Utilizing MCG Guidelines in Post-Acute Care Facilities: A ... · and business.“ Mark Sanborn . ACO – PAC partnership ... implement and adjust the plan of care as reported . SNF

Utilizing MCG Guidelines in Post-Acute Care Facilities: A Franciscan ACO &

CarDon/Lifespan Therapy Partnership

Michael E. Clancy HFA,BS, Post-Acute Continuing Care Network Manager

Terry Sprinkle, Therapy Supervisor, CarDon & Associates

Purpose

• To provide the audience with an overview of the utilization of MCG guidelines to deliver optimal care and reduce length of stay in the post-acute setting.

© 2015 Franciscan Alliance, Inc.

Objectives

Upon completion of this session the participants will be able to:

• Summarize the benefits of implementing MCG guidelines in Post-Acute Care (PAC) facilities to guide length of stay

MCG Post-Acute Care Support • Helps organizations consistently deliver the most

appropriate, evidence-based decisions for post-acute care. • MCG guidance enables optimal transitions to the next level

of care and reduces potentially avoidable complications that lead to readmissions.

• Coordinates an effective plan for transitioning patients to skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs) – once admitted, helps facilitate optimal care, including

comorbidity management, within the facilities.

MCG Guidelines

• A comprehensive set of guidelines for making informed healthcare decisions, providing the highest quality care, and managing resources effectively during transitions of care.

• Provide targets for diagnosis and condition-specific length of stay and care transitions with admission, goal, and median length of stay measures

MCG Guidelines

• Provide a general treatment course, including therapies expected in post-acute facilities and key physical, functional, and psychosocial recovery milestones.

• Offer information on when a stay may extend beyond the anticipated treatment plan

• Outlines comprehensive patient education that clinicians can offer to patients/families

“Your success in life isn't based on your ability to simply change. It is based on your ability to

change faster than your competition, customers, and business.“

Mark Sanborn

ACO – PAC partnership

• One of the key advantages of ACOs is that they are motivated to provide coordinated, team-approached care

• Therapists are vitals members of this team in a SNF setting

• Effective management of ACO referrals will be critical to the long term success of facilities’ relationships with referral sources

• Therapy’s goal is to provide optimal care that will require prompt evaluation and treatment, a clear focus on resident outcomes, and clear channels of communication

Benefits of a partnership The reward for managing this process can result in a big win for the facility. • Increased ACO census • Increased ACO revenue • Increased Medicare census – hospitals prefer those

facilities that work with both managed care systems and Medicare

• Increased trust from partnering hospital to implement and adjust the plan of care as reported

SNF Therapy Focus

• Knowledge that the ELOS goal of an ACO patient may be different than the non-ACO patient with similar conditions– motivation to move through the continuum of care rather than rehabilitation to the highest practicable level before discharge

• Offer the best quality of care • Communicate efficiently and effectively to maximize outcomes with

decreased cost • Have the technology and modalities to accelerate goals and

outcomes • Be flexible to roll with the changes

How can we impact the quality and cost for the episode of care?

• Focus on reducing LOS

• Emphasis on reducing cost per admission

• Improve measurable outcomes

• Reduce readmission

• Increase the value of therapy services -therapy will be a vital service to allow timely transition to a lower level of care

How to reduce cost & LOS

• Be a pro-active therapy team- timely evaluations, initiate discussion of ACO affiliation and ELOS, review DC plans and caregiver support upon evaluation (secondary DC plans if primary proves unrealistic)

• Maximize provision of therapy services and be flexible to meet ELOS goals

• Utilize a interdisciplinary team approach

Keys to a successful partnership

1. A solid commitment by CarDon/Lifespan Therapy and the facility leadership (administrative, nursing, therapy, and case managers) is essential and must be conveyed to all staff


2. Staff education, training and teamwork will be essential for success and encourage that each individuals efforts will make a difference


3. The plan will require ongoing assessment and

modification to ensure success.

• Utilize and modify the tools and strategies that work best in your facility.


4. We can’t improve what we don’t measure.

• Ensure standardized tests and measurements are utilized and outcomes are reviewed with the team.

