Quality soars in long-term care

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James Berklan
James Berklan

Much like a parent raising a child — a topic on my mind this week as I send my oldest son to college — dedicated advocates have long encouraged long-term care providers to do the best they can. This week, there's evidence that the effort has paid off, in seeing how many providers earned honors from the American Health Care Association/National Center for Assisted Living.

A bit of back story: There was a time perhaps six to seven years ago when providers and their advocates couldn't start or finish a sentence without including a vow to deliver higher quality care. It almost made one wonder just what the goals were before then, and why they were so intent on it now.

Regardless, a clear and obvious push was made, some of it admittedly at the end of a government cattle prod. It's clear now, however, that self-motivation is captivating a significant and growing number of providers with each passing year.

Take Exhibit A: Monday's announcement by AHCA/NCAL that six care centers had earned a 2014 Gold — Excellence in Quality Award. Make that a record six earned this highest possible honor.

In fact, just 24 communities have earned Gold designation (see a history of all winners here) in the 19-year history of the program. To say this year's crop of high-achievers was above average would be a huge understatement.

Last year, five achieved Gold status, which, coupled with this year's result, indicates that a new era has been ushered in.

To get to the Gold level, a provider has to achieve Silver status, and before that, Bronze status. This year's number of Silver recipients jumped to a record high 77 (18 more than the previous year). The Bronze class, meanwhile, rose to 397 (considerably higher than the previous year's 361, but still just fifth-highest in the program's history).

To back up a bit, these are providers paying to get their processes checked and dissected by third-party reviewers with no skin in the game. A review visit by the Gold judges is not an automatic pass to the awards podium, sources confirm.

This is not just cronies slapping their buddies on the back with feel-good awards. Judging is based on the core values and criteria of the business world's Baldrige Performance Excellence Program. Judges from out of state and other walks of life review long-term care's proudest providers each year. 

“People are increasingly seeing the value of the Baldrige criteria as a way to improve care and the quality of life,” Ed McMahon, the chairman of the Board of overseers for the AHCA/NCAL National Quality Awards, told me. “Even if they aren't honored, the feedback reports they get really help. It's never directive but says, ‘You might want to … or could …' [Providers] keep coming back. It demonstrates a commitment to quality.”

McMahon said that rules prevented him from revealing how many apply for recognition each year, but he clearly talks like the proud Papa of a growing brood.

“When you talk to people going for the Gold, usually there's an ‘Aha!' moment when they say, ‘Even if we don't get this, it's helping us achieve better outcomes, clinical care and business results. Then, they're hooked.”

It's kind of like having a child who can't put down a good book or who wants to practice his penmanship or improve her manners. Who would dare step in front of that motivation?

Providers have all the incentive in the world to continue pursuing Bronze, Silver and Gold. Various association quality initiatives are driving greater quality awareness, and so are federal efforts such as the not-yet-finalized QAPI (Quality Assurance Performance Improvement) program and other Affordable Care Act provisions.

While both children and nurtured providers may rightfully soar, the journey doesn't end with freshman orientation, or with an award. Parents will still be on hand to field phone calls (or, more likely, see a text) about an upcoming college-level test (or, more likely, a request for money). They are still there for their children in the same way AHCA and people like McMahon will continue to be there for providers. And whether it's a child or making a facility better, in both cases the time and effort are investments worth making. 

James M. Berklan is McKnight's Editor. Follow him @LTCEditorsDesk.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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