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 New Quality Goals Announced By Leading Skilled Nursing Center Association

AHCA President and CEO Mark Parkinson explains the rationale behind the Quality Initiative expansion. View here.

The American Health Care Association (AHCA) continued the momentum to improve care in skilled nursing facilities by expanding its Quality Initiative program.




The latest initiative for the next three years includes more ambitious targets in eight areas, with a strategic focus in three areas: organizational success, short-stay and post-acute care, and long term and dementia care.




“This is not a public relations effort. We are not aspiring to adjectives, we are aspiring to specific numbers and times,” said AHCA President and Chief Executive Officer Mark Parkinson in today’s press conference that unveiled the new quality metrics. “The next phase sets the bar even higher. The goals and priorities we have established will continue to improve lives and deliver solutions for the patients, residents, and families we serve.”




Janet Snipes, a nursing home administrator at Holly Heights Nursing Center in Denver, has seen the improvements of the Quality Initiative first-hand.




Initially her staff members were reluctant to reduce antipsychotic medications. However, they became believers after they personally saw the improvements in the lives of their residents. The facility has now reduced use of these medications from 19.6 percent to 1.2 percent.




“I started the initiative, but my staff are the champions,” says Snipes, who is also chair of the Quality Improvement Committee for AHCA. “When you work in a community and see residents happier, there is a reduction in staff turnover. It all comes together to enhance the day-to-day activities for all of us.”




In response to scrutiny over recent years by Congress, the Medicare Payment Advisory Commission, and the Centers for Medicare & Medicaid Services (CMS), AHCA, which represents skilled nursing and assisted living facilities, devised the Quality Initiative in 2012. The organization took a proactive approach by creating a nationwide, multiyear effort to improve quality and enhance patient outcomes in skilled nursing care centers.




Since the launch of the initiative, AHCA members have reduced the off-label use of antipsychotic medications by 21.2 percent, compared with the national average of 19.4 percent in the fourth quarter of 2014. As a result, 33,100 individuals are no longer receiving these medications. For hospital readmissions, AHCA members successfully prevented 40,424 individuals from unnecessarily returning to the hospital—a 14.2 percent reduction since 2011.




The organization plans to measure and align its goals with CMS data. Members can view their progress using AHCA’s Long Term Care Trend TrackerSM, a Web-based, data collection and benchmarking tool.




“Skilled nursing facilities that implemented business models for improved quality systems had striking results,” said AHCA Senior Vice President for Quality and Regulatory Affairs David Gifford, MD, alluding to the fact that health care centers applying this kind of approach consistently outperform those that do not in terms of quality. “We are basing our Quality Initiative goals on CMS data (such as Nursing Home Compare and Five Star) and will comply with the IMPACT Act.”




The new quality goals are:





  • ​Decreasing nursing staff turnover by 15 percent or achieving turnover of less than 40 percent.
  • Ensuring that at least 25 percent of member companies measure and report patient and family satisfaction survey results.
  • Reducing the number of unintended health care outcomes.
  • Safely reducing the number of hospital admissions within 30 days following discharge by an additional 15 percent, or achieving a rate of 10 percent readmissions.
  • Increasing discharges of short-stay patients back to the community by 10 percent or achieving an overall rate of at least 70 percent.
  • Ensuring that at least 25 percent of member companies adopt measures for mobility and self-care of short-stay residents and report functional outcomes.
  • Reducing the off-label use of antipsychotics in long term nursing home residents by an additional 10 percent by December 2105 and 15 percent by December 2016.
  • Safely reducing hospitalizations among long-stay residents by 15 percent or achieving and maintaining an overall rate of 10 percent or less by March 2018.





Jackie Oberst is Provider’s managing editor. Email her at or follow her on Twitter, @ProviderMag.

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