QRM Buzz Podcast: Recent Episodes
Casey Lee
Have you ever wondered what a good SNF “outcome” looks like? Join QRM’s Mark Hyder and Megan Ussery in the latest episode of the #BuzzPodcast as they discuss crucial elements to achieve optimal results.
Three Stars? Five Stars? What’s the difference? ⭐❓ Join Mark Hyder and Megan Ussery in the newest episode of the #BuzzPodcast as they delve into the intricacies of the #CMS 5-Star Program and discuss what the ratings mean for #LTC providers.
Gain valuable insights into the impact of the MDS coordinators' contributions and their indispensable role in maintaining a thriving healthcare environment.
Tune in now to elevate your understanding of the pivotal work undertaken by these professionals.
Join QRM's Mark Hyder for a captivating conversation with ADVION Executive VP, Cynthia Morton, as they discuss the recent CMS updates and Cynthia's response to the hypothetical scenario: "If you stumbled upon a genie in a bottle and granted 3 wishes for the SNF industry, what would you wish for?" Check it out now!
This week's episode of the #BuzzPodcast is all about the newly revised Quality Measure User’s Manual. Clinicians, administrators, and operators, are you ready to navigate these crucial updates?
Stay informed and tune in!
Are your morning meetings less than inspiring? 🔊 Join us for the latest episode of the #BuzzPodcast, where QRM’s Mark Hyder and Megan Ussery share strategies to transform your daily huddles into a source of productivity and team enjoyment!
Change is difficult, but sometimes we’re so focused on it, we can overlook the basics. Join QRM’s Mark Hyder and Megan Ussery as they discuss some of the important SNF fundamentals you don't want to forget.
In this week's episode of the #BuzzPodcast, Mark Hyder discusses changes to MDS Section J with QRM’s Stacey Hallissey and Megan Ussery. Enjoy this “pain-free” discussion about rating resident pain.
Tune in to learn how you can stay ahead of this critical issue!
In the latest episode of the #BuzzPodcast, Mark Hyder is joined by QRM's Director of Reimbursement, Megan Ussery, and Sr. VP of Integrity and Quality Improvement, Stacey Hallissey, to discuss CMS's move from the PHQ-9 to the PHQ-2 to 9 assessment model.
In this week's episode of the #BuzzPodcast, QRM's Mark Hyder and Megan Ussery explore the important topic of "Changes in Skin Integrity Post-Acute Care" and shed light on the newly released Standardized Pressure Injury Prevention Protocol (SPIPP) checklist.
Are these changes leading us to embrace a "back to the basics" approach to skin integrity? Tune in now to gain insight and decide for yourself!
In this episode of the #BuzzPodcast, Mark Hyder and #QRM's Chief Strategy Officer, Susan Krall, discuss the recently introduced CMS-mandated CoreQ survey; a new development for many in the #SNF community. Tune in to discover the ins and outs of this requirement!
In this week's episode of the #BuzzPodcast, #QRM's Mark Hyder and Ashley Duggan delve into the challenging yet significant topic: Documentation!
The recently mandated 5-claim review for CMS MACs brings documentation to the forefront. Listen along to gain valuable insight into how this critical form of communication can ensure accuracy, compliance and efficiency.
In this episode of the #BuzzPodcast, Mark Hyder spends time with QRM’s VP of Employee & Corporate Resources, Beth McCarty, discussing how HR departments can help provide organizational structure and support to keep their teams moving forward and meet business objectives.
Join Mark Hyder, QRM's VP of Reimbursement Strategy, as he discusses all the "Buzz" around CMS's newly mandated 5-Claim Audit with Ashley Duggan, QRM VP of Medical Review, and Stacy Grondel, QRM Director of Clinical Reimbursement. Get ready for these audits with the QRM Team!
In this episode of the Buzz Podcast, Mark Hyder spends time with QRM CEO, Freda Mowad, discussing the constantly changing SNF landscape, current issues facing providers, and some of the strategies that help leaders keep moving their teams forward.
In the latest episode of the #BuzzPodcast, QRM’s VP of Reimbursement Strategy & Education, Mark Hyder; Director of Reimbursement, Megan Ussery; and Sr. VP of Integrity & Quality Improvement, Stacey Hallissey discuss the impact of the upcoming proposed CMS changes to Section GG, the potential impact on various payment & quality reporting systems, and provide tips to prepare your team.
In the latest episode of the #BuzzPodcast, QRM’s VP of Reimbursement Strategy & Education, Mark Hyder; Director of Reimbursement, Megan Ussery; and Sr. VP of Integrity & Quality Improvement, Stacey Hallissey discuss the impact of the upcoming proposed CMS changes from a compliance perspective.
In the latest episode of the Buzz Podcast, QRM’s VP of Reimbursement Strategy & Education, Mark Hyder; Director of Reimbursement, Megan Ussery; and Sr. VP of Integrity & Quality Improvement, Stacey Hallissey enter the QM Corner to discuss quality measures focusing on preventing falls with major injury.
Introducing the newest series of the Buzz Podcast covering all things MDS! Led by our team of MDS and Section GG pros, this series will explore a variety of topics to equip your entire IDT with the knowledge, tools, and resources necessary for a smooth transition on October 1st.
Tune in to the first episode as QRM’s VP of Reimbursement Strategy & Education, Mark Hyder, and Director of Reimbursement, Megan Ussery, dive into the upcoming proposed CMS changes and share their views of what may be expected. As you prepare for the upcoming changes, this is worth a listen!
In this episode of the Buzz Podcast, Ryan sits down with Shay Akshay, a PTA and DOR out of California. They discuss what career capital is, what the modern career for a therapist assistant looks like, and how QRM is helping him achieve his goals for his team. This is an episode you wont want to miss.
In this episode of the Buzz Podcast, we sit down with QRM Regional Operations Director, Brett Seely, as he shares insight on the success he’s found with Section K Capture under the PDPM model at the facilities he oversees. Learn how PDPM has put the speech component front and center, what Section K involves, the importance of the interdisciplinary team in the modern-day SNF and much more.
