Administrative Memos

200602

FROM: Theodore O. Will, Chief Executive Officer
DATE: Aug 01, 2006
SUBJECT: "STAR" SETTING TARGETS ACHIEVING RESULTS
IPRO CONTACTS:

Pauline Kinney, R.N., M.A., L.N.H.A., Director - NHQI, extension 402

In November 2002, the Federal Centers for Medicare & Medicaid Services (CMS) launched the National Nursing Home Quality Initiative (NHQI). As the Quality Improvement Organization (QIO) for New York State, IPRO has been charged by CMS with assisting New York nursing homes (NHs) to improve the quality of care provided to all residents.

As of August 1, 2005, IPRO has entered our 8th Scope of Work (SOW) as the Medicare QIO for New York. Throughout the 8th Scope of Work, we will be working to improve performance on the clinical topics of high-risk pressure ulcers, chronic pain, depression and restraints. IPRO continues its commitment to provide NHs with the tools, materials and skills necessary to develop and implement successful Quality Improvement projects.

CMS requires IPRO to work with ALL nursing homes in New York on specific tasks. One of our most significant responsibilities in the 8th SOW is to assist facilities to set improvement targets on an annual basis for at least the high-risk pressure ulcer and physical restraint quality measures. In Year 1 of the 8th SOW, 53% of NY nursing homes set improvement targets for the chronic pain and depression clinical topic areas in addition to pressure ulcers and restraints.

As nursing homes continue to track and trend their performance, establish internal quality improvement goals, and measure improvement by incorporating the publicly reported data into their internal quality improvement efforts, we ask that targets be reset for Year 2 of the 8th SOW. We look forward to 100% of NY nursing homes setting their targets for at least high-risk pressure ulcers and restraints.

For your review, information about STAR "Setting Targets Achieving Results" is enclosed with this memorandum. We encourage you to meet with your team to discuss target setting, share the material, and set your targets.

Please note:

To facilitate target setting, IPRO staff will assist nursing home staff who need help to use the "Setting Targets-Achieving Results" (STAR) web based tool. As always, IPRO staff is available by phone to review the target setting process, field questions, and provide additional information and training as necessary.

IPRO is hosting a set of regional statewide conferences entitled "Fundamental Principles of Culture Change and Depression in Long Term Care." For your convenience IPRO's quality improvement coordinators will be on hand in the various regions to assist with setting your improvement targets.

For those who need in person assistance and will not be attending the statewide conferences, we will be available at the times listed in the attached document. Laptop computers will be available for your use. However, to avoid waiting times please sign up for a dedicated time slot on line at www.ipro.org/nhqi. To all conference attendees, the team will be available to assist you during morning and afternoon breaks and at lunchtime.

If you should have any questions please do not hesitate to contact any of the Nursing Home Quality Initiative (NHQI) staff members.

Attachments:

Registration for "STAR" dedicated time slots
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