The 2015 RIHCA Quality Report

Members of the Rhode Island Health Care Association
Looking ahead: Surging Demand for Quality Nursing Home Care
The first baby boomers have hit age
65. By 2030, 20 percent of the U.S.
population will be at least 65, up
from 13 percent today. In that same
period, the number of people 85
and older will increase more than
50 percent and the number of those
100 years and older nearly triples.
It’s common knowledge that the
prevalence of chronic illnesses
like Alzheimer’s disease, cancer
and diabetes increases with age.
Fifty-five percent of all cancers are
diagnosed in individuals 65 and
older, and by 2030, 7.7 million of
those 65 and older will suffer from
Alzheimer’s, 50 percent more than
today according to the Alzheimer’s
Association. By 2025, the number
of those 65 and older with diabetes
is projected to almost double to
10.6 million. As people live longer,
the levels of disability and frailty
will greatly increase.
Although the stated preference of
most people is to age at home, the
reality is that as retiring boomers
get older, more will need the type of
24-hour care that only a residential
skilled nursing center can offer.
The growing population of residents
65 and older will have a significant
impact on Rhode Island. In 2010,
there were 151,881 residents over
the age of 65. By 2025 that figure
is expected to rise to 219,917,
and by 2040, it is projected that
it will rise again to 264, 238 - an
increase of nearly 75% over 30
years. Businesses, organizations
and agencies who service seniors in
Rhode Island should expect steadily
increasing demand over the next
three decades.
Apple Rehab Clipper
Grand Islander Center l
Silver Creek Manor, Inc. s
Apple Rehab Watch Hill
Grandview Center s
South Bay Manor
Bannister House
Greenville Skilled Nursing &
Rehabilitation Center s
South County Nursing &
Subacute Center n
Greenwood Care &
Rehabilitation Center s
South Kingstown Nursing &
Rehabilitation Center s
Hattie Ide Chaffee Home
Hebert Health Center
Summit Commons Skilled Nursing
& Rehabilitation Center
Heritage Hills Nursing &
Rehabilitation Centre
Sunny View Nursing Home
Trinity Health & Rehabilitation s
The Holiday Retirement Home
Village House Nursing &
Rehabilitation Center s
Bayberry Commons n k
Berkshire Place s
Brentwood Nursing Home
Briarcliffe Manor s
Cedar Crest Nursing Centre Inc. s
Charlesgate Nursing Center
Cherry Hill Manor
Chestnut Terrace Nursing &
Rehabilitation Center n
Cortland Place
Coventry Health &
Rehabilitation Center s
Cra-Mar Meadows
Rhode Island’s population
of citizens 85 years old and
older is increasing, creating
a greater demand for nursing
home services.
Females 20152040Males
20152040
80-84 12,54326,738
80-84 8,01220,003
85+
85+ 8,27117,111
18,52529,000
Sources: According to the Rhode Island Population Projections: 2010-2040 published by the
Rhode Island Statewide Planning Program, April 2013 Kaiser Health News, January, 2012:
The Coming Nursing Home Shortage
Crestwood Nursing &
Convalescent Home, Inc.
Eastgate Nursing &
Rehabilitation Center
Elmhurst Extended Care Facility s
Elmwood Health Center s
Emerald Bay Retirement Living
Epoch Senior Health Care on
Blackstone Blvd. s
Evergreen House Health Center
Forest Farm Health Care Center s
The Friendly Home, Inc.
Golden Crest Nursing Centre, Inc.
Grace Barker Nursing Center, Inc.
PROVIDENCE – Rhode Island has ranked No. 1 on a state-by-state
nursing home report card published by Families for Better Care, a Florida-based
nursing home resident advocacy group.
Kent Regency Center s
Mansion Nursing &
Rehabilitation Center
Morgan Health Center s
Nancy Ann Nursing Home, Inc.
North Bay Retirement Living
Oak Hill Nursing &
Rehabilitation Center n
Oakland Grove Health Care Center
Orchard View Manor Nursing &
Rehabilitation Center s k
Warren Skilled Nursing
& Rehabilitation Center s
Waterview Villa, Inc.
