PA Long-Term Care Learning Collaborative Assembles Nursing Homes Amid Sea of Changes

The Centers for Medicare and Medicaid Services (CMS) recently announced two changes with significant implications for both the daily operations and overall health of the nursing home industry. CMS initiated changes to the required Minimum Data Set (MDS), which is an assessment tool that CMS uses to measure nursing home residents' health status, as well as minimum staffing mandates, which many nursing homes have cautioned they will not be able to meet.

Against this backdrop, the Pennsylvania Long-Term Care Learning Network convened on September 28 for its quarterly Learning Collaborative webinar. Nearly 200 participants from nursing facilities across Pennsylvania joined the webinar to hear how their peers have helped enhance their staff's clinical skills for complex conditions.

Larry Appel, MD, SFHM, medical director at the Pennsylvania Department of Human Services Office of Long-Term Living began by providing updates from his department. Three nursing facilities presented promising practices for helping staff provide care for residents with complex conditions. Nicole Watson, BSW, RN, WCC, vice president of clinical excellence at SpiriTrust Lutheran, highlighted how floor beds have helped her nursing home reduce bed falls by 77 percent, save nurses more time, and reduce costs associated with falls.

Linnie Clark, RN, infection control specialist, and Wendy Hildenbrandt, BSN, RN, CNDLTC, CDCP, director of nursing at Morningstar Living shared strategies to encourage staff to get vaccinated against COVID. Clark and Hildenbrandt walked through internal communications materials they created for the COVID vaccines such as a "Bee Safe for Summer" booster campaign.

Reformed Presbyterian Home's executive director Cara D. Todhunter, MA, CCC/SLP, MPM, NHA presented a creative approach to teach staff infection control: escape room activities. Hand hygiene, infection source control, personal-protective equipment, and cleaning were all incorporated into the escape room.

The meeting then shifted to the long-term care industry's controversial new federal regulation: the CMS staffing mandate, which requires minimum staff levels that many facilities will likely struggle to meet given the ongoing healthcare staffing crisis. The Pennsylvania Health Care Association's vice president of operations Chris Fisher, MS NHA and their director of policy and regulatory affairs Gail Weidman detailed the regulations and how they are supporting nursing facilities as they respond to this change.

Jewish Healthcare Foundation COO and Chief Program Officer Nancy Zionts, MBA described how the Pennsylvania Teaching Nursing Home Collaborative could help nursing facilities improve their workforce pipeline by establishing or strengthening their partnerships with local schools of nursing. The Collaborative is an extension of the Revisiting Teaching Nursing Home pilot, which established a foundation for relationships between schools of nursing and nursing homes. The next phase of the initiative aims to capitalize on the successes of the pilot by expanding the model across the state. Zionts invited all nursing facilities in Pennsylvania to join the Collaborative and build their workforce pipeline.

Brian Stever, RN, BSN, RAC-CT, a clinical reimbursement consultant with the Pennsylvania Association of Nurse Assessment Coordinator closed the meeting by highlighting the specific changes to the MDS and how it will improve information on residents' continuity of care.