IntelyCare Spotlights Janiene Morris, our resident nurse, and Quality Assurance Education Nurse Manager.
In her role as Quality Assurance Education Nurse Manager, Janiene works with both facilities and nurses to uphold the quality of care and clinical competence of our team. As a registered nurse with agency experience, Janiene plays a unique role as an advocate and educator for nurses. We are lucky to have her on our team, and we hope you’ll enjoy getting to know a bit more about her.
Janiene, what inspired you to become a nurse?
I originally became a nurse because I needed a career with security and hours outside a typical nine to five job so that I could be there for my two sons. Plus, I knew that becoming a nurse would give me the financial independence that I needed.
What is it about nursing that you most enjoy?
I’ve always loved being there for people, but what I really fell in love with was patient care. I saw how my presence and personal touch affected my patients. I found that I had a knack for bringing peace to my patients and I could easily put them at ease when they became anxious about a procedure or diagnosis. I made them feel comfortable and cared for and I advocated for their needs. I also had a way with ‘difficult’ patients’. I soon realized that it was my ‘way’ with my patients that made them feel cared for.
Nursing is so much more than ‘a good paying job’. You need to have compassion, empathy, and be willing to go the extra mile for your patient. Those are the qualities of a truly good, dedicated nurse.
Why do you love working with IntelyCare and with nurses?
I know that working for an agency has its challenges and I want to be there to provide support and education to our nurses, so they feel someone understands the challenges they face daily.
Based on your experience, how do you think IntelyCare improves the nursing experience?
Our Quality Assurance Team provides the nurses with a personal touch that they don’t get at your average agency. I can be an advocate for them when they need it, and I can be a resource if they’re seeking information.
I believe this personal touch can help them become better nurses; we all make mistakes, but we don’t always get the opportunity to learn from them, nor do we always have someone to reach out to us to talk about how the mistake could have been avoided or corrected. If one of our IntelyPros has a misstep, we can recognize where they took a wrong turn, we can reach out to them for some re-education, and through that process, help them to avoid making future mistakes.
IntelyCare also is there for our IntelyPros when they go above and beyond – we make sure to reach out to IntelyPros individually with praise from facilities so that they know they are valued. Nurses work hard, and they deserve to have someone rooting for them every step of the way.
How does your experience as a nurse inform the work you do here at IntelyCare?
Being a nurse is very helpful in my role because I have walked many miles in our nurses’ shoes. I also understand the terminology when speaking with nursing facilities, along with what is expected of nurses and nursing assistants. I can also empathize with both the nursing facilities and the nurses. This makes it easy for me to build a solid relationship built on trust with both.
Anything else you think our IPs would love to know about you or nursing?
My career goal is to become a nursing educator on the college level. I owe a great deal to those who taught me how to be a safe, compassionate, well-educated nurse and that has taken me very far in my 12 years of nursing. I would like to ‘pay it forward’ and teach nursing students before they get out into the field so that they too will be successful, competent, and compassionate nurses.
Last month, The Centers for Medicare & Medicaid Services (CMS) announced stricter standards for nursing home ratings, which includes smaller windows for staffing penalties and new ratings for short-term and long-term stays.
What you need to know
CMS will get tougher on all three metrics that inform star ratings; survey, quality, and staffing.
However, staffing ratios, in particular, seem to be at the heart of the CMS rating overhaul; starting this week, CMS will automatically hand out one-star staffing ratings to buildings that have four or more days in a quarter with no registered nurse on site, down from the current seven-day standard.
This is likely in response to the New York Times’ investigation this past summer that exposed skilled nursing facilities for inaccurate reporting of nurse coverage in their buildings.
What’s happened so far
Recent changes have made it more difficult to achieve above average ratings.
The American Health Care Association noted that 36% of skilled nursing facilities have already experienced a drop in their overall star ratings since the plan took effect last Wednesday. 33% of those facilities lost at least one star based on their staffing standards. (For comparison, only about 15% of facilities actually earned a star as a result of the changes.)
What does this mean for my facility?
Ultimately, this initiative will make it harder for your facility to earn an above average rating. This is not necessarily a bad thing; it just means that CMS is more serious than ever about making sure skilled nursing facilities operate to provide the highest level of quality care and that conditions are safe for both patient and caregiver.
With that said, your rating is still important, and you surely want to make sure it doesn’t drop.
So what can you do to maintain (or even improve) your rating?
In the words of CMS, staffing ratios aren’t a bad place to start if facilities are looking to improve quality. “Nurse staffing has the greatest impact on the quality of care nursing homes deliver, which is why CMS analyzed the relationship between staffing levels and outcomes,” the agency said in the statement that announced the new rules for the Five-Star Quality Rating System. “CMS found that as staffing levels increase, quality increases.”
Improving your staffing is no easy task, but luckily, you have a resource in us. If you’d like to have a conversation about how we can best suit your needs in light of these changes, let us know. We are here to help; we’d love to help tailor our services to meet your staffing needs.
Does your facility need help with your staffing needs? Request a demo with a member of our sales team for a walk-through of our intelligent solution.
IntelyCare was created by nurses, for nurses. We’re here to take care of those who take care of everyone else; our staffing solution gives nurses the opportunity for a better, more flexible schedule to help reduce nurse stress. Apply today to join the future of nursing.
On April 15, the Centers for Medicare and Medicaid Services (CMS) announced some new initiatives as part of their ongoing mission to make sure nursing homes adhere to the highest level of quality and safety.