West Shore Health Center s
Westview Nursing &
Rehabilitation Center n k
Westerly Health Center s
Westerly Nursing Home
Woodpecker Hill Health Center s k
Woonsocket Health &
Rehabilitation Centre
Overlook Nursing &
Rehabilitation Center
l AHCA
Pawtucket Skilled Nursing &
Rehabilitation Center s
n AHCA
Pine Grove Health Center
Riverview Healthcare
Community s
Sakonnet Bay Retirement Living
Quality Award
Gold Star Winner
Quality Award
Silver Star Winner
s AHCA
Quality Award
Bronze Star Winner
k RIHCA
Quality Award Winners
OUR MISSION
The mission of the Rhode Island Health Care Association is to enhance our members’ ability to provide
sustainable quality health care and quality of life to those individuals we serve.
The second annual report ranked states on eight federal quality measures ranging from the number of hours
professional and licensed nurses averaged to the percentage of facilities with deficiencies.
Last year, Rhode Island ranked second best for nursing home care. According to the report, Rhode Island
scored superior grades in the majority of measures for the second year in a row.
Perspectives on Quality
Scallop Shell Nursing &
Rehabilitation Center, Inc. s
R.I. tops in nursing home care in nationwide survey
By PBN Staff, 9/15/14
Hopkins Manor, Ltd. s
2015
RIHCA … Enhancing Quality in Rhode Island’s Nursing Homes
57 Kilvert Street, Warwick, RI 02886 | www.rihca.com | 401-732-9333
A report by the Rhode Island Health Care Association
Rhode Island Nursing Centers:
Future Forward with Quality Care
The perception of
quality can mean
different things to
different people.
In healthcare, the
simple definition
can be the ‘degree
of excellence’
to which care and services are
delivered. The challenge for skilled nursing centers
lies in achieving a balance between excellent, safe, and
effective clinical care with an excellent quality of life that
respects individual needs and values.
Delivering quality care is further challenged by the
characteristic differences among stakeholders. Skilled
nursing providers now serve two distinct populations:
long-term residents whose needs inspired the need for
culture change twenty years ago, and medically complex,
short-term patients whose numbers are rapidly growing.
As providers expand their perspective to the demands
of an aging baby-boomer population, 24-hour nursing
centers are rapidly embracing innovative practices, new
technology, new patient care resources, and personcentered care. On the post-acute side, they also face closer
management and financial relationships with hospitals,
through Medicare Accountable Care Organizations
and bundled payments demanding transparency on
every level. As nursing centers face change on an
unprecedented scale, they have embraced an increasing
investment in resources to achieve, measure and
report quality.
Rhode Island skilled nursing centers play a critical part
in the state’s long term care and health care delivery
systems. As this report highlights, the emergent aging
population demands that all participants of the healthcare
continuum be active listeners. Skillfully addressing
quality improvement, while moving forward with insight,
innovation and professional collaboration, will help
ensure that Rhode Island’s skilled nursing providers
remain the benchmark for the nation.
The Rhode Island Health Care Association – the State’s
largest professional organization of skilled nursing and
rehabilitation centers – is pleased to provide this annual
quality report as a way to outline important issues and
initiatives, as well as to demonstrate to consumers and
policymakers a concrete commitment to those in
their care.
QUALITY
Listening to Residents Helps Rhode Island Nursing
Homes Continue to Outperform the Nation
Quality of life and care for Rhode Island seniors and their families
reach above average marks, making the state a more desirable place for elders
PROVIDENCE, R.I., Aug. 28, 2014 (GLOBE NEWSWIRE) -- Nursing home providers
are increasingly recognizing that the people who call their facilities “home” should have
the opportunity to provide feedback about their care and environment. Under the .....
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“I’m pleased that residents and families continue to acknowledge the care and compassion of Rhode
Antipsychotic Drugs
Best Survey Results in the Nation
Island’s nursing homes. Most residents and families in Rhode Island are satisfied with their care,
A large number of the people in long-term care settings are
living with some type of dementia. For these individuals,
behavior is often one of the few remaining forms of
communication. This can be challenging for families and
staff, and too often, antipsychotic medication is used in an
attempt to modify their behavior. This use is considered
off-label by the FDA, which issued a “black box” warning
for the elderly with dementia. Antipsychotic drugs are
expensive, and cost hundreds of millions of Medicare
dollars. They also increase the risk of falls with fractures,
hospitalizations, and other complications resulting in poor
health and higher expenses.
All Rhode Island skilled nursing centers are licensed by
the state through the Department of Health and receive
an unannounced federal inspection by the Department.