In this episode of the Buzz podcast, Ryan sits down with Kris Brown, Project Coordinator for QRM. We explore the back end of what keeps the Hive Machine that is QRM moving smoothly and fluidly for our clients.
In this episode of the buzz podcast, your host, Ryan Blue sits down with Matt Cameron, one of QRM's divisional vice presidents to discuss his passion for long-term care programming. This is an episode you definitely won't want to miss.
In this episode of the Buzz Podcast, Ryan discusses the ins and outs of what makes QRM's marketing team magic including how they started, their service offerings, SEO, and what sets them apart from the rest!
Contact the QRM Marketing Team with inquiries at marketing@qrmhealth.com
In this episode of the buzz podcast, your host Ryan Blue, Sr. Quality Clinical Education Specialist for QRM sits down with Saousan Ramadan, a Regional operations specialist to discuss the impact she has seen in the field regarding how education and IDT collaboration makes all the difference for her patient's and clients alike.
Today we speak with Freda Mowad, CEO of QRM about the unique aspects of the QRM process and how it is truly, therapist focused. This 100th episode of the podcast is surely one you won't want to miss.
In today's episode of the Buzz Podcast Ryan Blue celebrates OT Month. He is an occupational therapist by trade and discusses the role an OT plays in the SNF setting. Additionally he describes the differences between short stay and long stay residents when it comes to interventions and how OT's make a difference. See below for his referenced scientific literature.
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain & process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1–S48. http://dx.doi.org/10.5014/ajot.2014.682006
Jette, D. U., Warren, R. L., & Wirtalla, C. (2005). The relation between therapy intensity and outcomes of rehabilitation in skilled nursing facilities. Archives of Physical Medicine and Rehabilitation, 86, 373–379.
Today we dive into the Nursing Component with our director of clinical reimbursement Megan Ussery. We specifically look at key insights involving Extensive Services, Special Care High, and how to best maximize your reimbursement for these categories.
In this episode of the Buzz Podcast, Ryan speaks with Ashley Duggan, QRM's VP of Medical Compliance and review to explore the service offerings and unique touch QRM brings to their clientele.
In this episode, Ryan sits down to discuss how QRM Regionals bring success to their clients through the lens of Kristen Posey, one of QRM's lead Regional Managers. It's an episode you won't want to miss.
In today's episode we meet with Trish Williams to discuss documentation audit trends and pitfalls. We discuss the following topics:
What to look for in a documentation audit that will cause a denial of payment for services provided by the therapist in the event of a payer review of documentation.
We will start with the evaluation and go through the necessary information needed to support the level of clinical services provided throughout the POC.
Additionally, we review some common denial reasons that are easily preventable.
The “What If” podcast series continues with the question: what if every patient received telehealth services during their rehab episode? In this episode, we’ll unpack “What if” and “Why Not”.
What if your rehab team could design and own the prevention and maintenance programs for every long-term care patient they served? Check out this episode in the “What if” series to find out more!
Register here for the our on demand event mentioned in this episode: https://attendee.gotowebinar.com/recording/2001950510588822791
The dreaded drama triangle describes 3 toxic roles unknowingly played in presence of conflict. But what if it didn’t have to be this way? What if the conflict could be controlled and resolved with a shift in roles and mindset?
New Year means new intentions and new goals. In 2022, we shift our approach to GG goal setting to a more modern and patient-centered approach.
Ryan joins the pod today to discuss our newest QRM clinical program to address your post-COVID population. You won’t want to miss this one…. We figured out sound effects!!!
We've got some great trends to share for Section GG self-care and mobility outcomes in 2021! In fact, we achieved the average expected scores for both in May June and July this year. Determine who you would like to nominate as your GG Champion who will be your community's designated expert on scoring methodologies, coding, and documentation for GG in 2022!
Megan joins the pod to share our QRM community PDPM trends from 2021 using QAI (Quality Assistive Insights) info in DataIQ. She takes us through each PDPM component and shares multiple great trends which are directly related to our QRM educational focus areas this year! Way to go QRM teams! She also pointed out what we will be working on together next year to address our trend opportunities.
If you didn't get a chance to hear about QAI from our partners at DataIQ, listen to this roundtable Friday's with Freda podcast episode: https://www.qrmhealth.com/podcast/episode/797537b6/fridays-with-freda-roundtable-with-data-iq
Reach out to Megan for any MDS questions using her MDS hotline: https://forms.office.com/Pages/ResponsePage.aspx?id=5QGdE4AYhEOO6Z2CGrlQTmicn3cArCpDgA-bFVoc1FJUQTZMWkRNM1o0VldCSVQ4OU5RV1RKQTQ2UyQlQCN0PWcu
And, if you need a PDPM refresher, register for Megan's most recent webinar training on PDPM with a case study: https://attendee.gotowebinar.com/recording/8231716322231967752
Trish Williams joins the pod today to discuss her MICRO goals system for short-term goals. In her experience with reviewing and defending rehab documentation denials, she's identified a pattern of goal setting behavior which contributes to unmet, unrealistic goals which may trigger a denial for payment post service. Use the MICRO goals acronym when setting short-term goals: Measurable, Incremental, Current, Realistic, Objective. This will set you and your patients up for success!
This week, the QRM team has gotten together for our annual summit and holiday party. It’s the first time we’ve been able to do this in person so it’s been really exciting and inspiring. We’ve been able to discuss our industry’s challenges and how we will face them together as a community in 2022. One of the summit educational sessions addressed the daily challenges of a DOR and how to overcome them. Listen to this episode for an overview of A Day in the Life of a DOR and check out the on demand video: https://attendee.gotowebinar.com/recording/1581592920446248460
In today's episode, Ryan reviews QRM's Fall Reduction Program specifically targeting a long-term care nursing home population where 50% of residents experience a fall each year. He discusses some of the challenges nursing home providers face when designing fall reduction programs like: how to address the frequent faller, what to do for the high level resident who hasn't not yet fallen, and how to transition fall programs effectively.
