A typical skilled nursing facility (SNF) produces an incredible amount of data. If this data can be captured, analyzed, and used effectively, SNFs can gain the ability to deliver significant improvements to resident care, reduce costs, and improve the overall efficiency and operations of the facility.

Unfortunately, many SNF organizations are unable to fully benefit from this potential. Rather than taking advantage of data and analytics to make stronger decisions, they’re still using manual processes, Excel spreadsheets, and paper records to collect and report facility metrics.

The path toward automation isn’t necessarily a straight line, but there are things SNF organizations can do to increase their capabilities and see a return on their investment. This blog will explain why the current approaches are no longer viable and how operators can successfully move toward automation at their SNF.

When Good Enough Is No Longer Enough

Many SNFs have been doing the same thing for years and these approaches work well enough in most situations. Staff are familiar and comfortable with the processes, and they may not realize that better tools, software, or methods exist. While they may understand that it’s not perfect, there’s no real pressure to change.

However, all it takes is an unexpected issue or crisis for good enough to quickly become insufficient. In these situations, the entire system breaks down, and this can have wide ranging consequences across the facility.

For example, a shared Excel spreadsheet may provide everyone with access to information, but a lack of proper permissions or backup capabilities means that anyone can permanently delete data without the ability to recover it. Similarly, many insurance companies require authorizations to be renewed on a regular basis. A missed call or a simple mistake by staff could result in a dispute or refusal to pay for a service that should have been covered.

In other cases, resident information such as fall data or medication management may be recorded manually, leading to the potential for errors and inaccuracies that could have a direct impact on their level of care.

In these instances, the ability to dive deep into data, spot trends, identify the root cause of issues, and take corrective action is extremely valuable. But for facilities operating manually, it’s difficult or impossible to take these steps.

The Path Toward an Automated SNF Organization

Change is hard, and it can often be overwhelming. As you head down the path, it may feel as though you’re putting in a lot of effort without seeing a significant return. And once you start considering automation, the sheer number of possibilities and approaches can make it difficult to know where to start

This is common when any organization undergoes significant change, but it’s important to remember that change does not have to happen all at once. Instead, the best companies take a strategic approach to automation and start with the areas that are required by government regulations and that will have the most impact at the lowest cost or complexity.

These are the low hanging fruit, and they’re the best place to start. Many SNF organizations take their first steps down the path computerizing their MDS because they are required to do so by CMS. Next, they look at other critical paths, such as their electronic health records (EHR). From there, they can identify and focus on the processes that take the most time, or where increased data and information would have the biggest impact on their operations.

As the benefits become clear, it’s much easier to build on these capabilities and increase levels of automation over time by adding more functionality and rethinking old ways of doing things to eventually arrive at a consolidated and efficient system.

Finally, while it’s difficult to predict the future, it’s important to take a long-term view of your facility when implementing new tools or software. The choices you make should consider not only your current needs, but your future requirements as well. Work with people who have experience in the SNF industry and help them understand your business goals and vision for the future. They’ll be able to guide you through the implementation to avoid potential pitfalls and challenges down the road.

Following the Path to Better Results

Increasing automation at your facility does not mean that you’ll be replacing humans with robots. Pre-authorizations, for example, will still require staff to contact insurance companies, answer follow up questions, and reauthorize residents on a regular basis. What can be automated is the process. Insurance records can be stored and accessed digitally, notifications can be sent out to staff to ensure they follow up, and every interaction can be tracked to have a clear record in case of dispute or payment issue. For SNF organizations at the beginning of this process, the key is to identify the areas where automation will have the most impact. As you become more familiar and comfortable, you’ll be able to build on this foundation and expand your capabilities to become more efficient, reduce costs, and improve outcomes for residents.  

To learn more about the SNF Metrics Platform and how it might help you and your organization to find focus in the chaos, schedule a demo or call (732) 836-8300.

A company inherited a Quality of Care Corporate Integrity Agreement (CIA) after acquiring a skilled nursing facility in 2015. In addition to the normal challenges faced when taking over a new building, the team also had additional oversight by federal monitors, and meet the many requirements of the CIA including the ability to create dashboards that track, analyze, and improve resident outcomes.  Under these difficult circumstances, the facility needed the ability to collect, analyze, use, and explain clinical and operations data in real-time.