This comes in response to a report from the U.S. Government Accountability Office that criticized CMS for gaps in federal oversight of nursing home abuse investigations. The report from the government watchdog claims that CMS failed to adequately track nursing home abuse allegations in Oregon and put patients in the state at risk.
While the statement issued by Seema Verma, the current Administrator of CMS, did not address the GAO report, it is clear that the organization is serious about reviewing and improving their nursing home oversight processes in order to rectify some of the glaring issues mentioned in the report.
Why is this important?
CMS, in addition to the administering of Medicare and Medicaid, is responsible for developing and upholding quality standards in long-term care facilities through its survey and certification process. This quality assurance is not only in the interest of protecting nursing home residents and their families, but also the individuals who work in them, like you.
Here are our 5 key takeaways from CMS’s five-part plan, and what it means for you:
1. There will be an effort to improve nation-wide consistency in nursing home oversight.
CMS uses the insight of State Survey Agencies (SSAs) to aid in the oversight of nursing home quality. SSAs are the boots on the ground eyes for CMS; they pay annual visits to facilities to make sure they are meeting health and safety requirements, as well as state licensure requirements.
However, there are overwhelming inconsistencies from state-to-state in how agency surveyors identify facility issues. This causes a large disparity in quality of facilities – so where one well-ranked facility may be in full compliance, another may have a score of issues that places residents and nurses in danger.
Verma writes that the first step is to examine processes of training state agencies from the top down. By re-educating state agencies on the expectations of a compliant facility and arming them with clearer procedures of identifying and reporting unsafe practices, the hope is that not only will more issues be caught sooner, but also that future negligence and abuse can be stopped in its tracks.
2. CMS will get tougher on compliance enforcement.
One major issue that plagues skilled nursing facilities is unsafe staffing ratios. Without safe staff ratios, providers cannot feasibly provide adequate, safe care to residents – putting nurses like you in uncomfortable, and potentially harmful situations. CMS is looking to toughen up on compliance, but by using data, they’re also hoping to be smarter about how they enforce it.
For instance, since late 2018, CMS has shared nurse facility staffing data with SSAs, so that agencies can predict which facilities have potential issues with staffing and can tailor their reviews – namely by conducting surveys unannounced at times that are statistically understaffed.
CMS is looking for ways to hold nursing homes more accountable with penalties for lack of compliance. The trickle-down effect of this tougher line on compliance means that nursing homes will be safer places for you to work.
3. There will be an increase in quality transparency.
Nursing Home Compare is a CMS-run website that shares quality and safety data to help the public make educated decisions on where they receive care, where they send their families for care, and where they work. While CMS currently shares important payroll-based journal (PBJ) data and quality ratings on their site, they have made a commitment to publish even more data.
When a facility is deemed unsafe, the public has a right to know. So, Verma promised that CMS will not only publish but also actively spread the word when nursing homes fail to meet minimum quality standards. CMS also recognizes that transparency means not only publishing more data, or making data more readily available, but publishing data that the public can understand and use to make informed decisions.
4. Quality can improve once old ways are removed.
“This is not business as usual — we are pushing beyond the status quo,” wrote Verma. While CMS has always been responsible for ensuring quality, just as healthcare practice continues to evolve, so should the methods by which we measure the quality of our healthcare facilities.
Part of pushing past the status quo comes with the hard look CMS takes on its current processes and asking how they can be improved.
One way is to score providers on outcomes, not on their adherence to facility processes. This helps facilities push past practices that are done because they always have been and evolve towards practices that are done because they actually improve patient outcomes.
Money can also be a key driver to improve quality. CMS fines facilities a Civil Money Penalty (CMP) for non-compliance and these dollars could be put to good use. CMS plans to invest these dollars “to reduce adverse events, improve staffing quality and improving quality of care for residents with dementia.”
5. CMS will prioritize patients (and providers) over paperwork.
While proper documentation is essential in any healthcare setting, patients lose out when paperwork forces nurses to spend more time in front of a computer and less time bedside. Studies also cite administrative burden as one of the leading reasons for nurse burnout. (Read more about our thoughts on nursing burnout here.)
But how do you minimize burden while keeping patients safe? CMS is promising to take the challenge head-on. When implementing new rules and requirements for quality and safety, they want to focus on taking the most efficient approach to training and compliance. Verma emphasizes this point, stating that “going forward, we will continue to think about how we can streamline processes and eliminate obsolete, unnecessary, or duplicative provisions and we are interested in hearing from all stakeholders on ways to improve our programs.”
At IntelyCare, we are in a unique position as a partner of both nursing professionals and skilled nursing facilities, two stakeholders at the very epicenter of this issue. While it’s troubling to see the myriad of problems that nursing homes face come to light, we’re encouraged by the words and promises of Verma and her team.
We believe it is a step in the right direction to acknowledge that our nation’s nursing homes could be better and that there are initiatives in the works to make them better. We can always do better for our most vulnerable population, whether it’s by improving the quality of their care or the conditions of their caregivers.
We look forward to watching these changes unfold, and hope a safer nursing home experience, for you and your patients, is on the horizon.
IntelyCare was created by nurses, for nurses. We’re here to take care of those who take care of everyone else; our staffing solution gives nurses the opportunity for a better, more flexible schedule to help reduce nurse stress. At IntelyCare, we’re driven to offer nurses and CNAs healthcare’s best working experience. Apply today.