WHCA/WiCAL is committed to quality and performance excellence for long-term care providers across the care continuum. WHCA/WiCAL, along with our national affiliate the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), is leading its membership in the direction of care excellence.
Please contact Rick Abrams at rick@whcawical.org for more information.
Quality Innovation Network-Quality Improvement Organization (QIN-QIO) are under contract with the Centers for Medicare and Medicaid Services (CMS) to support nursing home communities and promote improved healthcare services and quality of care for Medicare beneficiaries; working with diverse providers and the community on data-driven quality initiatives to improve resident safety, and improve clinical care; thus, making care safer by reducing Healthcare-Acquired Conditions (HAC) in Nursing Homes.
CMS recently awarded a contract to Superior Health Quality Alliance to serve as a Quality Innovation Network-Quality Improvement Organization (QIN-QIO) in Wisconsin, Minnesota, and Michigan. This contract runs through November 2024.
As part of Superior Health, MetaStar will be working with communities, health systems and nursing homes-including those serving rural populations-to:
Click HERE for CMS’ National Nursing Home Quality Improvement (NNHQ) resources.
Click HERE to contact the Superior Health Quality Alliance.
QAPI is the coordinated application of two mutually-reinforcing aspects of a quality management system: Quality Assurance (QA) and Performance Improvement (PI). QAPI takes a systematic, comprehensive, and data-driven approach to maintaining and improving safety and quality in nursing homes while involving all nursing home caregivers in practical and creative problem solving.
As a result, QAPI amounts to much more than a provision in Federal statute or regulation; it represents an ongoing, organized method of doing business to achieve optimum results, involving all levels of an organization.
CMS has developed a general framework for implementing a QAPI program in nursing homes, based on five key elements of effective quality management. Click HERE for detailed information on the Five Elements.
The Five-Star Quality Rating System is used to help consumers select and compare skilled nursing care centers. The rating system uses information from Health Care Surveys (both standard and complaint), Quality Measures, and Staffing. The Nursing Home Compare website features this rating system.
In 2019, Centers for Medicare & Medicaid Services (CMS) published a new Five-Star ranking on it’s Nursing Home Compare (NHC) website that reflects several significant updates to all three components of the system – Survey, Staffing, and Quality. A summary of the changes can be found here.
The Nursing Home Compare 5-Star Rating help desk for providers can be reached at 1-800-839-9290
The CDC’s COVID-19 Infection Control Assessment and Response (ICAR) tool was developed to help nursing homes prepare for coronavirus disease 2019 (COVID-19). Nursing homes and other long-term care facilities can take steps to assess and improve their preparedness for responding to COVID-19. This ICAR tool should be used as one tool to develop a comprehensive COVID-19 response plan. This tool may also contain content relevant for assisted living facilities.
Health departments can use this tool to assess infection prevention practices and guide quality improvement activities (e.g., by addressing identified gaps). This tool may be used for remote (e.g., by telephone or video chat) or onsite assessment. This tool may also be used by healthcare facilities to conduct internal quality improvement audits.
ICAR surveys are educational and non-regulatory assessments. The Wisconsin HAI Prevention Program conducts ICAR surveys after outbreaks or infection control breaches and upon request from the facility.
Please contact Vicky Griffin, RN, BSN, Infection Preventionist/Nurse Consultant or at (414) 227-4705 for more information.
A pressure ulcer, or pressure sore, starts as reddened skin that gets worse over time. It forms a blister, then an open sore, and finally a crater. The most common places for pressure ulcers to form are over bones close to the skin, like the elbow, heels, hips, ankles, shoulders, back, and back of the head.
Click HERE for resources from CMS for pressure wound prevention.
WHCA/WiCAL holds an annual WTA® (Wound Treatment Associate) educational program developed by the Wound, Ostomy and Continence Nurses Society (WOCN®) to meet the growing need for skilled wound care providers in all care settings and to enhance nurses’ ability to provide optimal care for patients with acute and chronic wounds, as members of a collaborative wound care team. The WOCN Society has been recognized with distinction by the ANCC as a provider of continuing education and is recognized by CMS as a resource for best practices related to wound management. Successful completion of this course provides 24 contact hours for continuing education and meets didactic requirements for WOCNCB certification as a WTA (WTA-C).
