Sunday, May 17, 2009

MO: Nursing homes see fiscal benefit in state program

Thursday, May 14, 2009

Nursing homes in Missouri that take advantage of a statewide program have saved more than $6 million over the past three years, a University of Missouri researcher has found.

Marilyn Rantz, an MU Sinclair School of Nursing professor, has been analyzing the Quality Improvement Program of Missouri since it began 10 years ago, but this is the first time she’s studied its fiscal benefits. She said her analysis was triple-checked, and her research has gone through a peer-review process.

“I knew it was effective, or at least I hoped it was, but I was amazed at the amount of cost savings that can be attributed to avoiding these clinical problems,” Rantz said.

The Quality Improvement Program of Missouri, or QIPMO, is a joint service of the Sinclair School of Nursing and the Missouri Department of Health and Senior Services. In the program, nurses skilled in geriatric care visit nursing homes to provide technical assistance, help identify and correct problems and make available the latest research. The voluntary program included 227 facilities in 2007-08.

In facilities that use QIPMO, 990 residents avoided developing clinical problems such as ulcers, depression and weight loss last year, saving $3.7 million, the study found. The research also indicated the program has reduced falls, the need for tube feedings and the use of restraints.

The program is funded through part of proceeds from a self-imposed tax on Missouri nursing homes. That tax is $8.42 per bed per day and supports several quality improvement programs, said Jon Dolan, executive director of the Missouri Health Care Association.

Administrators at The Bluffs in Columbia don’t doubt the monetary benefits of using QIPMO. “But the monetary value is not our objective,” said Shawn Ball, the facility’s data coordinator. “Our main goal is the care of the residents who live here and their quality of life.”

With the help of QIMPO, “we’re looking at changing how we think of the facility, as it being a home rather than an institute, and making sure our residents live in a home-like situation,” Ball said.

For example, Ball said, QIPMO nurse Sharon Thomas has helped The Bluffs revamp its restraints policy — the facility now only uses a self-releasing seat belt restraint when needed for a patient’s safety — and lower the risk of patients developing infections.

Thomas said she wasn’t surprised that improved care results in budget savings, but seeing the figures is “empowering.”

“It gives you a tremendous feeling of worth and makes you want to get out there and do more. … Not many states have a program like QIPMO,” Thomas said. “It’s a unique program, and Missouri is fortunate to have it. My mother, who is in long-term care, is very fortunate that there is QIPMO. It’s exciting to be making a difference for so many people.”

Reach Janese Heavin at 573-815-1705 or e-mail

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