Behavioral Issues Survey Coming This Week

On Thursday, October 18th, administrators for all VHCA nursing facility members will receive an email invitation to complete a critically important survey addressing behavioral issues in Virginia’s nursing facilities.  

This survey is intended to gather information about the prevalence of behavior and mental health issues in Virginia's nursing facility resident populations along with the treatments and services provided by facilities and other professionals.  Although we ask that the facility Administrator take overall responsibility for completion of the survey, we suggest that the responses be completed in collaboration with the interdisciplinary team.  While we acknowledge that too often survey requests can be intrusive and time consuming, we strongly encourage every facility to make an investment in the completion of this important survey.  Based upon facility testing of the survey prior to finalization, we anticipate that two to three hours of staff time will be needed to complete the survey.  We strongly recommend that members download a copy of the survey as a PDF so that staff can review the questions before attempting to respond. A link to the PDF will be provided in the survey invitation.

Over the past year, VHCA has seen an increase in multiple survey citations, including abuse and safety, related to resident behaviors. We are now challenged with a CMS national initiative to reduce the use of antipsychotic drugs in nursing home residents by 15% by the end of 2012, based on the CMS claim that too many residents with dementia are receiving antipsychotic medications inappropriately. There has also been an increase in inquiries about the limited availability of mental health services for residents with behaviors and the costs associated with providing care to respond to the behaviors and to protect other residents and staff. VHCA created a Behavior Management Workgroup to explore opportunities for providing additional resources to our members to assist them in successfully addressing resident behavioral issues within their organizations.

Another objective in collecting information about behavioral issues in nursing facilities relates to efforts now underway to redefine how care for dual eligible beneficiaries is coordinated and paid. Virginia is one of 26 states pursuing a plan to blend funding for Medicare and Medicaid services provided to duals. Under the Dual Demonstration proposed for Virginia, managed care organizations will be responsible for coordinating the care provided to duals and for paying providers some form of negotiated payment. It is very important that nursing facilities be able to quantify the resources necessary for safely caring for individuals with behavioral issues. Additionally, discussions are taking place concerning the development of a price-based Medicaid payment methodology for replacing our existing cost-based system. The identification of resources related to caring for residents with behavioral issues is one specific focus of these discussions.

Once the survey results have been tabulated, a report will be developed for purposes of quantifying and identifying services and resources that are available as well as those that are needed to best meet the needs of residents who have behaviors that may impact the quality of their life and the quality of life for other residents and nursing facility staff. The report will be shared with all survey participants. Please note that all survey information will be kept confidential and that no identifiable individual facility survey data will be disclosed.

While we trust facilities will see the benefit of making the investment in terms of time and effort required to complete the survey, as an added incentive we will award a no-cost registration to the 2013 Legislative Conference to be held in February to three facilities who complete and submit the survey.  The three winners will be selected at random from a pool of all submitted survey responses.  The winners are responsible for their own travel and lodging expenses in connection with attending the Legislative Conference.