Category: Resource

This Substance Use Disorder (SUD) Treatment and Access Policy and Procedure Toolkit for Nursing Homes and Adult Care Facilities is intended to provide easy-to-adapt policies and procedures for facilities that wish to implement or improve their care for residents with SUD, which includes access to behavioral health resources, medications, telehealth, and referral networks. Most of the policies deal with opioid use disorder treatment, as this was the overarching need identified by nursing homes and adult care facilities; however, this toolkit was designed to be modified, and future updates will include additional substance use disorder policies.

Toolkit contains patient and provider resources for anticoagilation medications, protocols, instructions and best practices.

This Staff Stability Toolkit is an Excel file that contains individual worksheets focused on selected areas related to “staff stability”.

The tool is intended to offer a “snapshot” of your current staffing situation allowing you to collect and analyze areas for detailed and focused areas such as

• Employment Status – The makeup of your current staffing situation as it relates to “full-time”, “part-time” and “per diem” employment status
• Current Staff by Length of Service – Summarizing the current staff into Length of Service classifications across several categories from “< 6 months” through “10 Years or More”
• Vacant Positions – Current vacant positions by FTEs across all departments and shifts
• Turnover Rates – The calculation of turnover rates by “Overall Facility” with the opportunity to drill down by individual departments or groups
• Cost of Turnover – The calculation of “Turnover Replacement Costs” to include recruitment, vacancy costs, and training/orientation costs based on current rate of terminations by position
• Terminations by Length of Service – Collects both the number and percentage of terminations either by “Employee Choice” or “Employer Choice” across several Length of Service categories from “< 6 months” through “10 Years or More”
• Absenteeism – The collection of Call-In Statistics by department and shift for categories to include “timely call-in”, “shift replaced”, “replaced with overtime”, “replaced with agency”, and any “incentives” that were paid for the replacement of the individual call-in. The categories are summarized and graphed by department and shift with the calculation of an overall call-in percentage related to scheduled shifts
• Financial Incentives – The collection and summary of any incentive programs currently in place with an annual cost estimate

It is believed that by collecting and analyzing these focused “costs”, a facility will be better positioned to strategize and plan their approaches to improve and maintain the staffing stability within their individual facility.

For questions on the Psychotropic Medication Tracking Form and Guide, please contact us at QIN-QIOR2@ipro.org.

According to a CMS memo regarding Mental Health/Substance Use Disorder (SUD), CMS has identified a need to improve guidance related to meeting the unique health needs of residents with mental health diagnoses and SUD. CMS clarified that when facilities care for residents with these conditions, policies and practices must not conflict with resident rights or other requirements of participation. They further clarified that facility staff should have knowledge of signs and symptoms of possible substance use, and are prepared to address emergencies (e.g., an overdose) by increasing monitoring, administering naloxone, initiating cardiopulmonary resuscitation (CPR) as appropriate, and contacting emergency medical services.^[1] This naloxone nursing home toolkit is intended to provide easy to adapt policies and procedures for nursing homes that need to implement or improve their emergency response to opioid overdose, which includes naloxone administration.

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[1] Revised Long-Term Care Surveyor Guidance | CMS. www.cms.gov. Accessed January 17, 2023. (https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/revised-long-term-care-surveyor-guidance)

The Nursing Home Naloxone Policy & Procedure Toolkit PowerPoint

This is another resource, designed to be used as an introductory presentation. This slide deck contains an abridged version of the Toolkit and provides a general overview of the Toolkit contents. It includes select references to regulatory guidance, background, need assessment, features, and brief descriptions of the policies, procedures, and resources contained in the Toolkit.

Nursing Home Naloxone Policy & Procedure Toolkit Implementation Checklist

This resource was created to help facilities implement the Nursing Home Naloxone Policy & Procedure Toolkit. This checklist provides an overview for a process to successfully implement select toolkit contents.

This manual is designed to assist organizations in identifying how a resident will “trigger” for a quality measure based on quality measure specifications and the coding of the MDS 3.0 Resident Assessment Instrument (RAI).

The LACE index identifies patients that are at risk for readmission or death within thirty days of discharge. It incorporates four parameters.

The AC Forum, in partnership with FDA, identified seven Core Elements for improving systemic management of anticoagulants. The Playbook, developed with input from more than 30 experts, offers detailed strategies for each Core Element and is designed to be used by organizations establishing or considering Anticoagulation Stewardship programs, as well as those with existing programs in place. While all seven elements are important for implementation of a stewardship initiative, the first Core Element—securing the commitment of administrative leadership—is a foundational priority to ensure success and sustainability.

Safer Medication Management for Better Transition of Care
SHM recognizes the importance of equipping hospital clinicians with evidence-based strategies to prescribe, document, and reconcile medications accurately and safely at times of care transitions.

Medication reconciliation, or med rec, is the process of compiling the most accurate list of medications a patient is taking to avoid dosing or other errors.

Take responsibility for med rec with your patients by:

Leading, coordinating or participating in med rec quality improvement efforts that incorporate best practices to improve patient outcomes.
Grasping key evidence-based interventions, such as obtaining the best possible medication history and effective discharge medication counseling.
Identifying patients who are at high risk for medication discrepancies due to the number and/or types of medications they are prescribed

A quality improvement tool for determining the reliability of a process by assessing the 5 attributes.

The Monthly Pressure Ulcer Tracking Form was developed to assist facilities track their pressure ulcers on a monthly basis with the ability to carry over unhealed/unresolved pressure ulcers unto a new monthly tracking form. It maintains an active list of all current pressure ulcers in real time to assist with the investigation, treatment and provide an important piece in the development of a targeted pressure ulcer prevention program. (See instructions below on how to download the tracking form.)

Complete this form to receive a link to download a zipped folder of the Pressure Ulcer Tracking Resources to include the Excel tracking form as well as a PDF instructional guide that explains the use of the tool.

For questions on the Monthly Pressure Ulcer Tracking Form and Guide, please contact QIN-QIOR2@ipro.org.