As discussed last month, the Quality Measure for Ability to Move Independently – Long Stay impacts Care Compare and Five Star. It may also impact Medicaid reimbursement dependent on the State. A decline in mobility can also have a negative impact during a State Survey.
How can we improve performance for this Quality Measure and prevent a residents’ decline in ambulation?
When applicable, a resident’s ability to walk should be regularly and continually assessed to promote the resident’s highest level of function, and therefore an improved quality of life with less risk for falls and a further decline in function
The first key is to analyze processes for screening and assessing a resident’s ability to walk 10 feet. This includes nursing and therapy screening and assessment.
· Therapy screening – upon admission, quarterly, as needed
· Nursing screening and assessment – upon admission, quarterly, as needed
· Nursing and Therapy Communication
Some additional ideas for improving performance of this measure include:
1. Ensure all team members know the Assessment Reference Date (ARD).
2. Make sure team members understand the requirements for coding Walk 10 feet per the Resident Assessment
Instrument (RAI).
3. Perform Utilization Review (UR) with the Interdisciplinary Team (IDT) prior to MDS completion and submission.
4. Review possible covariates and covariates in Sections A, B, C, GG, J, and O.
5. Audit clinical documentation to ensure it is clear, complete, precise, and timely.
6. Check the MDS software to determine if an alert has been triggered and correct the alert.
7. Treat and address health conditions and root causes impacting a resident’s ability to walk.
8. Refer residents to therapy as appropriate.
9. Initiate Restorative Nursing Program(s) with a walk to dine program, as appropriate.
10. Manage residents’ depression and/or pain.
11. Address residents’ refusals of treatment.
12. Ensure residents receive appropriate assistance from direct care staff.
13. Encourage residents to ambulate as independently as possible.
14. Encourage participation in activities.
15. Ensure residents have an appropriate assistive device to perform at their highest functional level.
Monitor success through chart audits. Review CASPER reports and Quality Measure data and provide continuing education and training to all staff involved in the residents’ care.
Stay tuned for next month's edition where we will review another quality measure…