Here is link to Ryan's webinar on the community-based fall program STEADI and a link to the CDC's website for STEADI resources:
https://attendee.gotowebinar.com/recording/7237971115534454027
https://www.cdc.gov/steadi/
Ryan Blue joins the pod today to discuss the occupational therapist's role in the identification and treatment of swallowing problems. Under a conventional model of care, you may have used an SLP to treat dysphagia but what if you could expand the roles of other disciplines to address swallowing needs? And when you have no other option, what if you had to come up with an alternative solution that doesn't include an SLP because you simply do not have access one? Ryan shares an alternative solution to address dysphagia under the OT scope of practice.
If you want to learn more, check out his 1 hour webinar on this topic -
Register for the on demand video here: https://attendee.gotowebinar.com/recording/6195855093841411587
Have you ever felt like you can't get all the important things you need to do done? You are not alone! There are times that it feels like EVERYTHING is important and it's impossible to get all of it done! The good news is, the statement "Everything is Important" is a painful paradox. While it might seem true, it simply can't be true because of a tricky constant variable: time. Time simply doesn't allow us to do all of the things therefore, we must prioritize and do what is really important first. Good news - the pain paradox has a solution and it's all up to you!
4 Power Prioritization Strategies:
1. Plan what is important and DO IT
2. Set goals - BIG dreams and Mini Wins
3. Hold Systems Accountable
4. Take out the Trash
If you're interested in The Liar Paradox, here's a YouTube video to enjoy:
https://youtu.be/4Q3bLv8a4Y8
Megan Ussery joins the podcast for part 2 of her 2 part Skilled vs. Unskilled series. In this week's episode she focuses on skilled documentation to support skilled services (check out Episode 81 for a review of skilled services). She offers a few simple strategies to enhance your documentation and support the skilled services provided:
1. Document point of service or right after a service is provided
2. Document services which address the primary reason for SNF and primary medical diagnosis
3. Document patient response to services and interactions with other health care professionals
4. Don't document unskilled, repetitive, redundant information. Instead, say more with less words
Special guest alert! In this episode, Chris Eamiguel and Derek Gay from Data IQ sit down with Freda and Haylie from QRM to discuss the evolution of QAI - Quality Assistive Insights. QAI is a complete, easy to use, real-time analytics platform which offers meaningful information to improve operational and patient outcomes.
Check out this video on how QAI started:
https://www.linkedin.com/company/dataiq-llc/videos/?lipi=urn%3Ali%3Apage%3Acompanies_company_index%3B3426395d-0bda-4bf2-b2af-ed800a183291
Megan Ussery joins the pod today for part 1 of a 2 part series on what defines a skilled level of care and the necessary documentation to support it.
Resources discussed in today’s episode:
Chapter 8 Medicare Benefit Policy Manual
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c08pdf.pdf
QRM MDS Helpline:
https://forms.office.com/Pages/ResponsePage.aspx?id=5QGdE4AYhEOO6Z2CGrlQTmicn3cArCpDgA-bFVoc1FJUQTZMWkRNM1o0VldCSVQ4OU5RV1RKQTQ2UyQlQCN0PWcu
Ryan Blue joins the pod today to share a smooth and simple program he created to address the LTC needs of 4 patient groups: Fall Risk, Incontinence, Dementia, Post-COVID syndrome. This program was created in an effort to make LTC patient identification, assessment, and intervention as easy and streamlined as possible for our healthcare industry that is struggling with workforce retention.
Telehealth extenders, facilitators, e-helpers: Call them what you will, but those helping a therapist during Telehealth assessments are a critical part of the health care process. Ryan Blue joins the pod to share his strategies on how to best support and utilize extenders for your telehealth visits.
Check out his webinar on Telehealth & Remote Visits: https://attendee.gotowebinar.com/recording/3178430148832135695
And here's a link to a $10 smart phone lanyard similar to what he discussed today: https://www.amazon.com/Gear-Beast-Universal-Compatible-Smartphones/dp/B01KYCQDUO/ref=sr_1_1_sspa?crid=1DHXH885C3KY9&dchild=1&keywords=cell%2Bphone%2Blanyard&qid=1634679925&sprefix=phone%2Blandyard%2Caps%2C199&sr=8-1-spons∣=A3IOU7TBTL62TF&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUFGSUM0T1NDT1pUVjMmZW5jcnlwdGVkSWQ9QTA3MjYxNjgzVUJJNEpLWEZKTlg3JmVuY3J5cHRlZEFkSWQ9QTA5NTY4NzVHVFAzWlJTTTBTODkmd2lkZ2V0TmFtZT1zcF9hdGYmYWN0aW9uPWNsaWNrUmVkaXJlY3QmZG9Ob3RMb2dDbGljaz10cnVl&th=1
Megan Ussery, RN, RAC-CT (Resident Assessment Coordinator - Certified) joins the podcast today to share her experiences as an MDS coordinator and how discusses important this role is in your facility. She recently read an article (link below) which describes the alarming spike in MDS coordinators are leaving long-term care. This is a problem!! Megan wants for all of us to thank an MDS coordinator today and offer them support. She offers her MDS hotline as a layer of support (link below) and invites MDS coordinators to check out her monthly webinar series - MDS QIEs to Success. We've included the link to this month's webinar below. Thank you MDS for all you do!!
McKnight's Article - https://www.mcknights.com/news/coordinator-turnover-threatens-to-cut-into-reimbursement-survey/
Megan's MDS Hotline - https://forms.office.com/Pages/ResponsePage.aspx?id=5QGdE4AYhEOO6Z2CGrlQTmicn3cArCpDgA-bFVoc1FJUQTZMWkRNM1o0VldCSVQ4OU5RV1RKQTQ2UyQlQCN0PWcu
MDS QIEs To Success: Solving the Diagnosis Puzzle - https://attendee.gotowebinar.com/recording/7025824744248220934
Ryan and I recently hosted a telehealth webinar which was very well attended and sparked some great questions. In this podcast episode, we will review those questions and share our excitement about the future of telehealth!
