Great River Klein Center is the only Iowa Health Care Association/Iowa
Center for Assisted Living-member nursing home in southeast Iowa to achieve
at least three of four national quality goals for skilled nursing care
by December 2014. It will be recognized with 27 other nursing homes in
Iowa at the American Health Care Association/National Center for Assisted
Living Quality (AHCA/NCAL) Symposium in February.
Launched in February 2012, the AHCA/NCAL Quality Initiative aims to improve
the lives of people receiving care in skilled nursing facilities by setting
four specific goals:
Achieve customer satisfaction, as evidenced by having 90 percent of residents
and families willing to recommend their center to others
The Klein Center’s score consistently is 94 percent or better. In
long-term care, elders or family members’ willingness to recommend
their nursing home to others is the survey question that best captures
perceived quality. Research shows that facilities with the highest rates
of satisfaction also perform better in other indicators, such as staff
stability, staff retention and resident population.
Safely reduce hospital readmissions within 30 days during a skilled nursing
stay by 15 percent
We have focused on reducing hospital admissions for the last year,”
said Klein Center Administrator Ann Abolt. “Our readmission rate
is 11 percent, compared to the national average of 14.7 percent.
Hospitalization puts the elderly at greater risk for complications and
infections, and it increases the likelihood of reduced functioning when
they return to the skilled-nursing facility.
Safely reduce the off-label use of antipsychotic drugs by 25 percent by
December 2015, and 30 percent by December 2016
The U.S. Food and Drug Administration approves a drug after it has been
proven safe and effective for treating a specific medical condition. A
drug is considered to be used off-label when it is prescribed in a way
that has not been approved by the FDA. Off-label use of most medicines
is legal, and some drugs are effective for uses that haven’t been approved.
Treating behavior associated with dementia with antipsychotic medicine
is an off-label use. The intent of the AHCA/NCAL Quality Initiative goal
is to encourage alternative strategies for responding to challenging behavioral
expressions in people who have dementia before considering medicines and
to ensure that antipsychotic medications, when used, are as appropriate
and safe as possible.
The Klein Center has reduced its use of off-label antipsychotics by nearly
“Our rate in 2012 was 26.4 percent. Now, it is 12.3 percent,”
Abolt said. “We are very proud of this achievement because we are
well under the national average of 19.1 percent.
Reduce nursing staff turnover by 15 percent
Research shows that the more consistent and dedicated the staff is, the
more they understand and effectively respond to elders’ care needs.
The Klein Center continues working on this goal. One improvement to employee
satisfaction is the introduction of the household and neighborhood concept
in which elders and staff remain together in small family-like groups.
The Iowa Health Care Association and Iowa Center for Assisted Living represent
more than 650 Iowa nursing homes, assisted-living and residential-care
facilities, home health agencies, hospice, and independent senior living
and retirement communities. The AHCA/NCAL supports more than 12,000 facilities.