State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Participants


Abt staff members Alan White and Donna Hurd spent three days in Jefferson City and Columbia, Missouri in July 2002, meeting with state survey agency staff, ombudsman, provider association staff and members, state Quality Improvement Organization (QIO) staff, QIPMO nurses and developer Marilyn Rantz as well as facility staff who had participated in QIPMO visits. Researchers were also allowed to accompany QIPMO nurses on a site visit to observe the TA visit in progress. The following individuals agreed to participate in discussions with the researchers:

  • Missouri Department of Health and Senior Services/Division of Health Standards and Licensure, Section for Long-Term Care Regulation
    • David Morgan, Manager
    • Lois Kollmeyer RN, Director
    • Darrell Hendrickson, Deputy Division Director
    • Betty Markway RN MSN, State MDS Coordinator
  • Missouri Department of Health and Senior Services, Senior Services and Regulations, State Office of Long-Term Care
    • Carol Scott, State Ombudsman
  • Missouri Association of Health Care (AHCA Affiliate)
    • Marlene Anderson
    • Terri Lueckenotte, Administrator, Capital Healthcare Center
    • David Duncan, President, Tiffany Care Centers, Inc.
    • Tim Francka, Administrative Director of Long Term Care Facilities, Citizens Memorial Healthcare
  • Missouri Association of Homes for the Aging (AHSA Affiliate)
    • Denise Clemonds, Executive Director
    • Patricia Kapsar, Vice President and Corporate Compliance Officer, Bethesda Health Group, Inc.
  • University of Missouri-Columbia, Sinclair School of Nursing
    • Marilyn Rantz, Ph.D, RN, NHA, FAAN
    • Any Vogelsmeier, MSN, RN, CS, GCNS
    • De Minner, RN
    • Steven Miller, Program Coordinator
  • Not-For-Profit Facility--122 Beds
    • Administrator
    • Director of Nursing
  • Not-For-Profit Facility--120 Beds
    • Assistant Director of Nursing
    • Charge Nurses
    • Physical Therapist
    • Director of Nursing
    • Administrator
  • Missouri Quality Improvement Organization
    • Catherine Gill, MS, PT, MHA, Director, Nursing Home and Home Health Services
    • Carolyn Spradlin RN, BSN, Quality Specialist, Nursing Home and Home Health Services
    • Deborah Finley, Director, Communications and Beneficiary Outreach Services
    • Carol Beahan, Communication Specialist

Marilyn Rantz and her colleagues at the University of Missouri-Columbia Sinclair School of Nursing were our primary contacts for the Missouri site visit. Dr. Rantz was very generous with her time providing information on state politics, history, development and implementation of the various components of the program both prior to our visit and while we were there. The two QIPMO nurses with whom we met, Amy Vogelsmeir and De Minner were extremely helpful in explaining and demonstrating their role in the program as well as the program's philosophy and in arranging for us to accompany them on a visit. Everyone that we contacted prior to our arrival was open to participating in discussions. Both provider associations invited members in to their office for meetings. Initially, the executive director of the AHCA affiliate had responded that he did not believe that many of his member facilities had participated in the QIPMO program. When assured that the research team was also interested in the reasons that facilities may have chosen not to participate, he was fully cooperative and invited member facilities to be present for our meeting. Interestingly, he was not able to be at the meeting as he was testifying in a lawsuit brought by the association against the governor over nursing home reimbursement. Our contact at the state survey agency included his immediate supervisors in our meetings as well as the individual who had had the most contact with the QIPMO nurses. The Missouri QIO director of nursing home activities contacted us prior to our site visit and requested that in addition to a scheduled meeting with her and members of her staff that she be allowed to sit in on visits with other groups as she too was gathering information on the QIPMO program in conjunction with their work for CMS on the Nursing Home Quality Initiative.

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