For more information on the program, please contact Jim Stoa at jstoa@whcawical.org.
Influenza can be introduced into a long-term care facility by newly admitted residents, healthcare personnel and by visitors. Spread of influenza can occur between and among residents, healthcare personnel and visitors. Residents of long-term care facilities can experience severe and fatal illness during influenza outbreaks.
Preventing transmission of influenza viruses and other infectious agents within healthcare settings, including in long-term care facilities, requires a multi-faceted approach that includes the following:
Click HERE for influenza outbreak management resources for long-term care facilities from the CDC.
Click HERE for additional resources from the state DHS.
The most commonly reported setting for Norovirus outbreaks in the United States and other industrialized countries is healthcare facilities, including long-term care facilities. Over half of all Norovirus outbreaks reported in the United States occur in long-term care facilities.
The virus can be introduced into healthcare facilities by infected patients, staff, visitors, or contaminated foods. Outbreaks in these settings can sometimes last months. Norovirus illnesses can be more severe, occasionally even deadly, in patients in hospitals or long-term care facilities compared with healthy people.
Click HERE for more information about Norovirus from the CDC.
Click HERE for the CDC’s Norovirus guidelines for healthcare settings.
Click HERE to view a YouTube video on how to clean up after someone with Norovirus vomits or has diarrhea.
A large number of the individuals in long-term care are living with some type of dementia. For these individuals and as illness progresses, behavior often becomes a key form of communication. This can be challenging for families and staff, and too often, antipsychotic medication is used in an attempt to modify behavior. The use of antipsychotic medication to treat behavior associated with dementia is not supported clinically and is considered off-label by the FDA, which issued a “black box” warning for the elderly with dementia.
Antipsychotic drugs are expensive, costing hundreds of millions of Medicare dollars. They also increase the risk of death, falls with fractures, hospitalizations and other complications resulting in poor health and high costs.
Click HERE for a presentation from CMS on the National Partnership to Improve Dementia Care in Nursing Homes and Quality Assurance and Performance Improvement (QAPI).
Click HERE for the CMS Antipsychotic Use Data Report.
Enterobacteriaceae are a large family of different types of germs (bacteria) that commonly cause infections in healthcare settings. Examples of germs in the Enterobacteriaceae family include Escherichia coli (E. coli) and Klebsiella pneumoniae.
Antibiotic resistance occurs when the germs no longer respond to the antibiotics designed to kill them. Enterobacteriaceae bacteria are constantly finding new ways to avoid the effects of the antibiotics used to treat the infections they cause.
When Enterobacteriaceae develop resistance to the group of antibiotics called carbapenems, the germs are called carbapenem-resistant Enterobacteriaceae (CRE).
CRE are difficult to treat because they do not respond to commonly used antibiotics. Occasionally CRE are resistant to all available antibiotics. CRE are a threat to public health.
Click HERE for CRE resources from the CDC.
Click HERE for the CDC’s guidelines for CRE prevention in healthcare settings.
Click HERE for resources from the state DHS on preventing the spread of CRE.
According to CDC, healthcare providers should do these 5 steps:
1. Place patients currently or previously colonized or infected with CRE on Contact Precautions;
2. Wear a gown and gloves when caring for patients with CRE;
3. Perform hand hygiene, use alcohol-based hand rub or wash hand with soap and water before and after contact with patient or their environment;
For additional resources from the CDC on common diseases and conditions, please click HERE.
Falls are a major cause of injury in all ages of the U.S. population, but a particular burden in older persons. One-third of people over the age of 65 years will fall every year.
Click HERE for resources from the state DHS on fall prevention for older adults.
Click HERE for resources from the CDC on effective fall interventions and the STEADI toolkit.