Skilled nursing facilities (SNFs), senior care facilities and long-term care facilities come in all shapes and sizes, but they all have a common goal: optimizing resident care and enhancing outcomes. Achieving this is no easy feat—it takes skill, planning, foresight and execution in many areas, including revenue cycle management, accounting and finance, Medicare compliance, EHR implementation and ongoing usage and more.

Then there’s clinical care, which resides at the heart of every long-term post-acute care (LTPAC) facility. Optimizing your facility’s clinical care function is essential—and in many cases, facilities simply don’t have the in-house infrastructure, expertise and resources to operate at their highest potential. Adding to the challenge, experienced clinical professionals are in high demand, which makes it increasingly difficult for LTPACs and other senior care providers to attract and retain qualified individuals.

In this regard, more and more LTPACs are turning to outside consultants for insights, expertise, training and customized solutions for a variety of clinical challenges.

Richter’s Clinical Consulting team has worked with skilled nursing and senior care facilities throughout the U.S. for more than 20 years. Our team includes registered nurses who have experience as minimum data set (MDS) coordinators, staff development trainers, former directors of nursing (DONs) and other SNF clinical leadership roles. So, what do LTPACs value most from a clinical consultant in terms of essential competencies, skills, services and resources? Through our work, we’ve identified five core competencies:

1. Assistance in achieving and maintaining regulatory compliance. As we’ve said in previous blogs, the only constant in the LTPAC realm is change. Regulations from multiple agencies and organizations continually evolve; technology never stands still; and resident needs are becoming more and more acute. Keeping current with it all is a daunting challenge; but regulatory compliance is absolutely essential. The consequences of non-compliance – audits, fines and more – are serious and have far-reaching implications on organizational well-being and resident care.

Accordingly, established and respected LTPAC clinical consultants continually review the latest regulatory issues to keep clients up to date on changes and best practices that impact operational efficiencies and outcomes. They also have the experience and know-how to develop customized solutions, along with policies and procedures tailored to a SNF facility’s unique needs.

2. Providing premier education and training. Today’s leading clinical consultants are themselves educated and trained on the latest regulations, as well as industry best practices. Moreover, they employ time-tested education and clinical compliance training regimens on areas that include:

• • MDS (best practice and basic education, work flow and CMI review)
  • Resident-centric care planning
  • Diagnosis management
  • Medicare documentation (including certification/recertification and skilled charting)

3. Orchestrating process review and design. As a SNF professional, you understand the vital importance that efficient and thorough processes play in streamlining clinical operations and optimizing resident care. Top LTPAC clinical consultants offer a depth and breadth of experience and expertise operationally—they can help your organization streamline current processes, or design new processes and clinical workflows around areas that include:

• • MDS and care plans
  • Antibiotic stewardship programs
  • Five-Star and Quality Measure improvement
  • Survey readiness
  • Risk assessments
  • And more

4. Implementing and optimizing your EHR solution. Your EHR solution should streamline reporting and management across your clinical and financial operation. Leading SNF clinical consultants are highly trained on major LTPAC EHR platforms and can provide assistance with database risk assessments, optimization, configuration, and end-user and “super-user” training.
   
   
5. Helping you achieve success through QAPI. QAPI is the coordinated application of two mutually-reinforcing aspects of a quality management system: Quality Assurance (QA) and Performance Improvement (PI).

Establishing and maintaining a strategic QAPI program can empower your LTPAC to achieve the next level of quality assurance and rectify issues throughout your facility without having to endure negative outcomes and/or survey citations. QAPI can guide your organization toward achieving high quality measures and positively impacting its Five-Star rating.

Accordingly, top clinical consultants are experts in QAPI and work with skilled nursing facility clients to provide education, technical assistance and support in the development of QAPI within their organization.

At Richter, we designed our QAPI consulting services to encompass the following:

• • An initial assessment designed to gauge your current Quality Assurance operations and establish program parameters and goals
  • Specialized training for selected staff
  • Development of a personalized QAPI toolkit, including resources for ongoing education, self-assessment tools, tracking and monitoring tools (e.g., dashboards) and job descriptions
  • Development of internal QAPI policies and procedures specific to your organization
  • Quarterly assessments, as well as strategic and tactical recommendations based on your organization’s progress to date

The Intangible Qualities of LTPAC Clinical Consultants That Make the Difference

Beyond the experience, capabilities and resources that clinical consultants offer, there are three essential intangible qualities that you should look for when considering a consultant for your facility:

1. Trust. Successful clinical consultants should instill confidence and trust by virtue of their experience, demeanor and personal qualities.
2. A track record of results. Highly capable consultants have tangibly moved the needle for clients in a variety of LTPAC settings. When evaluating them, be up front in asking about their work on different project scopes, and the results they achieved.
3. A willingness to invest in relationship building. Yes, your clinical consultants should be laser-focused on addressing the defined work scope; but they should bring a strategic mind-set to the table, be naturally inquisitive, ask questions that give insight on additional areas of potential improvement and show genuine interest in growing the relationship over time.
4. A valued part of your team