1. Indiana Healthcare Leadership Conference: Improving Nutrition

2. NextPrevious Review of Quality of Care Initiatives

3. NextPrevious Nursing Home Quality Status: 2007 High number of immediate jeopardy violations (5 th highest) High number of deficiencies per standard survey (7.6 compared with national average of 6.9) Above average number of deficiency free surveys (11.7% compared with national rate of 8.3%)

4. NextPrevious Quality Improvement Efforts: Studies Medical error reporting system (2005) Staffing study (2009) Bladder scanner study (2009)

5. NextPrevious Quality Improvement Efforts: Education Programs Alzheimer’s and dementia care training programs (2005) Leadership Conference (2007) Consultant program (2004) Healthcare Quality Resource Center (2009)

6. NextPrevious Quality Improvement Efforts: Communications ISDH LTC Newsletter (2008) Monthly meetings of provider associations and ISDH (2008) Regular meetings with consumer organizations to discuss quality of care concerns (2005)

7. NextPrevious Quality Improvement Efforts: Survey Process Implemented MDS 3.0 (2010) Implemented CMS Special Focus Facility Program (2008) CMS and ISDH consistency workgroups (2008) Review of immediate jeopardy surveys with provider associations (2008)

8. NextPrevious Quality Improvement Efforts: Collaborative Initiatives Indiana Pressure Ulcer Initiative (2008 – 2010) Indiana Healthcare Associated Infection Initiative (2009 – 2011)

9. NextPrevious Quality Improvement Efforts: Regional Projects Health Care Excel (QIO) statewide support of CMS GPRA goals (2004) Health Care Excel pilot of CMS care coordination project in Evansville (2009) CMS Critical Need Nursing Home Project Pilot in northwest Indiana (2010) coordinated by Health Care Excel

10. NextPrevious Quality Improvement Efforts: New in 2011 Community Foundation of St. Joseph County Regional Nursing Home Collaborative (2011) ISDH Survey Report System (2011) ISDH Posting of Surveys (2011)

11. NextPrevious OUTCOMES TO QUALITY IMPROVEMENT EFFORTS

12. NextPrevious Indiana Pressure Ulcer Initiative CMS GPRA Initiative – 2005 – 2007 Indiana Healthcare Leadership Conference on Preventing Pressure Ulcers – October 2008 Indiana Pressure Ulcer Initiative – August 2008 – November 2010 Quality Improvement Organization ongoing projects with providers

13. NextPrevious Indiana Pressure Ulcer Initiative: Outcomes Source: CMS GPRA data from PDQ

14. NextPrevious Indiana Restraint Reduction Initiative CMS GPRA Initiative: 2005 –2007 Indiana Healthcare Leadership Conference on Restraints and Behavior Management: March 2008 Quality Improvement Organization ongoing projects with providers Focus by provider associations

15. NextPrevious Indiana Restraint Reduction Initiative: Outcomes Source: CMS GPRA data from PDQ

16. NextPrevious Indiana Healthcare Associated Infection Initiative Overview –Collaborative initiative –Two-year initiative from Sept 2009 – Dec 2011 –130 participating facilities (80 nursing homes) Priorities –Catheter associated urinary tract infections (CAUTI) –Clostridium difficile (CDI)

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19. NextPrevious Indiana Nursing Homes: Deficiency Free Surveys 2006: 33 facilities - 7.0% 2007: 47 facilities - 9.6% 2008: 55 facilities - 11.0% 2009: 56 facilities – 10.7% 2010: 51 facilities - 10.3% Source: ISDH QAMIS

20. NextPrevious Outcomes: Average Number of Deficiencies per Standard Survey Indiana National Region V (fewest is 1 st ) Fed FY 2007 7.66.9 4th Fed FY 2008 8.0 6.9 5th Fed FY 2009 7.26.8 4th Fed FY 2010 7.16.3 4th Source: CMS data from CASPER 11/8/2010

21. NextPrevious Outcomes: Percent of LTC with a “J” or Higher on Standard Surveys Indiana National Region V (lowest is 1 st ) Fed FY 2007 5.02.1 4th Fed FY 2008 4.6 2.9 5th Fed FY 2009 1.82.7 2nd Fed FY 2010 2.92.5 2nd Source: CMS data from CASPER 11/8/2010

22. NextPrevious Outcomes: Number of Immediate Jeopardy Findings on all LTC Surveys Indiana Region V (lowest is 1 st ) Fed FY 2007 68 5th Fed FY 2008 50 5th Fed FY 2009 35 3rd Fed FY 2010 33 3rd Source: CMS data from CASPER 11/8/2010

23. NextPrevious Outcomes: Average Number of Onsite Survey Hours on Standard Surveys Indiana National Region V (lowest is 1 st ) Fed FY 2010 83.7 105.6 1st Source: CMS data from CASPER 11/8/2010

24. NextPrevious COMING QUALITY IMPROVEMENT PROJECTS

25. NextPrevious Coming Initiatives for 2011 Healthcare Associated Infections Three online learning modules designed for staff and consumers Consumer brochure In-service programs

26. NextPrevious Coming Initiatives for 2011 Education programs for wound care and infection prevention leading to increased staff certification Updated aide curriculum Long Term Care Bed Tracking System

27. NextPrevious Coming Initiatives for 2011 Leadership Conference on care coordination and transition Complete 50% of training for Quality Indicator Survey (QIS) Process Develop a care coordination and transition initiative for 2012 implementation

28. NextPrevious Improving Nutrition Conference Checklist Provide an in-service on information and resources provided at today’s conference Develop a plan for improving nutrition Identify and implement 3 activities for improving nutrition