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DOH Reviews NH Quality Pool Results; No Changes for 2019

At a meeting of the Nursing Home Quality Initiative (NHQI) Workgroup on Nov. 28th, the Department of Health (DOH) reviewed selected results of the 2018 NHQI and indicated that no changes were imminent for 2019. LeadingAge NY submitted detailed comments on the 2019 methodology, which has since been finalized and will be sent to facilities through the Health Commerce System (HCS).

DOH expects to finalize the results for 2018 and release the full set of facility-specific results for feedback on the HCS by no later than January. Key discussion points from the Workgroup meeting follow:

  • Pneumococcal and flu vaccination rates for long-stay residents fell modestly in 2018. Discussion focused on possible reasons for the flu vaccine rate not being closer to 100 percent, which include refusals and long stays that occur outside of the flu season.
  • Based on the available data, 95 percent of facilities received improvement points in 2018, compared to 94 percent in 2017 (slide 13 of the DOH PowerPoint).
  • For 2019, DOH had been considering the possibility of replacing or changing the scoring weight for two of the Quality Measures for which performance seems to be topping out: falls and urinary tract infections. There are three measures they have looked at as being possible replacements; however, each has its own issues (beginning on slide 17).
  • While facilities are required to electronically submit staffing data to the Centers for Medicare and Medicaid Services (CMS) through the Payroll-Based Journal (PBJ), there are concerns with data integrity. Accordingly, DOH plans to analyze the PBJ data for cost report data replacement in the contract staff and annual staffing measures sometime after 2019 (slide 26).
  • A discussion ensued on dental care, with just over half of long-stay residents having had routine care in 2015-16 (slide 29). The regulations require annual assessments and routine care as needed, and it is possible that facilities may not be reporting the annual dental assessments as routine care, or the assessments analyzed may be more often than annual. DOH is contemplating a possible dental quality measure in the future and will send results of this analysis to facilities for feedback.
  • DOH will update the PowerPoint presentation and share it with us when the missing measures are completed.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866