How do you use data? Numbers are just numbers unless they tell a story. How does data guide your decision making? Does the data you see provide you with meaningful insight?
When examined strategically, data has a voice, it comes to life, it can in fact speak volumes to you. Data speaks about the care you deliver, it provides insight into your treatment patterns, and data is used deliberately by the Centers for Medicare & Medicaid Services to compare communities to others in their locality and across the nation.
What does the data say about your community?
There are 15,000-plus nursing homes in the US and most are centers of caring and hope in their local communities. Each one taking the unique shape of the kinds of illness and wellness patterns flowing to and from surrounding healthcare systems.
Each one is also looking to accommodate those needs in the most advantageous way. Many look to publicly reported data, Nursing Home Compare and internally to CASPER. These are helpful and provide a good start but are limited in identifying the needs of local healthcare systems.
Where can providers turn for effective data of this type?
Perhaps here? This Data Speaks blog aims to share data plus actionable insight with hard working, dedicated post-acute care professionals.
Data Speaks has as its foundation data that is derived from the Research Data Assistance Center or ResDAC, a comprehensive database that contains a significant pool of information that can shed light on, among other things, how nursing facilities can accommodate local health system needs and prepare facilities for establishing a care niche in their health system communities.
Competition for referrals is a challenge. Especially since health systems work to shepherd patients through a post-acute pathway that will achieve the desired outcomes at an efficient cost. Publicly reported Quality Measures have become determinative along with rehospitalizations, and soon GG measured outcomes.
Data speaks volumes when it comes to understanding your community’s unique flow of residents. The bubble graphs above represents data from ResDAC about patients who were admitted to SNFs from hospitals who were subsequently readmitted to a hospital with septicemia.
Helpful questions
How many patients are going to what facilities?
What conditions do these patients have?
What needs do the health systems we serve have in terms of patient flow?
What needs may be going unmet?
To answer these, engaging your health system’s decision makers about preferred post-acute patient pathways is a start.
Data from ResDAC is also a powerful tool. Here we have been able to identify the one or two SNFs in each community that seem to get most of the hospital-initiated admission. Here we have also been able to see facilities with a good star rating that are physically close to a hospital system get bypassed for a SNF that is much further away with a poorer star rating.
These insights may not be a revelation to you but understanding them in your community might inform your approach as you consider a establishing a niche.
What else from ResDAC might be helpful?
- For the last two quarters of 2019, including the first quarter of the Patient-Driven Payment Model, septicemia is the DRG selected for 382,905 patients that were admitted to a hospital.
- The top 6 DRGs from these hospital claims represent 20.3% or one-fifth of all hospital admissions
- Of those, septicemia accounts for 7.4%.
- News flash: Nearly half of the top six DRGs for hospital admissions were septicemia.
It turns out, septicemia is prolific.
- Nearly 10% of all SNF admissions for the last two quarters of 2019 were admitted to the SNF after having septicemia in the hospital.
- 29% of those patients were readmitted to the hospital with septicemia during a SNF stay,
- 79.1% of patients readmitted to the hospital with septicemia during a SNF stay did not have septicemia initially.
In other words, a much larger proportion of resident were readmitted to the hospital from a SNF stay who did not have septicemia in the initial hospital stay than did. So, what happened in the SNF that may have contributed to these residents being readmitted to the hospital with septicemia? A clue might be found in principle diagnosis in on the SNF claim.
This is national data that applies to local communities. Does this kind of granularity opens a window into where opportunities may lie for your SNFs to engage your healthcare systems?
Observations
- Pulmonary/Respiratory conditions are the top transition issue in the SNF
- Surgical wound care appears in table 2 where it is absent in table 1
- Stress incontinence is the top diagnosis and chronic kidney disease newly appears in table 2
- Occlusive artery disease also shows up in table 2
Inferences? Large numbers of patients nationwide are admitted to SNFs who subsequently readmit to the hospital with septicemia during that SNF stay even if they did not have septicemia initially. And, something is happening in the SNF that accounts for this pattern.
Anecdotally, some residents do come to the SNF who are not ready for discharge from the hospital. Even so, SNFs can be asking themselves what they could we be doing to work with their health systems to identify issues revealed in the data related to septicemia. By doing so, partnerships might be formed to see this pattern decrease.
Conclusions
- If you listen to the data, actionable information will be brought to light.
- Knowing what the data speaks to you and your community, i.e. septicemia patterns, can help your facility establish niches that might help you build partnerships that may increase your census and effect positive patient outcomes.
That is a happy ending to a story that can only be told as the data speaks.
Joel VanEaton BSN, RN, RAC-CTA, Master Teacher, is Vice President of Compliance and Regulatory Affairs at Broad River Rehab. In this role Joel works with the company and its customers to stay current with the Medicare and Medicaid regulatory and reimbursement environment. He also provides guidance on the use of ResDAC data. He is a Master Teacher with AANAC and was recently named to the AAPACN Education Foundation board.
