This article is sponsored by ABILITY Network, an Inovalon Company. In this Voices interview, Skilled Nursing News sits down with ABILITY Network GM and President Bud Meadows to learn how skilled nursing facilities are leveraging unique tools to increase operational efficiency and improve the resident experience. Meadows also shares insight into ABILITY’s role in helping SNFs use data for infection surveillance reporting as the regulatory landscape changes.
Skilled Nursing News: You’ve been with ABILITY for 10 years and you’ve had a long career in the space prior to that. What are the top experiences that you most draw from in your current position?
Bud Meadows: When I started with ABILITY Network, we had developed a platform to connect providers with Medicare using the internet. At that time, this type of platform was considered disruptive for how providers would engage with a payer.
We successfully extended our platform into the administrative and clinical areas, which helped us understand the challenges providers face and how we could help. It gave us a very disciplined product roadmap aligned with the patient journey, moving through the care setting and into the clinical quality area.
Working with a company from its early stages involved in all areas of the business prepared me to succeed as the leader. Being hands-on in a startup phase allowed me to develop an appreciation of the complexity our customers face. This detailed focus by our entire team drove ABILITY’s growth in serving providers at more than 50,000 sites of care.
For many years, ABILITY has created software that addresses both administrative and clinical needs across several health care markets. What makes ABILITY’s applications particularly effective for SNFs?
Meadows: Because we originally connected everyone to Medicare, we had to learn how providers interacted with Medicare and build on those observations. As an example, we provided a secure way for our providers to submit their MDS reports. Extending this capability to support other payers or other reporting requirements was a natural extension.
We saw the opportunity to take our discipline, product management, development, distribution and support capabilities to help our partners scale so we could serve any site of care, regardless of size. We had 20 years of domain expertise from supporting skilled nursing providers, which is unique in this space. We also understood how patients transition to that setting.
A large portion of my career was spent on the ambulatory side doing EHR work for physician offices. Most of the companies helping with administration approached skilled nursing providers from an ambulatory care perspective. We understood those differences in the patient journey within that care setting and how they impacted the staff’s workflows.
We strove to fully understand that workflow and develop a software application that complemented it by automating a lot of the manual steps. We built that on the administrative side so eligibility transactions were run by the right person. If there was information that needed to be augmented by a clinician, that was available. Another advantage is that it could be maintained, stored and shared with the administrative side when billing.
We saw an opportunity to implement this on both the administrative and clinical sides to help them work together. Although their functions are very different, they’re both responsible for providing quality care. Whether that pertains to a patient’s administrative needs or their clinical needs, they’re both important.
Clinical care is an inherent part of patient health, but that is just one piece of the total patient experience. We want every point of care to have a positive impact, and that is where ABILITY has made a significant difference.
ABILITY places a special emphasis on post-acute organizations. What is that emphasis and why did you pursue it?
Meadows: Our focus on this market has grown. Our historical presence in supporting Medicare has since expanded to support all major payers. If you look at the post-acute market, the concentration of Medicare reimbursement created a beachhead that we grew to support other payers.
We also developed a deep understanding of those care settings, which has enabled us to build products that are complementary to EHRs. In fact, many of them are partners of ours. It has given us the domain expertise and knowledge to complement existing vendors in the space, while serving the provider workflow as well.
We continue to invest in that area, and our providers continue to find value in and extend our platform. We speak their language, understand their workflow and build applications that truly simplify and create value for them immediately.
Through the public health emergency of COVID, infection surveillance and reporting is of the utmost importance for SNFs. What role does ABILITY INFECTIONWATCH play in assisting facilities?
Meadows: Our customers mentioned that they needed a more robust solution. INFECTIONWATCH was designed to hit all of the requirements of participation with regards to infection control in a SNF. When the product was introduced, we were able to hit all of those different points. INFECTIONWATCH helps manage by exception, meaning the nurses and staff can quickly identify any quality improvement opportunities and perform root-cause determinations of infection outbreaks.
Additionally, we designed it to be easy to filter, sort, export — it has excellent export capabilities, which helps staff when surveyors ask for proof of documentation of surveillance. The NHSN requires weekly reporting and our customers are able to track the COVID-19 cases. They’re also tracking testing and vaccinations of residents and staff, which ties directly into one of the newly proposed SNF Quality Reporting Program measures.
MDS assessments and high reimbursements are critical for SNFs. With all of the industry turmoil, how can SNFs improve the data accuracy of resident assessments and prepare for surveys?
Meadows: Many of the SNF facilities have tasked the director of nursing and coordinators with infection control. They’ve been able to leverage either our CAREWATCH application or INFECTIONWATCH application to help manage by exception, which helps them save time. They can also use this technology to track quality measures for quicker identification of Quality Assurance Performance Improvement needs.
The technology also assists in the management of PDPM components. It’s helping them capture missed revenue opportunities and assist in the interim payment assessment, submissions and determinations.
CMS has proposed two new quality measures that are tied to the quality reporting program. One measure is tied to health care associated infections (HAIs). What does this change for SNFs and how should they prepare for this change?
Meadows: In the past, if a patient came down with symptoms of an infection after 48 hours, it was tied to the SNF as an HAI. They’ve changed it now, so if a patient comes into a facility and develops symptoms after 72 hours, the SNF will be credited for the HAI.
They also added that the SNF is responsible for that infection if the patient develops symptoms within three days of discharge, and that is going to be tracked using hospital claims. That’s a huge change for our industry and a different way of thinking. They will use INFECTIONWATCH to track the start and end dates of an infection.
They can even keep track if, let’s say, a patient is discharged home and they go back to the hospital and then end up back in the SNF. The INFECTIONWATCH software will allow them to note that the patient did contract an infection within 72 hours after discharge and keep that all recorded in one central location.
Vaccination hesitancy among nursing home staff members continues to be a challenge. Beyond the effort to get staff members vaccinated, what can SNFs do to track who has or has not been vaccinated, and how can ABILITY help those efforts?
Meadows: Our INFECTIONWATCH application tracks both staff and resident vaccinations. The facilities track it in a central location for easy access, with export capabilities to support their reporting. With the proposed vaccination quality measure, we have a non-applicable button that allows our customers to track vaccinations without skewing the actual infection data in their reports, which offers a lot of flexibility.
It also has tracking of antibiotic usage, which is another national initiative. With the ease of export, information can then be shared with the infection control committee, which saves them time. We’ve built in the flexibility to do that and increase ease of compliance with new requirements.
Entering this year, no one knew what to expect. What has been the biggest surprise to you so far in skilled nursing and what impact do you think that will have on the industry for the remainder of the year?
Meadows: I have witnessed so much resilience among providers in the post-acute market and, specifically, skilled nursing. They’re such a vital part of our care system, and it’s remarkable when you look at how their patients and staff were impacted by COVID-19.
But those providers have continued to do what they do regardless of the changes around them. I’m proud and humbled to help these providers who serve such a vital role in our care system. They did such an amazing job in spite of all of that they faced and endured, and they continue to lead as we move forward.
Editor’s note: This interview has been edited for length and clarity.
ABILITY is a leading information technology company helping health care providers and payers simplify administrative and clinical complexity by enabling data-driven improvements in health care. Learn more by visiting abilitynetwork.com.
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].