Register below to view our telehealth webinar training:
https://www.gotostage.com/channel/067e8b9b6c394fd09c2d13c0f9ac1ffe/recording/81ec26d8ac0445f99e2af73ff25f790d/watch
I got to chat with Becca Smith, VP of Reimbursement with Caraday Healthcare, at the THCA 71st Annual Convention and Tradeshow this week! She inspired our pod today which covers the new and modern flexibility under the 1135 for therapy assistants to deliver skilled maintenance therapy services! Skilled maintenance programs are not new or modern but have historically required a qualified clinician for delivery (an evaluating PT, OT or SLP). The modern ability for assistants to deliver maintenance therapy allows for skilled therapists to observe and monitor for signs and symptoms of silent hypoxia prevalent in our contemporary post-COVID population. And, if you listen to entire episode, you'll get a chance to meet my sweet dog, Zia - she just can't help herself sometimes!
It’s Fall! And with the new season, we start Fall Prevention Awareness Week. Listen to this episode to learn how to raise awareness in your communities about the impact of falls on older adults and how to start screening today for fall risks in order to develop individualized prevention programs.
National Council on Aging Falls Free Checkup
https://www.ncoa.org/article/falls-free-checkup
CDC STEADI website
https://www.cdc.gov/steadi/index.html
Trish Williams joins the pod today to discuss her upcoming education on MICRO goals which will help demonstrate incremental patient progression and reduce risk of denial.
Trish Williams joins the pod to share her audit findings specific to rehab denial risks. She shares the top reasons for denial and her method for auditing and providing education to reduce these risks.
Freda got to sit down and chat with Cassie Mistretta, CEO of Senior Living Properties (SLP) who was recently included in Fortune's 2021 list of 25 Best Large Workplaces in Aging Services: Senior Housing and Care. Cassie shares her long-term care professional journey, the surprisingly smooth transition to in-house rehab during the pandemic, and the work culture at SLP driven by open-communication, transparency, and ultimately the belief in the goodness of people who have chosen to serve aging adults.
For more info on the Fortune list, check out the link: https://fortune.com/best-workplaces-aging-services-senior-housing-care/2021/
In this episode, Ryan Blue, OT and Quality Clinical Specialist at QRM, explains remote patient monitoring (RPM): what it is, why we should consider doing it and how to implement a RPM program in an organization. He lays out best practices to adopting an RPM program including building your team, identifying appropriate patients, onboarding these patients and ensuring engagement and adherence. He also explains billing, reimbursement, and growth of your RPM program. Please reach out for more info on RPM!!
You can email us at buzzpodcast@qrmhealth.com
Join the advocacy effort! Freda and I talked today about H.R. 2168 - The Expanded Access to Telehealth Act of 2021. Listen to hear about Freda’s exciting conversation with ASHA’s Monica Sampson - Director of Healthcare Services in Speech-Language Pathology. And please click and share the links below to urge your representatives to cosponsor H.R. 2168
https://www.congress.gov/bill/117th-congress/house-bill/2168/text
https://takeaction.asha.org/asha/Telehealth
https://www.apta.org/advocacy/take-action/patient-action-center
https://cqrcengage.com/aota/app/onestep-write-a-letter?0&engagementId=510602
Welcome to the hive! The Quality Improvement & Education (QIE) team has new members - meet the whole crew on today’s quick episode.
Four telehealth experts from our QRM team share their real-life, multi-discipline experiences with planning and delivering remote therapy services.
WELCOME to the pod: Hayley Mason, Sarah Whealen, Keith McCrate, and Ryan Blue!!
We've got all therapy disciplines covered (PT, OT, ST) in this discussion so check it out and share with your rehab teams.
APTA statement on Telehealth
https://www.apta.org/apta-and-you/leadership-and-governance/policies/telehealth
AOTA position paper on Telehealth in OT
https://ajot.aota.org/article.aspx?articleid=2719223&resultClick=3
ASHA and Telepractice
https://www.asha.org/Practice-Portal/Professional-Issues/Telepractice/
If you’re hesitant about incorporating telecommunications into your practice, this episode is for you! Avoid dead-ending without access to patients by using a hybrid care delivery model of telecommunications and in-person visits.
Check out this episode to learn 3 ways to determine if your rehab plans are individualized or cookie cutter.
Join me for today’s episode recorded from Florida Health Care Association’s Annual Conference and Trade Show! I’ll discuss highlights from a session QRM co-presented with SimpleLTC and how it connects with the conference theme and keynote speaker, Mike Rayburn’s, topic
Oh, and check out this clip of Mike Rayburn - it’s amazing!
https://m.youtube.com/watch?v=jKKlvyRfr1E&feature=youtu.be
Welcome to the podcast Megan Ussery! Megan is an RN and joins today to share her thoughts on the PPS Proposed Rule for FY 2022. She joins the QIE team with extensive experience and expertise in skilled nursing care and reimbursement. You can ask Megan questions directly by copying the following url into your browser:
https://forms.office.com/Pages/ResponsePage.aspx?id=5QGdE4AYhEOO6Z2CGrlQTmicn3cArCpDgA-bFVoc1FJUQTZMWkRNM1o0VldCSVQ4OU5RV1RKQTQ2UyQlQCN0PWcu
If you do not have a QRM ID - enter 10000 to complete the form. Thanks!!
True colors is a personality framework that we use at QRM to enhance communication and relationships. Learn more about the 4 true colors and take the free quiz to find out your true color!
https://truecolorsintl.com/the-four-color-personalities/
Therapy Outcomes in Post-Acute Care Settings (TOPS) is a study which examined 1.4 million Medicare claims and assessments revealing the impact of PT and OT services on functional change and rehospitalization rates in 2015-2016. It also highlights the clear differences in the patients served in Home Health, Inpatient Rehab, and Skilled Nursing.
From APTA's website - TOPS Summary & Chartbook
https://www.apta.org/article/2021/04/05/apta-aota-joint-statement/tops-study-chartbook#
In this episode, SMART goal writing is discussed for short and long term goal development. They should be different! Short term goals are not simply mini versions of long term goals but are the concrete measurable opportunities to prove how a patient is responding to the therapy services provided and towards achievement of the long term goals or desired outcomes.
