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Aspects of QIPs that were Noted to be Less

State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Aspects of QIPs that were Noted to be Less Successful

The central themes regarding aspects of the Maryland quality initiatives that were less successful were around communication of quality initiatives with the Ombudsman, provider access to funding, and the minimum staffing requirement. With the exception of one person we spoke with (a supervisor), Ombudsman were not at all familiar with the Second S
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Role of the Federal Government in Quality

State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Role of the Federal Government in Quality Improvement

The Ombudsman stated that regulations alone are not enough to improve quality. She believes that multiple and varied approaches must be utilized to assist facilities in their quality efforts. Adequate numbers of, and respect for, staff is one such area. Another approach involves improving access for facilities to clinical informational resources a
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Impact of Iowa's Quality Improvement

State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Impact of Iowa's Quality Improvement Programs on Quality of Care/Quality of Life

No evaluation of the impact of these programs has been made to date. Some decrease in the number of deficiencies has been noted in recent years, but it is not clear that there is any connection between the quality improvement programs and the number of deficiencies cited. Although there are statistics available on how many people access the websit
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Aspects of Iowa's Quality Improvement

State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Aspects of Iowa's Quality Improvement Programs Noted to be Less Successful

Although there was agreement that nursing facilities appreciated recognition for good performance, there was concern expressed by the Ombudsman that these awards gave consumers a false sense of security. In their experience, they noted that consumers seeing a Best Practice icon on the website or a Deficiency Free Certificate assumed that the facil
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Aspects of Iowa's Quality Improvement

State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Aspects of Iowa's Quality Improvement Programs that Work Well

Provider representatives overwhelmingly agreed that recognition programs (Deficiency Free Certificates, Governor's Quality Award, and Best Practices) did much to boost nursing facilities' morale. Over and over, participants stated that in the heavily regulated and scrutinized nursing home environment, facilities were grateful for positive recognit
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Role of the Federal Government in Quality

State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Role of the Federal Government in Quality Improvement

Much of the feedback aimed at the Federal Government concerned the issue of reimbursement. One provider representative summed it up by saying that "You cannot separate money from care," and that Medicare and Medicaid programs have to pay reasonably for reasonable care. There has to be more emphasis on alternative care (home care, assisted living)
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Impact of Florida's Quality Improvement

State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Impact of Florida's Quality Improvement Programs on Quality of Life/Quality of Care

No formal evaluation of Florida's quality improvement programs has been performed to date. AHCA staff reported that they are interested in evaluating the success of the programs, particularly the TA component. However, because the programs have been operating only a short time, it is not yet possible to evaluate their impact. Because many of the p
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Aspects of Florida's Quality Improvement

State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Aspects of Florida's Quality Improvement Programs Noted to be Less Successful

Although some discussion participants praised the Quality Monitoring program, consumer advocates voiced some concerns, primarily because of the changes that were made to the original role and responsibilities as laid out in HB 1971 in 1999. The program as initially enacted was seen as separate from the survey agency and allowed the monitors to foc
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The Nursing Home Watch List

State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. The Nursing Home Watch List

The  Florida Nursing Home Watch List  is published by the AHCA to assist consumers in evaluating the quality of nursing home care in Florida (see App endix C  for an excerpt of the most recent Watch List).
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APPENDIX M. GLOSSARY

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Appendix M. Glossary

Accountable Care Organization (ACO)
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APPENDIX L. STANDARDS AVAILABLE TO SUPPORT HEALTH

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Appendix L. Standards Available to SUPPORT Health Information Exchange of Long-term and Post-acute CARE Data

TABLE L-1. Standards Available to Support HIE of LTPAC Data
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APPENDIX K. SUMMARY OF INFORMATION ROUTINELY

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Appendix K. Summary of Information Routinely Exchanged by the Three Sites Visited, by CARE Coordination Function

TABLE K-1. HIE Activities for Transitions of Care
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Attachment J-1. Eastern Maine Health System

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Attachment J-1. Eastern Maine Health System Pioneer Accountable Care Organization Quality Measures

Description of ACO Measures: Excerpts and Table from CMS "Accountable Care Organization 2013 Program Analysis--Quality Performance Standards Narrative Measure Specifications" Report
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Conclusion

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Conclusion

EMHS is an innovative organization providing industry leadership on how LTPAC providers and technology can be integrated into new care delivery and payment models. Their patient-centered approach to care coordination embraces the spectrum of providers and integration of community services. Technology plays an important role in coordination of care
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Barriers

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Barriers

Barriers to Expansion of Telehealth . The use of telehealth has shown promise for improving patient care management, outcomes and cost, but EMHC identified challenges with the reimbursement structure coupled with high cost of the equipment create challenges for expanding the technologies use across a broader population with a large, rural geog
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Health Information Exchange Related Measures

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Health Information Exchange Related Measures

TABLE J-7. HIE by Care Coordination Function and Partners, Eastern Maine HomeCare EMHC does not report or identify any specific HIE measures. They report the 33 required quality measures as a Pioneer ACO. These measures are detailed in Attac   hment J-1.
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Home Health Care Processes

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Home Health Care Processes

EMHC staff described the clinical workflow processes for care and how information is used and exchanged. Table J-6 describes the process, information collected and/or exchanged and observations by staff. TABLE J-6. Home Health Care Workflow Processes
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Health Information Exchange at Eastern Maine

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Health Information Exchange at Eastern Maine HomeCare

The availability, use and exchange of information is crucial for an EMHC to begin care and coordinate care with other service providers. Information exchange occurs through multiple different methods -- via phone, photocopies, fax and e-mail as well as through access to the hospital EHR, customized portals and the HIE. This section describes HIE i
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Eastern Maine HomeCare's Work List for

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Eastern Maine HomeCare's Work List for Electronic Health Record, Telehealth and Health Information Exchange

The EMHS's IS department in collaboration with EMHC have identified three priority projects currently under development. The following projects, once complete, will improve EMHC's interoperability and HIE capabilities:
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Eastern Maine HomeCare Technology Infrastructure

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Eastern Maine HomeCare Technology Infrastructure

TABLE J-5. EMHC Software Applications

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Form Approved OMB# 0990-0379 Exp. Date 9/30/2020