How healthcare scheduling software can help clinical resources to optimize patient care

Achieving optimal staffing levels in skilled nursing facilities (SNFs) has long been an issue, which is why many leaders in long term care (LTC) rely on healthcare scheduling software as an answer to staffing challenges. With the lingering effects of the COVID-19 pandemic still impacting SNF providers, the need for effective solutions like these is more important than ever.

According to a KFF analysis of national staff shortage trend data from May 2020 through March 20, 2022, up to 34% of nursing facilities reported a staff shortage during that period.1 Since then, the situation seems to have only gotten worse.

A survey of 759 nursing home providers conducted by the American Health Care Association (AHCA) and published in June 2022 revealed that among the nursing homes surveyed:

87% were experiencing moderate to high levels of staffing shortages
98% were facing challenges in hiring nursing staff
61% were limiting admissions for new residents
73% were concerned that staffing issues would lead to facility closure
Nearly all were asking staff to pick up extra shifts2

And although the Public Health Emergency (PHE) is officially over, nursing homes continue to lag other healthcare sectors when it comes to a post-pandemic staffing rebound.

Historic job losses

In its May 2023 Long Term Care Jobs Report, the AHCA and the National Center for Assisted Living (NCAL) said the nursing home workforce is “at levels not seen since 1995” and that nursing homes are “still facing historic job losses while other healthcare industries have mostly rebounded to pre-pandemic levels.”3

According to the report, 244,600 nursing home jobs were lost during the pandemic. To return to pre-pandemic staffing levels, nursing homes would need to hire an additional 189,500 workers and — at the current pace of hiring — it will be late 2026 before that can be achieved.

Various factors, such as pre-existing nurse burnout exacerbated by the pandemic, are fueling ongoing staffing shortages. And as the AHCA notes, the more stringent staffing regulations recently initiated by the Biden Administration will only add to the difficulties SNFs face.4 The resulting strain on the resources needed to provide optimal resident care means SNF leaders are faced with an urgent need to develop effective staffing solutions that are easy to deploy.

Implementing healthcare scheduling software supports effective staffing strategies

A SaaS-based scheduling system, such as Inovalon’s Schedule Management, can help SNFs overcome staffing challenges by making the scheduling process more efficient, creating “always-ready” staffing, enabling better nurse engagement, and boosting staff morale. As a result, SNF leaders can devote more time and resources to improving resident care, rather than dealing with staffing issues.

With Schedule Management, SNF leaders can achieve results quickly, effectively, and affordably:

Low cost: Since this is a cloud-based solution, there is no need to invest in expensive hardware — which means upfront costs and cost of ownership are low.
Easy maintenance: Inovalon maintains the system — which eliminates the headaches and expense associated with doing so yourself. And if any technical troubles do arise, Inovalon’s customer support team is ready to promptly resolve the issue.
Cost savings: With this healthcare scheduling software, staffing can be optimized throughout your organization — which ensures that all employees are meeting their commitments and that agency costs and staff overtime are contained.
Using healthcare scheduling software means better staffing, which means better care

Appropriate staffing levels can contribute to higher quality care. The authors of a recent quality improvement study cited several studies which found that higher staffing levels of registered nurses (RNs), licensed practical nurses (LPNs), and certified nurse aides (CNAs) led to:

Fewer deficiency citations for deviations from state and federal quality standards
Fewer hospitalizations and emergency department (ED) visits
Better scores on other quality measures (QMs), including some of those reported in the Nursing Home Care Compare (NHCC) report card published by the Centers for Medicare & Medicaid Services (CMS)5

Noting that such studies typically measure staffing as average levels over time, the authors said their study of 14,717 nursing homes examined the association between staffing instability and quality of nursing home care.

Measuring staffing instability as “the percentage of days substantially below average levels,” they said the findings suggested that “holding average staffing levels constant, day-to-day staffing stability, especially avoiding days with low staffing of licensed practical nurses and certified nurse aides, is a marker of better quality of nursing homes.”

The study authors also expressed a sentiment that captures the potential available when an effective healthcare scheduling software is part of the solution: “The ability of a nursing home to avoid days with low LPN and CNA staffing, perhaps by building more flexibility into staffing availability or better planning and anticipation of changes in staff availability or resident census, appears to offer a new pathway to quality improvement.”

SNF leaders cannot afford to overlook the link between optimal staffing and quality of care. In fact, a CMS analysis that examined the relationship between staff turnover and quality of care found a correlation between a decrease in average staff turnover rates and an increase in the facility’s overall Star Rating.6

Improving resident care with quality management solutions

To help improve such measures, in addition to using healthcare scheduling software like Schedule Management, SNFs can implement Inovalon’s clinical quality applications. When used to their fullest potential, these tools can streamline post-acute quality reporting and care management to optimize and improve reimbursement, quality measures, documentation accuracy, and CMS Star Rating performance.