SMART Goals are-
Specific
Measurable
Attainable
Relevant
Time-based
After visiting with facilities who’ve demonstrated low goals met performance for 3 or more months in a row, we’ve identified the top 3 reasons why this happens.
In part 3 of her "In-House Done Right" series, Freda interviews special guest, Hayley Mason - a speech-language pathologist who's experienced a transition from outsourced rehab to in-house with QRM support.
Listen to this inspiring interview with Ron Haney, co-founder, and partner of Cascade Health Services. Freda and Ron discuss transitioning from third-party rehab to in-house with QRM from a client's perspective.
In today’s episode we discuss step 1 of our QIE multi-step Quality Documentation Improvement Program: Documentation 101 Basics training. Whether you are a new clinician, new client, looking for a refresher on doc basics, or were invited to attend due to goals met performance, Doc 101 training is for you!
In today's bonus episode, Freda shares what a QRM transition looks like for an operator. Whether you currently outsource your rehab services or would like support for your in house therapy program, we can help! Freda takes our audience through the transition process step by step, phase by phase:
Phase 1
- Initial contact to understand your individual needs and goals
- Financial analysis to understand cost savings and revenue opportunities
- Contract negotiations and scheduling of Go Live day 1!
Phase 2
- Pre Go-Live weekly meetings
- Review technology integrations weekly during pre go-live meetings
- Weekly recruitment updates
To set up an initial contact meeting with QRM, Contact us at qrmhealth.com!
Listen to the evolution of our Quality Documentation Improvement Program. It started out as a audit and has grown into much more!!
Send us your thoughts!
buzzpodcast@qrmhealth.com
She's back to the pod folks!! Freda Mowad, QRM CEO, joins the Buzz today for the first of many "Fridays with Freda" episodes. On today's episode, In House Done Right #1, she covers some of the most frequently asked questions about transition from outsourced rehab services to an in-house model with QRM support. Check out this episode and all of the upcoming "Fridays with Freda" episodes!
In this episode, we explain the QIE (Quality Improvement & Education) Team, QIE Programs and QIE Concepts by breaking down the evolution of our very first QIE Program - Improving Section GG Outcomes.
Please reach out to the QIE team for more info!
buzzpodcast@qrmhealth.com
clee@qrmhealth.com
Check out this episode for a heated discussion about logical vs. illogical storytelling. If a story is illogical, let's really understand why and what it says about our services, our patient population, and the care we provide. Logic has an emotional foundation as it drives us to action! In this episode, we discuss how to apply emotional logic to your PDPM storytelling. Let's get fired up!
Rita joins the pod to continue her PDPM series focused on the ST component. Today she reveals a new Quality Improvement & Education (QIE) Program to improve the allocation of resources to the residents we serve by increasing accuracy of conditions captured. This program is called the SLP Road Map to Success and she takes us through a case study of questions to ask when you approach a Yellow Light Road - check this one out!
Check out this episode to hear about confusing data trends which suggest that despite the presence of COVID increasing in our population last year, we reported a decrease in patient complexity in the ST PDPM component. Rita shares her SLP perspective with listeners while describing the acute and post-acute COVID symptoms and impairments which should be included in your interdisciplinary screening process to avoid missing a COVID condition.
Articles references during this episode:
Kwok, Amy M et al. “Post-extubation dyspaghia in trauma patients: it’s hard to swallow.” American Journal of Surgery vol. 206,6 (2013): 924-7;disucussion 927-8. Doi:10.1016/j.amjsurg.2013.08.010
Brodsky, Martin B et al. “Laryngeal Indury and Upper Airway Symptoms after Oral Endotracheal Intubation with Mechanical Ventilation during Critical Care: A Systematic Review.” Critical care medicine vol. 46, 12 (2018): 2010-2017. Doi:10.1097/CCM.0000000000003368
Listen to today's episode for an overview of May topics focused on speech therapy and the ST PDPM component. Rita joins the pod all month and will be sharing a new initiative she's working on with our QRM Wellness Division: Recovery in a Post-COVID World. You won't want to miss this series!!
On today's episode, 2 guests join the pod - Michele Morris, operations manager with QRM and Jake Kline, rehab director from Ashford Hall Nursing and Rehab. Jake and his rehab team were recently inducted into the very elite QRM QIE Club (Quality Improvement & Education)! Check out this episode to hear all about how Ashford Hall and others joined QIE Club and what it's all about!
Listen in to hear how QRM communities have performed so far in 2021 with GG functional outcomes. It’s a great story you won’t want to miss!
Rita and I discuss presumption vs. non-presumption of care categories specific to the SLP PDPM case mix groups and the trends based on 2020 and Q1 2021 data. The majority of our residents are in non-presumptive categories but is this an accurate story?
Medicare recently updated the list of authorized telehealth evaluation and treatment codes during the public health emergency and GREAT NEWS!! The list was expanded to include CPTs specific to SLP practice areas: swallowing, cognition, and speech generated devices. Listen to this episode for Rita's strategies for setting up a pre-planned telepractice swallowing evaluation and treatment with patient safety and outcomes in mind.
SPECIAL 50th Episode!!
On this 50th Buzz Podcast episode, I got to sit down and have chat with Freda Mowad - founder and CEO of QRM health. She and I discuss QRM: the thriving hive, and how it all started. She attributes success to an inclusive, supportive, engaged community of QRM team members, clients, and partners working together and sharing resources to achieve mutual goals.
Let’s Get Clinical series wraps up today with a discussion about maintenance and prevention programs - how to write goals and design programs for not just improving function, but also maintaining function and preventing decline.
In the continuation of our "Let's Get Clinical Series", we case study how to implement an effective fall prevention program which addresses the actual needs of your unique population. Take the extra time to complete a comprehensive pre-program needs assessment and identify the most common risk factors contributing to falls in your community.
Let's Get Clinical Part 5! We are just loving the podcast series focused on clinical programs. Today's episode is all about fall prevention programs and resident identification based on extrinsic and intrinsic fall risk factors. During the episode, the CDC's STEADI program was referenced. Here's the website if you want to learn more about this great program!
https://www.cdc.gov/steadi/
A successful dementia program cycle has to be measurable, easy to understand/execute, and must meet the actual needs of the population it serves.
