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How Human Resources can Improve Skilled Nursing Facility Quality Ratings


The pressure of managing human resources for a skilled nursing facility never ends. From hiring workers to keeping them, from paying people to engaging them, every day can feel like a race toward an unreachable finish line. Day-to-day strains can often cause you to lose sight of what matters most in your role — helping to improve the lives of the patients you serve.

Simply put: By doing HR right, you’re better able to do right by your patients.

This is especially important given recent changes to the Centers for Medicare & Medicaid Services’ (CMS) Nursing Home Compare system, which aims to help consumers, families, and caregivers compare nursing homes. of the scale is based on one to five stars, the more stars, the greater the quality of the nursing home. CMS bases its ratings on three main sources of information:

  1. Health inspections, which accounts for recent investigations and complaints.
  2. Staffing, which includes details about average hours of care provided to residents based on their needs.
  3. Quality measures, a mix of 17 different physical and clinical factors impacting nursing home residents.

Essentially, CMS has revamped its methodology to create more stringent standards. For example, instead of seven or more days per quarter without an onsite nurse, you now risk a low rating if a nurse is present fewer than four days.

As a result of the changes, 37% of Skilled Nursing Facilities have lost one or more stars. Translation: It is now much tougher for your nursing home to attract patients. Never mind that hospitals will also consider your CMS rating when deciding whether to include your facility in their preferred networks.

What’s this got to do with HR?

Everything. Yes, CMS’s overhaul of criteria increases makes it more challenging to ensure your facility ranks well. But this is also an opportunity to help your organization take action to reach for the stars. (Terrible pun intended!). You have the ability and responsibility to keep your current stars from fading and even add new ones. (No more puns, promise!)

Actions like hiring more workers can help, but let’s face it — your budget may not allow this. And besides, it’s increasingly tough to recruit nurses and other professionals. So while addressing staffing issues may be important, it’s worth pointing out that CMS most heavily weighs quality measures, which rely strongly on resident surveys. Which means that the best thing you can do to improve patient satisfaction is to improve employee satisfaction. The latter greatly influences the former. Some actions you can take include:

  1. Hire beyond skills. Sure, your people need to have some technical skills related to their job, but as Virgin CEO Richard Branson said, “Most skills can be learned, but...if you can find people who are fun, friendly, caring, and love helping others, you are on to a winner.”
  2. Emphasize timeliness. Residents are more likely to give lower scores if they feel like they are constantly playing a waiting game. (Naturally, we offer time and attendance software to help.)
  3. Offer training. Again, money might be tight, but consider paying for people to receive various certifications. Your employees will feel empowered as they grow their skills, and best of all, they’ll be able to use them to elevate the care they provide to your patients. Keep in mind that there is actually tax-favored treatment for qualified employee educational assistance – and you want an HCM partner knowledgeable in how to handle this benefit.
  4. Say thanks. Praise your workers regularly for their work. When you show gratitude, your people will pay it forward to patients.
  5. Cultivate culture. Highlight stories of amazing employees doing amazing work. That will go a long way toward building a patient-centric environment.

There are countless other steps you can take to make your facility a better place to work. Ultimately, by acting in the best interest of your people, you’ll be acting in the best interest of your patients. Or vice versa.

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