Providers can cheer widespread quality improvement, but infection control poses a challenge: AHCA report

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More long-term care facilities are earning top marks in national quality ratings, but providers may need increased focus on infection control, according to the American Health Care Association's 2013 Quality Report.

The annual report from the nation's largest long-term care provider association in based on in-house research and government data. Between 2011 and 2012, providers improved “in almost all the quality measures generally used,” the report states. This builds on trends identified in the 2012 report.

For example, the percent of long-stay residents receiving an off-label antipsychotic medication decreased from about 24% to 23%. The percent with moderate to severe pain decreased from more than 12% to 10%. And the percent with a pressure ulcer decreased from 7% to 6.4%.

Furthermore, between 2008-2013, direct care nursing hours per resident day increased for all levels of nursing staff, according to the report.

Spurred by a Quality Initiative that began last year, AHCA members have improved faster than the national average on a number of these measures, the association found.

The focus on quality has translated to more top-rated skilled nursing facilities. Between 2009-2013, the number of SNFs receiving five stars on the government's Five Star rating system increased from about 12% to nearly 20%.

Infection control emerged as a problem area, the report shows. In 2008, surveyors cited 20% of SNFs with this tag, F441. In 2013, 40% have been cited with this tag.

Government agencies such as the Centers for Disease Control and Prevention have sounded increasingly dire alarms about the need for infection control and prevention in healthcare settings, due to the emergence of threats like the deadly carbapenem-resistant Enterobacteriaceae. The CDC recently classified CRE and Clostridium difficile as “urgent threats.”

The shift to short-stay, post-acute patients versus long-term residents is another “notable trend” identified by AHCA. A “typical, 100-bed center” will serve 189 short-stay patients and 86 long-term care residents over the course of a year, according to the report.

Click here to access the complete document, which was released yesterday.