assignment, view this University of Arizona Global Campus Library Quick ‘n’ Dirty (Links to an external site.) tutorial, which introduces the University of Arizona Global Campus Library and the research process, and provides some library search tips.
- Must document any information used from sources in APA Style as outlined in the University of Arizona Global Campus Writing Center’s APA: Citing Within Your Paper (Links to an external site.) guide.
- Must include a separate references page that is formatted according to APA Style as outlined in the University of Arizona Global Campus Writing Center. See the APA: Formatting Your References List (Links to an external site.) resource in the University of Arizona Global Campus Writing Center for specifications.
Carefully review the Grading Rubric (Links to an external site.) for the criteria that will be used to evaluate your assignment.
Expert Solution Preview
Introduction:
Long-term care is an essential aspect of healthcare, providing services to individuals who require assistance with activities of daily living (ADL) due to chronic conditions or disabilities. Maintaining the quality of care in long-term care facilities is critical to ensuring the well-being of residents. In this assignment, we will review long stay quality measures implemented by the Centers for Medicare & Medicaid Services (CMS) and create a proposal to compare and contrast documentation in MDS 3.0 with information abstracted after a resident’s discharge.
Question:
Review the quality indicators and select two of the quality measures.
Answer:
The quality indicators implemented by CMS for long-stay residents include falls with major injury, self-reported moderate to severe pain, pressure ulcers among high-risk residents, seasonal influenza and pneumococcal vaccines, urinary tract infections, loss of bowel or bladder control among low-risk residents, catheter insertion, physical restraints, increased need for help with ADLs, weight loss, and depressive symptoms. For this assignment, we will select two quality measures: percent of residents experiencing one or more falls with major injury and percent of residents who self-report moderate to severe pain.
Question:
Create a proposal to compare and contrast the MDS 3.0 findings with the information abstracted after the resident’s discharge.
Answer:
To compare and contrast MDS 3.0 findings with information abstracted after a resident’s discharge, we propose conducting a retrospective chart review of all long-stay residents who were discharged from the facility in the past year. This review will be conducted by a trained nurse or physician assistant who will abstract relevant data points from the resident’s health records. We will use a structured data collection tool to ensure consistency in data collection.
The number of resident cases to be used in the study will be 50, with 25 cases for each of the quality measures. All long-stay residents who were discharged and met the quality measure criteria will be included in the study.
For falls with major injury, we will identify codes related to falls in the resident’s health record, including the date, location, and severity of the fall. We will also abstract data related to fall prevention strategies implemented by the facility, such as bed and chair alarms, and fall risk assessments completed by staff. We will compare this data with the MDS 3.0 documentation to identify any discrepancies or errors.
For self-reported moderate to severe pain, we will identify codes related to pain assessments in the resident’s health record, including the date, location, and severity of the pain. We will abstract data related to pain management strategies implemented by the facility, such as medication administration and non-pharmacological interventions. We will compare this data with the MDS 3.0 documentation to identify any discrepancies or errors.
The end of study report format will include an executive summary, methodology, results, discussion, and recommendations. The executive summary will provide an overview of the study and its findings. The methodology section will describe the data collection and analysis methods used in the study. The results section will present the study’s findings for each quality measure, including any discrepancies or errors identified between the MDS 3.0 documentation and information abstracted from the resident’s health records. The discussion section will interpret the study’s findings and offer recommendations to improve documentation and quality of care.
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