1. Start with a comprehensive needs assessment including residents, families, and caregivers.
2. Determine what measurable outcome best matches your population's needs.
3. Complete baseline staging assessments followed by appropriate therapy referrals
4. Transition to caregiver team who has been educated on cognitive assistance strategies developed by the therapy team through the rehab episode
5. Review changes in the measurable outcomes established in Step 2 routinely to determine when to repeat the cycle
We discussed a case study today specific to an ACL Mode 3.4. There are many dementia staging frameworks out there. Select the one that best suits your organization. Here's are a couple quick reference links to the Allen Cognitive Levels & Modes -
https://allencognitive.com/wp-content/uploads/Ed-Corner-Allen-Cognitive-Levels-and-Modes-of-PerformanceCombo.pdf
Major Descriptions of the Modes of Performance (allencognitive.com)
Join Casey and Rita for part 3 of the "Let's Get Clinical" podcast series where we reflect on our past experiences with dementia programs and offer solutions for implementing an effective dementia program that meets the specific cognitive and functional needs of your residents. We had so much fun with this episode that we've already planned on taking it a step further next week! Join next week for Dementia Programs: How to get it RIGHT! part 2
In Part 2 of the "Let's Get Clinical" series, we'll discuss the different therapy treatment modes: individual, concurrent, co-treatment, group, telehealth. Each are clinically effective for different reasons and should be provided at different times throughout the episode of care.
Welcome back! Our next podcast series is focused on clinical programs and effective patient interventions. In this episode, exercise prescription is reviewed with strategies on how to develop and measure programs to improve strength and aerobic condition.
Here are the American College of Sports Medicine recommendations for exercise prescriptions for older adults discussed during this episode:
Summary of ACSM/AHA physical activity recommendations for older adults.
The current consensus recommendations of the ACSM and AHA with respect to the frequency, intensity, and duration of exercise and physical activity for older adults are summarized below. The ACSM/AHA Physical Activity Recommendations are generally consistent with the 2008 DHHS Physical Activity Guidelines for Americans, which also recommend 150 min/wk of physical activity for health benefits. However, the DHHS Guidelines note that additional benefits occur as the amount of physical activity increases through higher intensity, greater frequency, and/or longer duration. The DHHS Physical Activity Guidelines stress that if older adults cannot do 150 min of moderate-intensity aerobic activity/wk because of chronic conditions, they should be as physically active as their abilities and conditions allow.
Endurance exercise for older adults:
FREQUENCY: For moderate-intensity activities, accumulate at least 30 or up to 60 (for greater benefit) min/d in bouts of at
least 10 min each to total 150–300 min/wk, at least 20–30 min/day or more of vigorous-intensity activities to total 75–150 min/wk, an equivalent combination of moderate and vigorous activity.
INTENSITY: On a scale of 0 to 10 for level of physical exertion, 5 to 6 for moderate-intensity and 7 to 8 for vigorous intensity.
DURATION: For moderate-intensity activities, accumulate at least 30 min/day in bouts of at least 10 min each or at least 20 min/d of continuous activity for vigorous-intensity activities.
TYPE: Any modality that does not impose excessive orthopedic stress; walking is the most common type of activity.
Aquatic exercise and stationary cycle exercise may be advantageous for those with limited tolerance for weight bearing activity.
Resistance exercise for older adults:
FREQUENCY: At least 2 days/wk.
INTENSITY: Between moderate- (5–6) and vigorous- (7–8) intensity on a scale of 0 to 10.
TYPE: Progressive weight training program or weight bearing calisthenics (8–10 exercises involving the major muscle groups of 8–12 repetitions each), stair climbing, and other strengthening activities that use the major muscle groups.
Flexibility exercise for older adults:
FREQUENCY: At least 2 days/wk.
INTENSITY: Moderate (5–6) intensity on a scale of 0 to 10.
TYPE: Any activities that maintain or increase flexibility using sustained stretches for each major muscle group and static rather than ballistic movements.
Balance exercise for frequent fallers or individuals with mobility problems:
ACSM/AHA Guidelines currently recommend balance exercise for individuals who are frequent fallers or for individuals with mobility problems. Because of a lack of adequate research evidence, there are currently no specific recommendations regarding specific frequency, intensity, or type of balance exercises for older adults. However, the ACSM Exercise Prescription Guidelines recommend using activities that include the following: 1) progressively difficult
postures that gradually reduce the base of support (e.g., two-legged stand, semi-tandem stand, tandem stand, one-legged stand), 2) dynamic movements that perturb the center of gravity (e.g., tandem walk, circle turns), 3) stressing postural muscle groups (e.g., heel stands, toe stands), or 4) reducing sensory input (e.g., standing with eyes closed).
The ACSM/AHA Guidelines recommend the following special considerations when prescribing exercise and physical activity for older adults. The intensity and duration of physical activity should be low at the outset for older adults who are highly deconditioned, functionally limited, or have chronic conditions that affect their ability to perform physical tasks. The progression of activities should be individual and tailored to tolerance and preference; a conservative approach may be necessary for the most deconditioned and physically limited older adults. Muscle strengthening activities and/or balance training may need to precede aerobic training activities among very frail individuals. Older adults should exceed the recommended minimum amounts of physical activity if they desire to improve their fitness. If chronic conditions preclude activity at the recommended minimum amount, older adults should perform physical activities as tolerated so as to avoid being sedentary.
Join our podcast guest today Rita Ramos for a review of 2020 lessons learned related to the negative impact of social isolation and how we can safely bring people back together in a FUN and relevant way!
Here are the links and resources discussed during today's episode:
https://www.cms.gov/files/document/qso-20-30-nh.pdf
https://www.cms.gov/files/document/qso-20-30-nh.pdf and https://www.cms.gov/files/document/qso-20-39-nh.pdf
https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html
https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/strategies-optimize-ppe-shortages.html
In this episode, we'll review the most common post-acute COVID symptoms in order of prevalence based on lessons we learned in 2020. Here is the list of common post-COVID symptoms to anticipate and address with your aging adult population
Fatigue
Breathlessness
PTSD, Anxiety/Depression
Concentration Problems
Pain
Voice Changes
Cough
Memory Problems
Continence Problems
Dysphagia
In this episode, we discuss treating the acute, newly diagnosed COVID patient in your SNF/LTC setting. Make sure to complete a comprehensive assessment of cardiopulmonary function before, during, and after activities to rule out the following common issues identified with this population: shortness of breath, asymptomatic hypoxia, hypotension, lowered ejection fraction.