For instance, MDS Intelligence helps improve resident assessment data accuracy and enhance care plans via analysis of the MDS. This SaaS solution can help you by:

Simplifying submissions: Transmit assessments directly to CMS, and receive feedback, validation, and CASPER reports in one dashboard.
Driving quality improvement: Monitor your star ratings and quality measures, and compare your results with state and national benchmarks. Use readmissions data to identify at-risk residents.
Improving reimbursements: Find untapped, justifiable revenue, estimate Interim Payment Assessment daily rates, and manage Medicare Value-Based Purchasing Program revenue.
Reducing survey citations: Spot risks for survey tags, identify mismatches in logic, and transmit MDS assessments directly to CMS.

Additionally, Infection Surveillance can help SNFs identify outbreaks, reduce antibiotic resistance, and improve resident outcomes. As a SNF leader, you can empower your team with:

Real-time outbreak data: View all infection alerts, tasks, reports, and analytics in real-time in an easy-to-navigate facility dashboard.
Advanced tracking capabilities: Track the presence of HAIs, CAIs, and “present on admission” infections to better identify appropriate, timely prevention and interventions.
Automated and customizable notifications: Get up-to-the-minute alerts when a new infection record is entered or resolved, an infection threshold is reached, or there is a potential outbreak.
An interactive infection map: See where and when infections occur in your facility to detect potential clusters and initiate appropriate precautions.
Achieving optimal SNF staffing will be an ongoing challenge

The number of individuals age 65 and older is projected to hit 80.8 million by 2040 and 94.7 million by 2060,7 which means SNF capacity will need to continue to expand, along with the staffing needed to make that possible. An evolving regulatory environment will also add to the urgency to deploy effective staffing solutions.

As noted previously, the Biden Administration announced in February 2022 that it was launching new initiatives to help ensure that nursing home residents receive the quality care they need — including plans to establish a minimum nursing home staff requirement.8

The announcement also noted that in addition to nursing home staff turnover and weekend staffing levels that CMS currently publishes, when the new minimum staffing levels are determined, CMS will “prominently display whether a facility is meeting these minimum staffing requirements.” Since Care Compare helps future residents and their families make nursing home selections, the information provided there can have a significant influence on their decision-making.

Additionally, on July 31, CMS issued a final rule that updates Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2024.9 In addition to updates to the SNF Quality Reporting Program (QRP), CMS made changes to the SNF Value-Based Purchasing (VBP) Program, which provides incentive payments to SNFs based on the quality of care provided.

In a nod to the link between optimal staffing and quality of care, the fact sheet notes that “CMS is adopting the Nursing Staff Turnover Measure for the SNF VBP program beginning with the FY 2026 program year. This is a structural measure that has been collected and publicly reported on Care Compare and assesses the stability of the staffing within an SNF using nursing staff turnover. …Facilities would begin reporting for this measure in FY 2024, with payment effects beginning in FY 2026.”

Optimize your staffing, quality performance, and regulatory adherence with Inovalon

With so many factors converging on an already battered sector of the LTC industry, there is no time like the present for SNF leaders to adopt more effective staffing strategies to optimize patient care, improve quality initiatives, and enhance staff satisfaction.

By implementing technology solutions like healthcare scheduling software, you can be well on your way to doing exactly that — and Inovalon’s cloud-based software solutions can help you get there.

Request a demo today.

Sources:

Nursing Facility Staffing Shortages during the COVID-19 Pandemic,” Ochieng, Nancy, Priya Chidambaram, and MaryBeth Musumeci. KFF, April 4, 2022. https://www.kff.org/coronavirus-covid-19/issue-brief/nursing-facility-staffing-shortages-during-the-covid-19-pandemic/
“State of the nursing home industry,” June 2022, AHCA. https://www.ahcancal.org/News-and-Communications/Fact-Sheets/FactSheets/SNF-Survey-June2022.pdf.
“Long Term Care Jobs Report,” AHCA/NCAL, May 2023. https://www.ahcancal.org/News-and-Communications/Fact-Sheets/FactSheets/JOBS%20REPORT%20MAY%202023.pdf.
“Letter to President Joseph R. Biden,” AHCA/NCAL, June 24, 2023. https://www.ahcancal.org/News-and-Communications/Fact-Sheets/Letters/AHCA-Letter-Biden-QualitySolutions-7.24.23.pdf
“Staffing Instability and Quality of Nursing Home Care,” Mukamel, Dana B., Debra Saliba, and Heather Ladd. JAMA Network Open, January 10, 2023. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800160.
“HHS Takes Actions to Promote Safety and Quality in Nursing Homes,” HHS.gov, April 11, 2022. https://www.hhs.gov/about/news/2022/04/11/hhs-takes-actions-to-promote-safety-and-quality-in-nursing-homes.html.
“Projected Future Growth of Older Population,” ACL Administration for Community Living, May 4, 2022. https://acl.gov/aging-and-disability-in-america/data-and-research/projected-future-growth-older-population.
“Fact Sheet: Protecting Seniors by Improving Safety and Quality of Care in the Nation’s Nursing Homes,” The White House, March 14, 2022. https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/28/fact-sheet-protecting-seniors-and-people-with-disabilities-by-improving-safety-and-quality-of-care-in-the-nations-nursing-homes/.
“Fact sheet fiscal year (FY) 2024 skilled nursing facility prospective payment system final rule – CMS-1779-F,” CMS, July 31, 2023. https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2024-skilled-nursing-facility-perspective-payment-system-final-rule-cms-1779-f

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