At a time when Medicare Advantage is becoming a bigger piece of the pie in long-term care, Amy Goldsmith, senior vice president of care management and care coordination for SavaSeniorCare, thinks hiring MDS (minimum data set) nurses and getting everyone involved in care coordination is one way skilled nursing operators can better move toward the future.
Goldsmith said during a SimpleLTC virtual symposium this week that Sava has looked to expand the job roles of its staff because “there’s not really an option.”
“We have always worn multiple hats in long-term care … but now I feel like they’ve just gotten heavier. So our MDS nurses and our managed care coordination nurse have come together as case management,” she said.
Goldsmith expects nurses to take on more of an administrative role with managed care for Sava, which can be extremely valuable as operators struggle to recruit and retain staff. Nurses should also understand how to coordinate care with all payer types.
“They are doing some of the discharge planning and quarterbacking that process,” Goldsmith added.
She pushed for operators to do more with less at their facilities and expand the roles of all their team members, with rehabilitation teams picking up case support and respiratory documentation and training teams working, teaching and training certified nursing assistants.
“When you look at administrators, obviously they’re the operator, but they also need to have clinical understanding, they need to understand about those admissions that are coming in the door, what those diagnoses are and what the expectation is,” she said.
Even the admissions and sales teams at Sava have “beefed up” their knowledge in the patient driven payment model (PDPM) and diagnosis understanding.
“We’ve given them tools to help them alert us about different aspects of the clinical complexity and acuity of the patients that are admitting to us,” she said.
Goldsmith suggested that clinicians and nurses be taught quality measure scoring and understand when authorizations are coming due, which patients are in their 30-day window and be equipped to assess for case mix.
“I know nurses want to be a part of that and they understand their patients better than anyone,” Goldsmith said. “It’s all about engaging all the professionals and coming together. I think we’ve done a nice job at Sava trying to really encourage that crossing of the silo and making sure we are all working together.”
She felt that even amidst a push toward care in the home, skilled nursing remains critical and continues to have a place in long-term care.
One way Sava is trying to take some burden off its staff is with technology.
The Atlanta-based operator has added kiosks and other machines at the front door of their facilities.
“I would strongly encourage everyone to look at those devices for their facilities,” she said. “I don’t need a registered nurse or licensed practical nurses sitting at the front desk answering phones and doing temp screens. There’s much better use for that nurse in direct patient care.”
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