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DOH Reviews NH Quality Pool Results, Proposes No Changes

At a meeting of the Nursing Home Quality Initiative (NHQI) Workgroup on Nov. 7th, the Department of Health (DOH) reviewed selected results of the 2017 NHQI and indicated that no changes are proposed for 2018. A copy of the DOH PowerPoint is available here. Meanwhile, the payment adjustments for the 2013-16 NHQI final results are still on hold.

DOH expects to finalize the results for the three cost report-related measures included in the NHQI later this month and to release the full set of facility-specific results for feedback on the Health Commerce System (HCS) in December 2017.

Key discussion points from the Workgroup meeting follow:

  • Pneumococcal vaccination rates for long-stay residents fell modestly in 2017, and the flu vaccine rate for this population was at 84 percent in 2017. 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 (see slide 10 of the PowerPoint).
  • Of the 12 quality measures, 10 improved or stayed the same on a statewide basis in 2017 (slide 10).
  • Based on the available data, 93 percent of facilities received improvement points in 2017, compared to 95 percent in 2016 (slide 12). However, the 2017 figure may go up when the 2016 cost report data are available.
  • No changes are proposed for the methodology in 2018 (slide 15).
  • A discussion ensued on dental care, with just over half of long-stay residents having had routine care in 2015-16 (slides 21-24). 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. DOH is contemplating a possible dental quality measure in the future, after further data analysis is conducted.
  • After the Payroll Based Journal (PBJ) data are validated, DOH plans to use them for the staffing hours and contract labor QMs in lieu of the cost report data. Next year, DOH will consider calculating and publishing the staffing measures using both platforms for facility informational purposes, but not begin using them for scoring until the following year.
  • There was discussion about incorporating resident and family satisfaction surveys and results into the quality pool. DOH will be looking at other states’ approaches as part of their research.
  • DOH will update the PowerPoint presentation and share it with us when the cost report-based measures are completed.

LeadingAge NY will be closely reviewing the 2017 results and 2018 methodology and commenting as appropriate. Members with comments or questions on the 2018 methodology or other aspects of the NHQI should contact us as soon as possible.

Concerns remain on the ongoing delays in making associated payment adjustments. DOH officials have indicated that unresolved litigation challenging implementation of the NHQI has delayed the payments, which the federal government has already approved for 2013-2017. LeadingAge NY is tracking the litigation closely and advocating for resolution.

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