2017 AHC/NCAL Annual Convention & Expo

Improving Your Five Star Rating by Disrupting the Status Quo in Post-Acute and Long Term Care

Wednesday, October 18
1:30 PM - 3:00 PM
Location: Mandalay Bay Ballroom J
CE: Nurses: 1.5 | NAB: 1.5

PAC and LTC operators are increasingly squeezed between decreasing reimbursements and increasing costs of care, while clinical practice models have not changed in decades. Part of the challenge stems from a lack of risk assessment and evidence-based management tools for the most clinically vulnerable and costliest resident population. As recent CMS changes create pressures to move away from a volume-based model to a quality and value-based model, centers are seeing fewer traditional post-operative rehabilitation residents and more who are medically complex and frail. We will address these pain points and present several case studies where state-of-the art software and data analytics unlocked the potential value of centers’ own data to improve outcomes and their Medicare Star rating, while decreasing readmission and utilization costs.

We present an approach to long term and post-acute care that begins with an evidence-based pre-admission assessment tool that collects all pertinent admission information and generates an initial care plan based on the risk of vulnerability associated with frailty. Knowing the degree of vulnerability to adverse outcomes at the time of admission allows necessary preparations to be made before admission, and it prompts clinicians to complete the admission examination keeping in mind risk and the likelihood of hospital readmission if residents and families do not communicate with the clinicians as early as possible. After admission, MDS data is routinely processed for analyzing and reporting, in real time, all outcome measures triggered, vulnerability and re-admission risks, clinical decision support recommendations, and multiple domain assessments important for proactive rather than reactive care. Having access to real-time MDS data gives authorized professionals access to all reports for focused QA, root-cause analysis, and multiple co-owned centers summaries. Case studies with measurable results will be presented.

Learning Objectives:

Steven Buslovich

Medical Director and Geriatrician
Team Health

Dr. Steven Buslovich is a practicing geriatrician and medical director of several nursing homes and post-acute care facilities in Western NY. He completed medical school at Stony Brook School of Medicine; completed Internal Medicine residency training at Yale New Haven Health System and Geriatrics Fellowship at Mount Sinai Hospital. He is currently serving as an executive committee member in the American Geriatrics Society’s (AGS). He is the recipient of several innovations awards and has published research in multiple academic journals. He is also an Assistant Clinical Professor of Medicine at the University of Buffalo School of Medicine and is actively involved in clinical research on improving models of care for frail populations. Dr. Buslovich is the co-Founder of Patient Pattern a population health company developing prescriptive analytics.


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Margaret E. Sayers

Geriatric Nurse Practitioner
Patient Pattern, Inc.

Margaret Sayers, MS, NP, VP Product & Research, Patient Pattern, Inc., graduated from Upstate Medical Center, Syracuse, NY, as a Geriatric Nurse Practitioner in 1983 and from the School of Social and Preventative Medicine at the University of Buffalo in 1993. She has been ANCC credentialed since 1983 and has decades of clinical, administrative, and teaching experience, primarily in the long term care and post acute care settings in Western New York. From 2009 - 2014 she was Principal Investigator for the first US research study using the Comprehensive Geriatric Assessment and Frailty Index to identify acute care patients at risk for adverse outcomes. (Evans S, Sayers M, et al. The risk of adverse outcomes in hospitalized older patients in relation to a frailty index based on a comprehensive geriatric assessment. Age and Ageing 2013; 0: 1–6 doi: 10.1093/ageing/aft156) Since 2014 she has been a partner in Patient Pattern, Inc. and along with a team of experts in geriatrics, IT, health policy, and data analytics, her focus has been on developing frailty risk based software to identify and manage the most vulnerable clinically complex patients residing primarily in the long term care setting. The software is designed to analyze routinely collect MDS data to calculate a frailty score and to communicate with clinicians, the patient risk, paired with decision support recommendations, based on geriatic evidence - based guidelines, who in turn can make targeted patient visits to address the outcomes identified, discuss with patients and families, document priorities and patient-centered decisions, and discuss all with the professional staff. Margaret remains focused on the slope of decline in the elderly that occurs as their frailty increases and continues to be passionate for the challenges and complexities of providing both beneficial and desired quality health care to this most vulnerable population. She extends this message to community elders as a private Health Care Advocate with membership in two international health care advocacy organizations.


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Eugene Gonsiorek

VP of Post-Acute and Long-Term Care
Kaleida Health

Dr. Eugene Gonsiorek has a background in physical therapy and a PhD in neuroscience. Currently, he is the Vice President of LTC for Kaleida Health and in his role as vice president, he oversees two very large PA/LTC facilities in Western NY. He obtained his Bachelor of Science in physical therapy from Daemen College and his doctor of philosophy, neuroscience program from the State University of New York at Buffalo (UB).


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Improving Your Five Star Rating by Disrupting the Status Quo in Post-Acute and Long Term Care


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