– This will assist staff in focusing on ways to improve success


5. Ongoing communication with ACO

• Share what differentiates our facility from others

• Continue to demonstrate our commitment to avoiding re-hospitalizations and our progress in reducing them

Average Length of Stay 2015

Franciscan

ACO PAC

CCN

Facilities


Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Average YTD LOS/Facility

Aspen Trace 38 30 29 23 25 18 21 33 23 38 46 16 28 Beech Grove Meadows 17 25 ND 30 16 29 30 18 9 15 24 13 21 Greenwood Meadows 31 26 19 18 20 16 22 22 28 19 16 16 21 Manor Care 26 37 28 24 18 12 11 43 20 27 23 15 24 Meadow Lakes 25 25 18 24 17 21 16 16 26 21 Miller's Merry Manor 33 41 24 14 17 53 9 46 20 15 13 26 Rosegate Village 36 18 43 26 27 33 37 34 33 33 20 21 30 SouthPointe 36 28 25 23 24 19 25 18 26 25 19 23 24 The Springs 14 9 12

Monthly Overall LOS 30 29 27 23 21 25 21 29 23 25 22 16 24 YTD Overall LOS

Franciscan

ACO PAC

CCN

Facilities



Altenheim 12 20 21 13 29 19 Aspen Trace 25 27 26 19 16 19 15 23 12 19 23 19 20 Beech Grove Meadows 21 26 18 13 28 23 13 19 24 19 13 15 19 Greenwood Meadows 13 12 23 9 20 21 16 19 14 10 16 16 17 Kindred Southpointe 31 35 14 9 17 14 45 19 21 0 0 0 21 Kindred Southpointe-IIMC 22 21 22 21 18 16 14 18 18 26 25 14 19 Manor Care 18 12 15 20 20 14 11 24 16 11 17 8 16 Miller's Merry Manor 20 13 5 24 22 20 29 40 17 32 29 20 23 Rosegate Village 35 26 25 33 29 32 26 39 29 22 23 26 29 The Springs 23 22 18 21 28 12 13 14 14 20 17 11 18


Franciscan ACO

PAC CCN

Facilities



Ashford Place 34 28 17 35 35 17 9 15 13 24 25 17 21 Morristown Manor 18 21 19 18 19 21 26 16 22 25 22 19 21 Waldron Health & Rehab 49 59 19 17 14 15 29 25 13 21 26 33 23


Major Health Partners PAC CCN Facilities



Altenheim 18 23 17 12 18 Aspen Trace 12 17 17 16 14 Beech Grove Meadows 13 19 15 15 16 Greenwood Meadows 10 11 13 9 11 Southpointe-IIMC 10 20 19 17 17 Manor Care 15 15 11 8 12 Miller's Merry Manor 10 24 15 24 18 Rosegate Village 16 29 33 25 26 The Springs 11 10 13 10 11

Monthly Overall LOS 13 19 17 15 16 YTD Overall LOS

Goal = 19 Days or Less

Franciscan

ACO PAC

CCN Facilities



Ashford Place 22 23 20 35 25 Morristown Manor 26 20 23 13 20 Waldron Health & Rehab 36 36 27 31 33

Monthly Overall LOS 28 26 23 23 26 YTD Overall LOS

Major Health Partners PAC CCN Facilities

Goal = 19 Days or Less

Average Length of Stay Trends

0

5

10

15

20

25

30

35

40

2015 2016 2017 2018

Nu

mb

er

of

Day

s

A

B

C

D

E

F

G

H

I

J

Overall Average Length of Stay

0

5

10

15

20

25

30

35

2015 2016 2017 2018

Nu

mb

er

of

Day

s

Year

2015

2016

2017

2018

Questions?

References

MCG Health (2018). Retrieved from https://www.mcg.com/

https://www.mcg.com/



Documents

Utilizing MCG Guidelines in Post-Acute Care Facilities: A ... · and business.“ Mark Sanborn . ACO – PAC partnership ... implement and adjust the plan of care as reported . SNF