Question

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 1North, 2 North, 1 East, 2 East, 1 West, and 2 West.

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.

1.Review the quality indicators and select two of the quality measures.

Quality Measures:

*Percent of Residents Who Have Depressive Symptoms (Long Stay)

*Percent of Long-Stay Residents Who Received An Antipsychotic Medication

2.Create a proposal to compare and contrast the MDS 3.0 findings with the information abstracted after the resident’s discharge.

a.Determine the number of resident cases to be used in the study.

b. Identify the codes abstracted from the residents’ health records related to each selected quality measure.

c. Identify data that is not currently abstracted from the health records related to each selected quality measure.

d. Outline the end of study report format.

Answer 1

1)Quality indicators (in healthcare) : it is standardized evidence based measures of health care quality that can be used with readily available hospital inpatient adminstrative data to measure and track clinical performance and outcomes, quality indicators (nursing) these indicators are said to reflect three aspects that are determined to be nursing sensitive because they depend on the quality or quality of nursing care a) residents. a)quality measures: percentage of residents who have depressive symptoms(long stay): the quality measures is calculated: numerator : those residents who have had symptoms of depression during the 2 week period procedding the assessment reference date( or triggers, those 2 conditions where the target assessment must meet either 1) little interest or pleasure doing things half or more of the days over the past 2 weeks or2) feeling down depressed or hopelesshalf or more of the days over the past 2 weeks) denominator: all long stay reisdents with a selected target assessment except those with exclusions. b)percent of long stay residents who received an antipsychotic medications:this measures reports the percentage of long stay residents who are receiving antipsychotic drugs in the target period. measure specification: numerator: long stay residents with a slelected target assessement where the followingcondition is true : antipsychotic medications received this conditions is defeined as 1) for assessment with target dates on or before, 2) for assessments with targets dates on or after , Denominators: long stay residents with a selected target assessment except those with exclusion. 2)a)the number of reisdent samples selected ( with in 6 months for short stay)will be placed in the short or long stay samples and that the 2 smaples are mutually exclusive, the discahrge assessment includes slinical items for quality montoring as well as discharge tracking information. b) codes are those values that correspond to the OBRA required and medicare required PPS assessment represented in items A0310A,A0310B,A0310C,A0310F of the MDS 3.0. given time is over to complete.