Staffing to Acuity GHCA Quality Committee Objectives Understanding - PowerPoint PPT Presentation

Staffing to Acuity GHCA Quality Committee

Objectives • Understanding Your PPD And The Hours You Have Available • Understanding Top of Scope Practice • Understanding Acuity • Understanding Your Need • Being a Good Steward of the HPPD/PPD and Staffing Dollars Allotted

Understanding Your PPD And The Hours You Have Available • How is Hours per patient day (HPPD) defined? • What’s included in the Nursing HPPD? • How does census affect the total hours available? (Photo property of Tobin & Associates)

Understanding Top of Scope Practice • What is Top of Scope practice? • What does that mean for CNAs? LPNs? RNs? • Where do we go from here?

Understanding Acuity • Acuity defined. • What parts of acuity are captured in the Case Mix Index? • What parts of acuity are NOT captured in the Case Mix Index? • How can Utilization Review improve the way care is captured? • How can increased acuity lead to an increase in available nursing hours? • What does the regulation require in regards to staffing hours and acuity?

Understanding Your Need • Consider the specialty or niche of the center. Based on the center specialty or the population served, what staff mix is needed to serve that population? – Behavior Communities – Rehab Centers – Transitional Care Units – When are most staff members scheduled to work?

Being a Good Steward of the HPPD/PPD and Staffing Dollars Allotted • How does overtime, agency hours, in-service time and orientation time affect the PPD? • What strategies can be used to best manage the available labor hours in the center?

Conclusion • Staff dollars account for a large portion of the expenses in each center. • Staffing time at the bedside is a precious commodity that requires close monitoring to assure that the available hours and dollars are used in a way that best supports the needs of the residents and the center. • While there is not a one size fits all formula to give an answer to how best to staff to the acuity of the center, there are strategies to review what is needed, what is available and methods to determine how to use that best. • Through creative thinking and strategic planning we can appropriately allocate the resources available to optimal efficacy and efficiency in a way that gives the best outcomes possible.

Discussion • Questions?

References • Centers for Medicare and Medicaid Services (2012). State operations manual. Washington, DC: Retried April 29, 2012 from https://www.teamtsi.com/Intellilogix/Library/SuperGuide. • Centers for Medicare and Medicaid (2012). Medicare benefit policy manual chapter 8 coverage of extended care services under hospital insurance. Washington, DC: Author. Retrieved April 18, 2012 from: http://www.cms.hhs.gov/manuals/Downloads/bp102c08.pdf • Habasevich, B. (2012) Managing to Nursing HPPD . Mediware. Accessed • June 24, 2016 https://www.mediware.com/rehabilitation/blog/managing-to-nursing-hppd/ • • Virkstis, K. (2014) What is top-of-license nursing practice? Advisory Board. Accessed June • 24, 2016 https://advisory.com/research/nursing-executiveenter/multimedia/video/2014/defining- top-of-license-practice • • The Free Dictionary (2016) Accessed June 24, 2016. • http://medical-dictionary.thefreedictionary.com/acuity • • White, A. & Rowan, P. (2013) Differences in Resident Case-mix Between Medicare and Non- • Medicare Nursing Home Residents. MedPac. Accessed June 24, 2016 • http://www.medpac.gov/documents/contractor- reports/mar13_nursinghome_contractor.pdf?sfvrsn=0