Over the last few years we have all become accustomed to the process of choosing which Quality Add-On Points we wanted our buildings to focus on for that year. In past years there were many categories to choose from. Now there are only a meager, 5 categories. Each category is equally weighted and worth 1 point, for a total of 5 points.

5 Quality Add-On Points for 2016

1. Preventable Hospital Readmissions:  Most facilities have already put processes in place to decrease hospital readmissions. If you have not yet done so, you should start as soon as possible. It is important that you are tracking hospital readmission in order to identify trends. The data used for this point will be coming directly from the hospitals. The best thing you can do is to educate your staff and attending physicians on what your specific facility can do in-house to prevent unnecessary hospital transfers.
2. Employee Retention: The employee retention point is very straight forward. If you are in the 75th percentile or higher you will receive this point. This year will be evaluated from July 1, 2015 to December 31, 2015 for the rate setting for July 1, 2016. The following years will include the previous calendar year from January 1 to December 31.
3. Antipsychotic Drug Use: In order to receive the point for this category you will need to be at or below the threshold that has been set for both long and short term residents. The current threshold has been set for the 25th percentile and will use data from the third quarter of 2015 for the 2016 rates.
4. Pressure Ulcers: In order to receive the point for this category you will need to be at or below the threshold that has been set for both long and short term residents. The current threshold has been set for the 25th percentile and will use data from the third quarter of 2015 for the 2016 rates.
5. The Preferences for Everyday Living Inventory (PELI) will be the only process point included in the calculation of your Skilled Nursing Facility (SNF) quality points. Your facility may choose which version they would prefer to use: the 10-page Mid-Level PELI or the 30-page Full PELI. Ohio Department of Medicaid (ODM) officials have stated “they expect all SNFs to meet the PELI measure.” Although ODM has not given specific direction on which version to use, it is possible for ODM to release more specifics in the future. Remember, this assessment needs to have been completed for all residents by 12/31/2015 in order to qualify for the 7/1/15 rate changes.

This data is already being collected for all five categories. If you have not already incorporated these measures into your Quality Assurance & Performance Improvement (QAPI) process, then you should not hesitate in doing so immediately. You need to manage these categories and not let them manage you!

For more information please contact Jennifer Leatherbarrow RN, BSN, RAC-CT, Clinical Consultant, at 216-593-7142 or via email at Jennifer.leatherbarrow@richterhc.com.