Overview

From Manual to Automated Data Collection and Analysis

Historically, staff used pen and paper or simple spreadsheets to collect and analyze clinical, financial, staffing, and compliance data. This led to inaccurate, incomplete, and sometimes outdated information. High staff turnover also made it challenging to maintain consistency as each staff member had their own way of doing things.

As a result, the SNF operators had limited visibility into their facility and resident outcomes and lacked actionable insights that would allow them to make changes to improve operations. Where data was available, operators could only see raw numbers and were unable to compare trends over time, explain the reasons behind the numbers, or accurately determine the effectiveness of changes on fiscal or resident outcomes.

The regulatory and compliance requirements placed additional pressure on the facility to track metrics such as falls, medication errors, pressure sores, unplanned hospital visits, functional decline, and signs or symptoms of depression. The SNF also needed to conduct root cause and trend analysis and demonstrate the actions they were taking to improve these outcomes.

To achieve these goals, the facility adopted the SNF Metrics dashboard that collected data from a single, accurate, and consistent source and displayed these metrics to decision-makers in real-time. Users could click-through data to view extremely granular levels of information and conduct root cause analysis. With this information, they could identify and implement changes and easily communicate their actions with federal monitors to demonstrate their commitment to correcting and improving outcomes for residents.

Challenges

• Inheriting the CIA placed additional strain on staff and resources during the acquisition of the long-term care facility.
• Limited data and analytics capabilities at the time of acquisition meant the facility was starting from scratch to address regulatory and CIA requirements.
• Staff turnover and a lack of uniformity in reporting meant any existing data was inconsistently tracked, measured, and stored, limiting its usefulness
• Manual data collection and entry meant a lot of pressure was placed on the staff when developing clinical dashboards.
• The data showed a “point-in-time” metric which didn’t answer the question “why?”

Solution

The facility identified the need for improved data and analytics capabilities for business intelligence data, SNF operations data, and clinical data.

Creating a Dashboard

The dashboard provided users with real-time visibility into critical metrics, trends, and resident outcomes to improve decision making and achieve and maintain SNF compliance requirements.

Automating Data Collection From a Single Source

The system drew clinical data from electronic medical records (EMRs) to ensure consistent, accurate, and timely information for users.

Providing Granular Data for Root Cause Analysis

Decision-makers could easily drill down to highly granular levels of data, such as the resident, caregiver, or time of day to identify the cause of issues and determine the best course of action.

Making Data Easy to Use and Communicate

Operators could easily communicate data and explain the underlying causes behind the numbers, the steps taken to address them, and the outcome of those actions.

Benefits

• The ability to identify the root causes of issues and take action led to substantial improvements in clinical and fiscal metrics across the board.
• The facility went from one of the lowest-performing buildings in the organization to one of the highest, with a dramatic reduction in complaints, negative survey results, and resident issues. 
• Federal monitors and the OIG were extremely impressed with the facility’s ability to understand and analyze  SNF operations and resident outcomes, as well as the steps taken to address issues.
• As a direct result of the platform’s capabilities and fiscal and clinical improvements made by the facility, the CIA was completed in only four instead of five years; a nearly unprecedented achievement in the industry.

Results

• Operators noticed that a high number of falls occurred under the care of a single staff member. Through root cause analysis and interviews with staff, they identified that she was overburdened with difficult cases. The facility was able to redeploy staff to evenly spread the workload, and the number of falls decreased significantly as a result.
• Fall data in the month of February had increased substantially compared to January. Through root cause analysis the operators were able to demonstrate that one resident accounted for the majority of these falls and explain how their environment and care had been adjusted. Data from March showed significant improvements, and federal monitors were impressed with the facility’s ability to explain these outcomes and take corrective action.
• Federal monitors wanted the facility to demonstrate that they were able to self-analyze, self-correct, and improve outcomes for residents. The platform made it easy to identify issues, implement new approaches, and communicate the impact of these changes to federal monitors, leading to an accelerated timeline for SNF compliance.

To learn more about the SNF Metrics Platform and how it might help you and your organization to find focus in the chaos, schedule a demo or call (732) 836-8300.