Tag: Respiratory Assessment

Breathing New Life into Respiratory Care: NHC’s Success with ACPlus® Respiratory Assessment

Key highlights:

NHC’s pilot of ACPlus® Respiratory Assessment (ARA) in 3 centers since June 2023 has significantly improved respiratory care.

ARA has helped reduce rehospitalization rates by 36% and has ensured that Medicare and Medicaid submissions reflect the medical complexity of the patient population, enhancing patient care and financial performance.

NHC plans to expand ARA to all 11 facilities, emphasizing staff buy-in, systematic implementation, and patient-focused benefits for success.

Respiratory care is a critical, often challenging, aspect of patient health in skilled nursing facilities. The ACPlus Respiratory Assessment (ARA) is changing this landscape, offering an innovative approach to identifying and managing respiratory issues. National Healthcare Corporation (NHC) recently piloted ARA in three of its facilities, with results that are transforming patient care and operational efficiency.

Sarah Ison, Regional Therapy Director, NHC

We spoke with Sarah Ison, Regional Therapy Director for NHC’s central region, to learn more about their experience with ARA, how they have been using it across their pilot facilities, and the results they have seen since implementing it in June 2023.

Implementing ARA

Various staff members, from nurses to therapists, can perform an assessment with ARA, allowing for flexibility in implementation. “Most of the buildings have three or four people doing the assessment,” Ison notes. “We have therapists doing it, nurses, and some nurse practitioners and respiratory therapists.”

After some trial and error, they found a sustainable workflow to ensure each new admission was assessed in a timely manner. “We test every new admission within the first three days,” said Ison. “For our long-term care population, we test quarterly and as needed if someone notices a change.”

Uncovering Hidden Health Issues

Ison reveals one of the biggest surprises they have encountered since adopting ARA is the volume of patients experiencing respiratory deficits who show no obvious symptoms. She estimates that of the patients they have assessed, 95% return results indicating a respiratory deficit. “It has really helped us to identify patients who would benefit from respiratory therapy, whom we might not have typically provided that service to,” said Ison.

Strengthening Documentation

In an era of frequent healthcare audits, ARA provides robust documentation and objective data that has been invaluable for NHC’s staff. “Our documentation is constantly being reviewed, so we have found it was extremely beneficial having those ARA results and the documentation of those deficits to support what we were capturing on the MDS,” said Ison.

ARA’s Impact by the Numbers

One of NHC’s inpatient facilities saw significant year-over-year improvement, which Ison attributes in part to their use of ARA starting in June 2023:

Rehospitalization rates dropped 36% from May 2023 vs May 2024
Average daily Medicare Part A reimbursement increased by 4%
Medicaid reimbursement rose 7.4%

These numbers reflect not just financial value but also improved patient care and better outcomes.

Finding Success with ARA

For those interested in implementing ARA in their facility, Ison offers the following framework to extract the most value from the tool:

Secure buy-in from leadership and key staff members
Develop a systematic approach to conducting assessments
Remain flexible and willing to adjust processes
Focus on the patient benefits to motivate staff

Looking Ahead

As a testament to ARA’s success, NHC plans to roll out ARA across all 11 facilities in Ison’s region. NHC’s experience with ARA emphasizes how early detection of respiratory deficits can transform patient care. By providing precise data and robust documentation, ARA is helping facilities like NHC deliver more comprehensive, targeted care for better patient outcomes.

Transform Respiratory Outcomes with ARA

Interested in bringing ARA to your skilled nursing facility? Learn more and request a demo today.

LEARN MORE

National Healthcare Corporation’s (NHC) experience does not represent a claim made by Accelerated Care plus. Your results with ACPlus® Respiratory Assessment may vary.

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Transform Respiratory Outcomes with ACPlus Respiratory Assessment (ARA)

We are thrilled to announce the launch of our newest product, ACPlus® Respiratory Assessment, or ARA. ARA is an innovative software enabling skilled nursing operators to proactively identify patients with pulmonary dysfunction and provide them with the care they need. ARA’s objective data helps clinicians build an effective treatment plan while providing robust documentation needed to justify respiratory care and support reimbursement.

ARA Features & Results

ARA makes respiratory assessment easier than ever. Here are just a few of the key features that make it a powerful tool to enhance your respiratory care:

Data-Driven Care: ARA identifies patients with pulmonary dysfunction and automatically suggests possible lung disease patterns and severity levels to deliver the precise data needed to build an individualized treatment plan.
Early Patient Identification: ARA helps capture potential respiratory concerns during the initial assessment, which is more critical than ever with higher acuity patient populations and today’s PDPM requirements.
Robust Documentation: ARA’s objective data provides documentation required to justify respiratory care, helping you get reimbursed for the true complexity of your patient population.

Don’t just take our word for it – we implemented ARA in skilled nursing facilities and found that ARA helped operators:¹

Conduct efficient, standardized respiratory assessment
Identify undiagnosed respiratory deficits
Establish baseline respiratory deficits upon admission
Eliminate external spirometry Pulmonary Function Test wait time
Justify respiratory services
Enhance treatment planning

Explore our study to learn how inpatient, outpatient, and contract rehab providers within skilled nursing have used ARA and see their results.

