Georgia Quality Incentive Program Teresa Costello Customer

Georgia Quality Incentive Program Teresa Costello Customer Support Manager

Agenda GHCA Quality Incentive Program Program Requirements Reports 2

Georgia Nursing Home QIP Program Quality Incentive began in 2003 Longest running satisfaction measurement program for nursing homes Partnership with Georgia Healthcare Association and Dept. of Community Health 3

Georgia QIP Requirements Skilled Nursing Homes Medicaid Provider Annual Resident and Family Survey Annual Employee Survey Monthly Quality Profile data collection

Quality Incentive Reports Each quarter NRC Health prepares a report and sends the results to the DOH Each facility receives an individual Quarterly Report Reports show scores and add-on incentive earned 5

Quarterly Reports 4 non-clinical measures 6 clinical measures Must participate in family, resident employee surveys 6

Non-clinical data 1 point each Employee survey – survey from the last calendar year Resident/family recommendation – combined score from the last calendar year (failure to participate in the annual survey affects eligibility for entire year) 7

Non-clinical data 1 point each Quality Profile Nursing Staff stability – Licensed Nurses, RNs, LPNs Nursing Staff stability – Certified Nursing Assistants, CNAs 8

Clinical Data 1 point each Quarterly data pulled from CMS: % of high risk long-stay residents w pressure sores % of long-stay residents physically restrained % long-stay residents w moderate to severe pain* % short-stay residents w pressure ulcers new/worsened % residents who received influenza vaccine % residents w one or more falls with major injury NRC Quality metrics entered monthly will be used in the event the above CMS data is not available. 9

NRC Clinical Data 1 point each Entered Monthly by each Center: % of residents w pressure sores % of residents physically restrained % of residents with significant weight loss/gain % residents w pressure ulcers worsened % residents who received influenza vaccine % residents w one or more falls with major injury NRC Quality metrics will be used in the event the above CMS data is not available. 10

Eligibility Requirements for Quality Data Must have submitted as final at least two months of NRC Quality data during the reporting quarter Data must be submitted by the 10th of the month for the previous months data 11

New data entry process effective Nov 1 2020 Beginning with October data submission November 1-10 th Email link sent to the administrator for each Center for submission Administrator will forward the email to correct individual for submission No more My InnerView portal submissions after Q3 (September data submission in October) 12

Timing 1st of the month (Nov 1 for October data) Due 10th of the month You are responsible for ensuring NRC Health is notified if there are changes in your leadership or who is submitting the data 13

Data Entry Worksheet

Monthly Data Entry 1st of the month Complete by 10th 15

Quarterly Reports Threshold for each metric will determine points earned Family Resident Satisfaction- must be at or above combined % (Top3 Box CoreQ Recommendation) responses to recommendation to others across participating facilities No threshold is required for Employee data 16

Thresholds Nursing Stability CNA Stability Clinical Metrics Equal to or less than the GA quarterly average of other participating facilities in the program will earn 1 point per metric CMS Clinical metrics- must be to or less than threshold *Exception: Influenza vaccine must be to or greater than threshold 17

Sample Report This facility earned 2 points for Non-clinical, 2 points for clinical 1% add-on 1% add on at least 1 point from 4 non-clinical, 1 from 6 clinical and a 3rd point from either 2% add on at least one point form 4 Non-clinical, 3 points from 6 clinical and 2 points from either 18

Reports Timing Quarter 1: January-March Data collection Quarterly Incentive Reports (QIP) delivered late June (end of Q2) Impacts Incentives payments for Q3 (July 1) Q2 reports delivered in late Sept for Q4 incentives (Oct 1) Q3 reports delivered in late Dec for Q1 incentives (Jan 1) Q4 reports delivered in late March for Q2 incentives (April 1) 19

Teresa Costello [email protected] Beginning Nov 1 dedicated CS contact: [email protected] 888-343-2851 option#2