Providers are also expected to meet hundreds of federal
regulations. During the second quarter of 2014, Rhode
Island skilled nursing centers averaged 1.5 deficiencies
per survey, compared to 5.7 nationally, the lowest number
of deficiencies of all fifty states. Thirty-two, or 32%, of
Rhode Island’s 84 skilled nursing
and rehabilitation centers were deficiency-free.
In 2012, CMS initiated the National Partnership to Improve
Dementia, partnering with organizations including the
American Health Care Association, with a national goal
of reducing use of antipsychotic drugs by 15 percent. For
the CMS quality measurement related to antipsychotic
medication use, Rhode Island has outperformed the
nation for both short-stay patients and long-stay
residents.
“The road to greatness in America has been,
short-stay: RI 2.2 / US 2.5
long-stay: RI: 17.6 / US 20.3
Award exemplify that spirit. This year’s
which speaks to the commitment of Rhode Island facilities to provide high quality of care while
becoming more home-like and giving their residents choices.”
—Director of the Rhode Island Department of Health, Michael Fine, M.D.
Listening to Residents Helps Rhode Island Outperforms Nation
This is the eighth consecutive year that Rhode Island nursing homes have outperformed the nation on annual Resident and
Family satisfaction surveys. Under the direction of the Rhode Island Department of Health, the state’s nursing homes survey
their residents and family members every year using products from My InnerView by National Research Corporation.
The satisfaction survey results from late 2013 show that:
• More than nine out of every 10 nursing home residents and their family members would recommend their nursing home
• 89 percent of residents say their quality of life and quality of care in Rhode Island are “excellent” or “good”
• The questions that residents rank best relate to safety, cleanliness, care, and respectfulness of staff
• Rhode Island nursing homes outperform the nation on satisfaction, quality of life, quality of care, and quality of service
Excellence in Action
Rhode Island Raises the Bar for Quality
The Excellence in Action award from My InnerView is a
national recognition program that distinguishes skilled
nursing homes and senior living communities that achieve
outstanding resident and/or employee satisfaction. In 20132014, fourteen Rhode Island nursing homes were proud
to receive this accolade that acknowledges the percentage
of “excellent” responses to the question “What is your
recommendation of this facility to others?” This ranks Rhode
Island 9th in the country, or in the top 10% percent of all
qualifying facilities.
The Centers for Medicare and Medicaid (CMS) systematically
collects standardized data for long-stay residents and shortstay patients in every nursing center. This information is
updated quarterly and is available for public review on
www.medicare.gov. Rhode Island consistently outperforms
the nation, and most recently scored better in 13 out of 18
published quality indicators.
From 2011 fourth quarter to 2014 first quarter, Rhode Island
skilled nursing centers decreased unnecessary hospital
readmission rates by 18.7% compared to the average national
decline of 14.3%.
Hospitalization is disrupting to elderly individuals and
puts them at greater risk for complications and infections.
Hospitalization also increases the likelihood of reduced
functioning on return to the skilled nursing facility.
and always will be, traveled by those who
embrace change and work hard every day to
be the best; the organizations we honor today
with the Malcolm Baldrige National Quality
recipients have shown how quality, innovation,
and an unending quest for excellence help
strengthen our nation and brighten the future
of all Americans.”
—Barack Obama,
44th President of the United States
RI Nursing Centers Better than Nation in Reducing Unnecessary Hospital Readmissions
Sixty-four percent of Rhode Island Nursing Centers have
succeeded in achieving a national goal of reducing hospital
readmissions by 15%, outperforming the nation.
source: ahca summary of health survey results by state, june 2014
Hospital readmissions not only have the potential for negative
physical, emotional and psychological impacts on individuals
in skilled nursing care, but also cost the Medicare program
billions of dollars.
Preventing these events whenever possible is always beneficial
to patients and has been identified by policymakers and
providers as an opportunity to reduce overall health care
system costs through improvements in quality. The issue has
become a top priority for CMS and managed care programs
over the past several years. (Source AHCA)
American Health Care Association
Award Winners
Rhode Island is pleased to claim 31 AHCA Quality Award
winners. Awards are given in three categories: Bronze,
commitment to quality; Silver, achievement in quality; and
Gold, excellence in quality.
Utilizing the well-known Baldrige Performance Program,
the process of simply completing the challenging application
process rewards the candidates with outstanding benefits as
it supports and frames innovative strategies for success in
years to come.