How ARA Works

ARA is designed to be simple and easy to use, seamlessly integrating respiratory assessment into clinical workflows.

Using an iPad and Bluetooth spirometer, a clinician can select a patient in the app, enter their demographics, and conduct breathing tests that capture baseline metrics.

ARA interprets the data to suggest possible lung disease patterns and severity levels the clinical team can use to tailor the best treatment plan for that patient.

If a re-assessment is needed, the clinician can access the patient’s record and easily conduct a follow-up.

Unlock Efficiencies with EHR Integration

You can get even more out of ARA through EHR integration with PointClickCare. By enabling EHR integration, ACPlus can instantly sync ARA results, reports, and notes with your EHR at the point of service, proactively identifying patients who may benefit from respiratory therapy upon admission.

Transform Your Respiratory Care with ARA

We believe that ARA has the potential to help SNFs tap into the power of respiratory care, provide more targeted interventions, and ultimately achieve better patient outcomes. Are you ready to bring the power of ARA to your facility? Contact your CPC or request a free demo to get started.

Request a Demo

Based on ACPlus Respiratory Assessment Pilot Study data. ↩︎

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Improving Patient Outcomes Through Early Respiratory Assessment

The highlights:

Early respiratory assessment in SNFs can improve patient outcomes and ensure PDPM reimbursement is appropriate to address underlying medical conditions.
PDPM emphasizes the value of respiratory therapy, providing higher reimbursement for patients in the special care high category.
ACP will launch a new tool to streamline and document the respiratory assessment process.

When a patient is admitted to a skilled nursing facility (SNF), the first few days are critical in setting the stage for their care plan through thorough and accurate intake assessment. This is especially true under the Patient-Driven Payment Model (PDPM). As SNFs navigate a complex reimbursement landscape and manage more acute cases, capturing conditions as early as possible in a patient’s stay has become more important than ever. One evaluation that can make a significant difference in patient outcomes and clinically appropriate reimbursement is the respiratory assessment.

Advantages of Respiratory Assessment for Patients and Facilities

Early respiratory assessment can benefit both the patient and the facility. For the patient, it ensures that any respiratory issues are identified and addressed. For the facility, it can lead to improved patient outcomes and increased reimbursement under PDPM. Cardiopulmonary issues are a leading source of hospital readmissions; early and repeated respiratory assessment enables operators to avoid these costly events through proactive intervention, helping patients access the right care plan.

Respiratory Assessment and Therapy within PDPM Guidelines

Under the PDPM reimbursement structure, patients receiving respiratory therapy are classified into a -Nursing Case Mix Group with a higher daily reimbursement rate than those not receiving this service. SNFs that can accurately identify patients in need of respiratory services can secure additional reimbursement for necessary care ranging from an average of $50 to $100 per day throughout the patient’s stay.¹

The coding of the Respiratory Therapy on the MDS (Section O0400) requires:

Respiratory therapy 7 consecutive days (to be captured within the first 8 days of admission and reflected in the Assessment Reference Date)
At least 15 minutes per day (105 minutes total per week)
Respiratory-trained nurse or respiratory therapist daily intervention may include any of the following:
- Assessing
- Teaching
- Training
- Breathing exercises
- Delivering Nebulizer Therapy
- Biofeedback Respiratory exercise training

In the RAI User’s Manual, Appendix A (page Appendix A-18), the following definition is provided for the Minimum Data Set (MDS) application of Respiratory Therapy:

Services that are provided by a qualified professional (respiratory therapists, respiratory nurse). Respiratory therapy services are for the assessment, treatment, and monitoring of patients with deficiencies or abnormalities of pulmonary function. Respiratory therapy services include coughing, deep breathing, heated nebulizers, aerosol treatments, assessing breath sounds and mechanical ventilation, etc., which must be provided by a respiratory therapist or trained respiratory nurse.

The RAI User’s Manual defines a respiratory-trained nurse as one who received education in delivering respiratory services and assessment through formal training or during nursing education. For guidance on establishing a respiratory nurse, please refer to your respective State Practice Act and confirm that nurses comply with their scope of practice as defined by the State Specific Board for Nursing and according to Facility Policy.

Overcoming Barriers

Time constraints and lack of training prevent many facilities from effectively incorporating respiratory assessment and intervention into staff workflows. To address these challenges, we are excited to share the upcoming launch of an innovative tool designed to expedite the assessment process. Our product ensures swift and efficient respiratory assessment, enabling more users to seamlessly integrate assessments into their workflow. Additionally, ACP offers Continuing Education (CE) courses for nurses and nursing home administrators to bridge the training gap, empowering SNFs to harness the full potential of respiratory therapy services for both patient care and facility sustainability.

Estimate based on analysis using CMS’ PDPM Calculation Worksheet for SNFs (pgs.25-29) and CliftonLarsonAllen 2024 Skilled Nursing Facility PDPM PPS Rate Calculator. ↩︎

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Early respiratory assessment in SNFs can improve patient outcomes and ensure PDPM reimbursement is appropriate to address underlying medical conditions. PDPM emphasizes the value of respiratory therapy, providing higher reimbursement for patients in the special care high category. ACP will launch a new tool to streamline and document the respiratory assessment process.