Six years ago we laid out a bold plan to improve the quality of care in our long term and post-acute care centers and communities. We weren’t told to launch this effort. We didn’t wait for an act from Congress or a CMS directive. We took the initiative. We set our own goals and charted our own course to show measurable, sustained advances in three years. We did just that but did not stop there. 

In 2015, we set the bar even higher for excellence and success. We challenged you to be even better by reaching for more ambitious three-year goals. That three-year mark is up and once again, I’m incredibly proud of the work you and your fellow members do each and every day on behalf of millions of patients and residents. 

This major undertaking is a reflection of our profession’s leadership in the quality arena. It’s because of you our sector is making a real difference. Patient and resident quality outcomes demonstrate that we continue to improve. Across the profession, re-hospitalizations and the unnecessary use of medications are down. It’s because of you we are leading the way. 

The ongoing, determined pursuit of quality has put us in the position to not only help our patients and residents, but also fight for them in Washington and in statehouses throughout the country. 

The measurable quality improvement results we have achieved have created a solid foundation for our successes on the legislative and regulatory fronts. These results are tangible proof of our commitment to our mission of improving lives by delivering solutions for quality care.

Our marked gains will not and cannot stop. Now more than ever we must push ourselves to reach for even better outcomes. This is why I am excited to announce the next phase of our Quality Initiative. 

Identified and endorsed by members of the AHCA/NCAL quality committees and approved by the AHCA/NCAL Quality Cabinet and Board of Governors, the new targets continue to build on the successes you have achieved over the last six years. For the next three years we challenge each of you to meet and sustain measurable results in key areas by March 2021. 

Skilled Nursing Care Centers

The new quality metrics for skilled nursing centers have been chosen carefully. First, they are all tied together and reinforce each other. Success in one area will lead to success in the others. Second, we have aligned all four goals with top priorities for the Centers for Medicare & Medicaid Services (CMS), Accountable Care Organizations (ACOs) as well as Managed Care Organizations (MCOs), and with federal mandates that link financial outcomes to quality performance. The new targets are:

• Safely reduce long-stay and short-stay hospitalizations by improving 10 percent-or maintain a rate of 10 percent or less;
• Improve functional outcomes (self-care and mobility) by 15 percent;
• Improve long-stay and short-stay satisfaction by 10 percent-or achieve a rate of 90 percent or greater; and
• Safely reduce the off-label use of antipsychotics by 10 percent-or maintain a rate of 8 percent or less in long-stay residents, and maintain a rate of 1 percent or less in short-stay residents.

Learn more about the skilled nursing goals at qualityinitiative.ahcancal.org. 

Assisted Living Communities

The Quality Initiative is also inspiring the state-based, assisted living profession to collect and report national quality data without a government mandate. Similar to the skilled nursing goals, all the assisted living goals work in tandem. The three-year goals for assisted living communities are:

• Reduce turnover among direct care staff¬ to a rate of 50 percent or less;
• At least 90 percent of customers (residents and/or families) are satisfied with their experience;
• Safely reduce hospital readmissions within 30 days of hospital discharges to a rate of 20 percent or less; and
• Safely reduce the off¬-label use of antipsychotics to a rate of 15 percent or less.

Learn more about the assisted living goals at qualityinitiative.ncal.org. 

Measuring Progress

To monitor progress among skilled nursing centers, AHCA will use CMS measures to track progress on antipsychotic usage, and measures endorsed by the independent rating organization National Quality Forum (NQF) to track progress on re-hospitalizations, functional outcomes and customer satisfaction. The assisted living goals will use measures developed by AHCA/NCAL. 

Resources & Tools to Help

I’m confident that the next three years of the Quality Initiative will position skilled nursing care and assisted living providers for even greater successes. 

To help you achieve the new goals, I encourage you to take full advantage of the free member resources available on the Quality Initiative website’s for skilled nursing and assisted living providers, as well as on ahcancalED at educate.ahcancal.org.

And without a doubt, please be sure to view and track your progress using AHCA/NCAL’s LTC Trend Tracker, our web-based, data collection and benchmarking tool. If you are not sure if your organization uses LTC Trend Tracker, email the team at help@ltctrendtracker.com. 

I also encourage members to apply for a National Quality Award this year. This program is based on the Baldridge Criteria for Performance Excellence, a nationally recognized method known for improving business performance. 

In April we have scheduled webinars for both skilled nursing and assisted living members that will cover the new goals in more detail. Both webinars are free for our members. I encourage you to register below. 

Skilled Nursing: The Quality Initiative 2018-2021: What’s New & What It Means for You
April 12 | 3:00 – 4:00 pm

Assisted Living: The NCAL Quality Initiative 2018-2021
April 10 | 3:30 – 4:30 pm

You have wholeheartedly embraced the Quality Initiative. I know you agree that we can all be proud of the significant results we have achieved. The next phase is a natural progression and sets the bar even higher. The new targets and priorities will continue to improve lives and deliver solutions for the patients, residents and families we serve.

Thank you so much for what you do every day and for your continued commitment to quality.

Sincerely,

Mark Parkinson
President & CEO