QIPP Nursing Home Program: too good to be true?

Putting our loved ones into a nursing home or assisted living facility is never a favorable choice but is one that is sometimes necessary. When you find that you are no longer able to properly care for your loved one, you, of course, trust the doctors, nurses and other faculty to treat your loved one with the same care as they would if it were their own family member. But, what if that trust is being betrayed?

The following is the first in a series of stories that will take a look into Texas nursing homes, quality of care, Medicare and Medicaid involvement and how the facilities function under the Quality Incentive Payment Program (QIPP).

The QIPP program came to fruition in recent years after the Texas Health and Human Services Commission (HHSC) was directed to encourage transformative efforts in the delivery of nursing facility services, including efforts to promote a resident-centered care culture through facility design and services provided, according to the HHSC website.

According to the HHSC website, the program encourages nursing facilities to improve the quality and innovation of their services and uses the Centers for Medicare & Medicaid five-star rating system as a measure of success for four quality measures: high-risk longstay residents with pressure ulcers, percent of residents who received an antipsychotic medication (long-stay), residents experiencing one or more falls with major injury and residents who were physically restrained.

Enrollment for the second year of the program began in April 2018.

In terms of funding, the maximum amount of funds available to nursing facilities is recalculated every six months and quarterly payments to nursing facilities will be triggered by improvement on specific indicators, according to the HHSC website.

The Olney-Hamilton Hospital district currently maintains a partnership with three nursing homes as part of the QIPP program: Grace Care Center in Olney, Texhoma Christian Care in Wichita Falls, Texas, and, most recently, Trinity Healthcare Residence in Fort Worth, Texas.

The next story in this series will discuss issues that have recently arisen with the QIPP program in Texas, such as the recent audit of the program in Texas by the Office of Inspector General for the U.S. Department of Health and Human Services.

The Olney Enterprise

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Olney, Texas 76374

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