W NHSWA Fall Conference 2012 Division of Long Term Care Initiatives Part 1

1. WNHSWA Fall Conference 2012Division of Long Term Care InitiativesPart 1 Kevin Coughlin and Carrie Molke September 20, 2012

2. Introduction

4. Agenda – LTC Initiatives • Falls prevention initiative in nursing homes • Connections to Community Living - NH residents interested in community placement • Nursing home quality and performance improvement initiative • Nursing home modernization initiative

5. Key Findings (The Burden of Falls in WI) • Falls have surpassed motor vehicle crashes as the most common cause of injury related death • A large majority of fall-related deaths (87%) and inpatient hospitalizations (70%) involve people age 65 or older. • Hospitalizations and emergency department visits due to falls result in $800 million in hospital charges each year in Wisconsin. • Over 70% of the costs for fall-related hospitalizations and emergency department visits are paid by government insurance programs such as Medicare and Medicaid. • The majority of falls that result in death occur in a person’s home. • Approximately 40% of those admitted to a nursing home had a fall in the 30 days prior to admission.

6. F323 - Regulation The facility must ensure that – The resident environment remains as free of accident hazards as is possible; and each resident receives adequate supervision and assistance devices to prevent accidents.

7. F323 - Intent • Intent of this requirement is to ensure the facility provides an environment that is free from accident hazards over which the facility has control and provides supervision and assistive devices to each resident to prevent avoidable accidents. This includes: • Identifying hazard(s) and risk(s) • Evaluating and analyzing hazard(s) and risk(s) • Implementing interventions to reduce hazard(s) and risk(s) • Monitoring for effectiveness and modifying interventions when necessary.”

8. F323 citations

9. F323 Ranking • #1 citation in WI for 2008, 2009 and 2010. #2 in 2011 (by 1 cite) • # 2 citation for the 1st 6-months of 2012 with 113 (27 at harm or IJ) • WI ranks 10th nationally for F323 citations

10. Fall prevention is so much more than decreasing F323 citations …. • Avoids premature transfer/discharge • Decreases hospitalizations • Decreases staff time • Increases independence • Improves quality of life!!

11. Division of Long Term Care Division of Quality Assurance Division of Public Health

12. NH Falls Prevention Project • DHS Initiative – DLTC, DQA, DPH • Collaboration with LeadingAge WI and WI Health Care Association • Collaboration with CHSRA using CMP $ • Collaboration with Metastar for training

13. NH Falls Prevention Project • Find leaders within the provider community leaders and those with recent improvement • Study what’s working • Match what’s working to those needing improvement

14. NH Falls Prevention Project • Study the effectiveness • Publish successful model • Increase effective falls prevention across the provider communities • Goal – decrease falls; decrease citations; decrease cost to system; improve Quality of Life!!