Alexian Brothers Sherbrooke Village in St. Louis recently received the Outstanding Achievement Award from the Centers for Medicare and Medicaid Services (CMS) in recognition of the ministry’s accomplishments in leadership, teamwork and versatility in support of the CMS Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents.
Beginning in 2012, CMS selected seven organizations, known as Enhanced Care and Coordination Providers, to implement the initiative with nursing facilities within their state. Alexian Brothers Sherbrooke Village is partnering with the University of Missouri to implement the initiative over the next few years.
Through this program, advanced practice registered nurses (APRNs) are assigned to facilities to provide direct services to residents while mentoring and educating the nursing staff about early symptom/illness recognition, assessment, and management of health conditions commonly affecting nursing home residents. Additionally, the program facilitates enhanced communication among social workers, the residents’ primary care providers, nursing facility staff, and APRNs to assure consistent communication about resident needs and preferences.
During the award presentation, Alexian Brothers Sherbrooke Village was also recognized for its work in end-of-life care and willingness to share best practices with other partners.
Alexian Brothers Sherbrooke Village has made great strides in reducing re-hospitalizations through the CMS program and its own initiatives. These include implementing all care paths, conducting post-acute admit surveys, leveraging clinical liaisons, using in-depth follow-up protocols, creating reports for local hospitals regarding readmissions, and meeting with hospitals to review medical records and determine how each readmission could have been prevented. In the last year and a half, the ministry’s readmit percentage has gone down from 17 percent to 9.8 percent.