Respiratory muscle weakness is a very common impairment and can easily be addressed using the following exercise program:
Diaphragmatic breathing exercise:
Lie on your back with knees bent. Put a pillow under knees for support if needed
Place one hand on belly below rib cage.
Inhale deeply through your nose for a count of three. Belly will rise. "Smell the roses"
Tighten/flatten stomach muscles and exhale for a count of six through pursed lips. Belly will fall. "Blow out the candles"
We learned a lot in 2020! Let's use these lessons to help enhance our 2021 practice for improve efficiency, quality outcomes, and patient satisfaction. Today, let's discuss 4 tips for providing telehealth services:
1. Be Prepared - have a plan for equipment, set up, interventions, assessment strategies
2. Be Creative - think how to accomplish goals with verbal and visual cues
3. Be Flexible - go with the flow and use environmental cues to drive interventions
4. Be Compliant - know your state practice act and follow CMS guidance (see resource links below)
In this episode, CMS resources were referenced - here are the links to find these tools:
https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers
https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes
Happy New Year!! Check out our first pod series of 2021 - Applying 202 Lessons Learned into 2021 Practice. Our industry was shaken by a new diagnosis last year but we learned invaluable information on how to manage during a crisis. The next 4 episodes will focus on lessons learned and applications into practice.
3 Key Elements of quality daily note documentation are the What, the Why, and the How. Listen to our final pod of 2020 and last episode in “Improving Quality Documentation” series to learn how to avoid the nonsense daily note and focus on what really matters.
We continue our series on improving the quality of rehab documentation with tips to enhance the initial rehab evaluation. The initial eval is Chapter 1 of a unique patient story and requires a discipline specific reason for referral which drive, measurements, assessments and functional measurable goal selections.
Our podcast series focused on improving the quality of rehab documentation continues with a review of progress reports and why goal modifications are a required element of our QRM Quality Documentation Audit process.
How does your organization define quality documentation? Compliant documentation and quality documentation are two different things. Check out part 2 of our quality rehab documentation series where we discuss how a strong finish helps define quality documentation.
Listen in to the last podcast series of 2020!! Based on data collected this year on the percent of rehab goals met, we've created an audit tool to understand WHY don't we meet the goals? Through the end of December, join the QRM Quality Team to help answer this question as we deep dive quality improvement opportunities related to our audit findings.
The dining room is a natural environment for identifying long-term care resident needs in real time. There's no better place to easily explore and examine activities of daily living in action! And since all IDT members play a role in dining room support, this is an area where we all can share perspective to address resident needs.
If you remember Grand Rounds, check this one out! We may not “round” anymore but we still collaborate to determine individual patient needs.
Join QRM's CMI expert Rita Ramos for a discussion on how to use case mix index weights to drive LTC programming initiatives. What does CMI tell you and how can you use this information to individualize care plans and allocate appropriate resources for your LTC patient population? Check out this episode to find out!
Part 2 of our LTC Quality Improvement and Clinical Programming series
Tune in for a review of the nursing home compare publicly reported long-stay quality measures used to help consumer make informed decisions about health care providers. Today we dig into the long-stay QMs used to calculate the 5 star Quality Domain
Introduction to a new podcast series: Long-Term Care quality improvement and clinical programming. In the next 5 episodes, we will navigate the new Care Compare website and analyze Nursing Home Compare 5 star quality measures specific to long-stay residents. We will discuss CMI and what your weighted Case Mix Index means, how it differs by state, and how to analyze monthly CMI trends to address LTC patient needs. The final 2 episodes in this series will be dedicated to LTC patient identification using an interdisciplinary Grand Rounds process and LTC clinical programs to consider in-room and in a COVID safe group setting.
Please check out your Care Compare 5 Star Quality Measures before next week's episode at:
https://www.medicare.gov/care-compare/
Reach out to the Buzz Podcast team at:
buzzpodcast@qrmhealth.com
During today's episode, QRM's VP of Medical Review Ashley Duggan shares 3 potential audit & denial risk areas her team has identified related to COVID.
Resources discussed in today's episode:
Let's Get to the Point: Coding and Documenting to Capture Isolation
Given the current COVID-19 Public Health Emergency, providers have incorporated isolation into resident care to minimize infection transmission. While isolation may be essential to resident safety, it may not always meet the RAI Manual criteria for claiming on the MDS. Per the RAI Manual, there are 4 specific criteria that must be met in order to claim isolation - criteria that have not changed with onset of the current Public Health Emergency.
Code for “single room isolation” only when all of the following conditions are met:
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The resident has active infection with highly transmissible or epidemiologically significant pathogens that have been acquired by physical contact, airborne or droplet transmission.
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Precautions are over and above standard precautions. That is, transmission-based precautions (contact, droplet, and/or airborne) must be in effect.
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The resident is in a room alone because of active infection and cannot have a roommate. This means that the resident must be in the room alone and not cohorted with a roommate regardless of whether the roommate has a similar active infection that requires isolation.
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The resident must remain in his/her room. This requires that all services be brought to the resident (e.g. rehabilitation, activities, dining, etc.).
The RAI Manual also reminds us that specific examples of when the isolation criterion would not apply include urinary tract infections, encapsulated pneumonia and wound infections.
