Eight-Year Nursing Facility Grant Initiative Comes to a Close

After eight years, the RAVEN (Reduce Avoidable Hospitalizations using Evidence-based Interventions for Nursing Facility Residents) Initiative is ending. Funded by a grant from the Centers for Medicare & Medicaid Services, RAVEN was led by UPMC, with the Jewish Healthcare Foundation (JHF) as subgrantee and lead educator. RAVEN was designed to improve nursing facility resident outcomes, improve the transitions between hospitals and nursing facilities, and reduce overall health spending while ensuring access to care and choice of providers among Pennsylvania nursing facility residents. The collaborations resulted in a wealth of partnerships that will be invaluable for future work in these areas.

RAVEN was initially designed as a four-year initiative (2012-2016) to implement evidence-based interventions of four components (clinical, pharmacy, telehealth, and education) in Western PA facilities. During this phase, JHF conducted site visits, developed individual education plans for facilities, and delivered frontline education. The JHF core RAVEN team brought an interdisciplinary approach and expertise on a variety of topics relevant to improving quality of skilled nursing care, especially dementia, end-of-life and palliative care, quality improvement, and nursing home administration and policy. Core team members included JHF COO and Chief Program Officer Nancy Zionts, MBA; UPMC geriatrician Judy Black, MD; Senior Quality Improvement Specialist Stacie Bonenberger, MOT, OTR/L; Senior Quality Improvement Specialist Anneliese Perry, MS, NHA; and Quality Improvement Specialist Nicole Greer, RN, MPH, MPA.

In 2014, CMS recognized the potential for growth and renewed the RAVEN initiative for a second phase through 2020. JHF continued to serve as the education lead and remained as the only external partner in the second phase, which involved a new group of Eastern PA nursing facilities to examine the potential for a new incentive payment model.

For the JHF team, key takeaways included recognizing that skilled nursing facilities meet difficult and competing challenges each day, so a successful project requires customized education models to meet a team's needs and remove barriers to education. As an investment in sustainability and to assure the facilities' access to resources after the initiative's conclusion, the JHF team created a RAVEN toolkit of educational resources, available here: https://www.jhf.org/raven/

JHF expresses many thanks to contacts at UPMC, including Mary Ann Sander, Vice President, Aging and Disability Services, UPMC Community Provider Services, April Kane, Project Co-Director for RAVEN, and Deborah Brodine, President of UPMC Community Provider Services through May 2019, for their partnership.

As a result of the RAVEN initiative, JHF has developed a wealth of educational resources for facilities, as well as partnerships that have led to relationships with CMS and PA government departments, including JHF's involvement in the ESCCP (Educational Support and Clinical Coaching Program) and RRHCP (Regional Response Health Collaborative Program). These programs convened educational, academic, and government leaders to support personal care homes, assisted living facilities, and long-term care facilities during the COVID-19 pandemic. With these resources and connections, JHF is well-positioned to continue addressing the needs of facility residents and staff into the future.