When conducting clinical audit, the following are frequently overlooked areas that may contribute to lack of proper claiming of isolation:
• MDS Section G coding of walking in corridor and locomotion off the unit
• Lack of lab results to substantiate active infection above/beyond standard precautions
• Lack of documentation that all services were received in the resident’s room, including meals, therapy and showers/weights
• Lack of documentation of a private room on a daily basis
The Point Is: Educate and prepare facility teams to document to capture isolation for accurate reimbursement
From the QRM office of Medical Review & Compliance | Author: Ashley Duggan, OTR, RAC-CT, Vice President
Our COVID Clinical Practice Series continues with a review of the functional impact of COVID and strategies you can utilize to improve functional outcomes following the dramatic decline our industry experienced in March 2020
Our guest Rita is back on the pod to give our audience infection control strategies to implement before, during, and after resident interactions. She discusses why having an infection control plan before any resident activity is so important and how to incorporate infection control education into your activities to promote adherence - "this is MY dance space, and this is YOUR dance space"!!
Resources discussed during this episode:
Phase reopening guidelines: https://www.cms.gov/files/document/qso-20-30-nh.pdf
CDC guidelines for Optimizing PPE: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html
Quick reference for Optimizing PPE: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/strategies-optimize-ppe-shortages.html
Joining the pod for the next 2 episodes is QRM's new team member Rita Ramos, SLP and Quality Clinical Specialist. In this episode, Rita discusses the negative impacts of social distancing and isolation on the 3 D's: Depression, Delirium, Dementia and offers strategies to safely bring residents back together for carefully planned, choreographed social activities.
Resources discussed in this episode:
https://www.cms.gov/files/document/qso-20-30-nh.pdf
We are back!! The next 4 episodes will focus on clinical practice strategies based on what we’ve learned over the last 7 months of PHE. Today is an introduction to our series on COVID strategies. Stay tuned for more!!
Additional Show Notes:
Polling Question of the Week - submit answers to buzzpodcast@qrmhealth.com
What best describes your birth order style for keeping up with COVID-19 information?
Oldest Child - independent seeking information on your own
Middle/Only Child - rogue doing your own thing
Youngest Child - sitting back waiting to be instructed
Fall Prevention Awareness Week Resources discussed on pod:
•CDC’s STEADI website: https://www.cdc.gov/steadi/index.html
•National Council on Aging fall prevention week resources: https://www.ncoa.org/healthy-aging/falls-prevention/falls-prevention-awareness-week/
In this episode, we review caseload management strategies to reduce the risk of cross contamination during the public health emergency while also ensuring our patients have access to the services the need.
A traditional therapy model presents challenges to reducing cross contamination during the public health emergency. We offers suggestions on how to utilize technology to reduce practitioner travel between long-term care facilities
Options for adjusting documentation requirements to ensure uninterrupted care and decrease risk of COVID 19 spread
We revisit some of the most frequently asked questions during the public health emergency and give a shout out to a few of our rehab teams who are keeping residents engaged and moving despite barriers during current climate
Review of AHCA and NCAL guidance for therapists in LTC and SNF to prevent the spread of COVID-19
The first of many episodes dedicated to supporting our rehab teams working in skilled nursing facilities during the COVID-19 pandemic. Subscribe to the Buzz podcast to get daily treatment ideas, documentation tips, health promotion and safety strategies to utilize during this global crisis.
Use a 4 Quadrant Priority matrix to prioritize patient needs and services under PDPM. Focus on working in the Quadrant of Quality to improve outcomes and show value.
Too many redundant goals can dilute your plan of care and make it challenging to achieve functional goals. Tune in for strategies on selecting the best goals: 1. Choose less goals 2. Pick functional goals related to the reason for referral 3. Use consistent and measurable scales 4. Always include an education goal.
Unmet goals are a direct reflection of our rehab outcomes. When a discharge is planned, all goals should be met. Ask the following 3 questions when discharge planning to avoid unmet goals and negative outcomes: 1. Which goals are unmet? Focus on these areas ONLY prior to discharge 2. Does the goal need to be downgraded or discharged? If the patient will not achieve the established goal by the planned discharge date, the goal is NOT appropriate 3. Is there a patient/caregiver education and training goal? This ensures a safe and properly trained transition helping avoid RTA.
Therapy, we can show our value in PDPM by focusing on outcome measures to drive goals, treatments, and discharge planned. If you want to get better at the “thing”, then DO the “thing”!
What is your process for collecting and recording GG functional scores? GG impacts reimbursement under PDPM so accuracy and clear source documentation is critical! Try our 3 step process if you’ve identified gaps in your system -
1. Initiate 2. Collaborate 3. Document
With PDPM 6 weeks away, how do we assign therapy minutes when therapy minutes are no longer based on a RUG levels? I’ll walk you through my perspective on this question which will hopefully help you plan therapy minutes after October 1st.
We’ve identified 8 PDPM trends and opportunities based on grouper software data and share strategies you can implement now to prepare for October 1st.
On Day 3 of a skilled part A stay, meet as a team to predict the PDPM case mix groups. You’ve got until day 8 to confirm the CMGs so use the day 3 meeting to identify any questions and missing info impacting reimbursement.
What is your current pre-admission process and are you gathering the critical info need to predict case mix groups under PDPM? In this podcast, we review what questions to ask before the SNF patient admits to improve efficiency of the IDT collaborative meeting.
A review of PDPM HIPPS codes and what they can tell you about our patient populations and MDS coding trends. Start pulling your own PDPM data to predict and prepare for October 1st!
Review of GG audit trends including too high admission GG scoring and too low discharge scoring. These discrepancies impact outcome reporting and safe transitions. What are the best GG goals to set for each patient based on the transition plan? How can each member of the IDT play a role in GG discharge success? Listen in to find out!
In this episode, I’ll explain one approach to group therapy including how to set up a class, create a playlist, and address the needs of the group via verbal visual cues and encouragement.
Oh yes we CAN (and should) provide Group Therapy! The benefits of group are clear, so let’s understand the definitions and get back into the habit of delivering Group and Concurrent therapy services.
An Acute Neuro diagnosis makes all the difference for the SLP component under PDPM. But, what is the ACTUAL primary reason? Is it Neuro or Ortho or what? Select I0020B based on the actual needs of the patient as an interdisciplinary team.
Hey PT/OT - Don’t just take the diagnosis code given to you. Use your clinical skills, IDT collaboration and the ICD 10 mapping tool to find the BEST diagnosis.