​A quartet of providers has received the preeminent Gold National Quality Award designation from the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) for 2020 and was honored for their achievement during the association’s annual convention, which ran on a virtual basis through the month of October.

Starting With Bronze

Jane Martin, RN, director of nursing, Treutlen Health and Rehabilitation, Soperton, Ga., says for her 50-bed facility in rural Georgia, the latest attempt to achieve Gold started five years back when the organization earned Bronze from AHCA/NCAL, then Silver in 2017.

“That is when we decided to go for the Gold,” she says. “We [earned] a site visit last year, and then this year got the Gold award.”

Going for the top honor and going for the Bronze or Silver are worlds apart, Martin notes. “The Gold is so much different, and you really need to dedicate time to it.” This work includes copious writing down to report quality-based outcomes for residents, since getting positive results is what the award process is all about, she says.

“Probably the most difficult things is collecting the data. Everything has a different measurement time frame, so I really rely on LTC Trend Tracker [from AHCA/NCAL], NursingHome Compare… You need to know all of these data today on a regular basis.”

Once all the hard work resulted in the Gold, Martin says sharing the good news, in a COVID-sensitive manner, was a great feeling for staff and residents alike.

“We were in a huge open area when we told them, and it was a lot of yelling through masks,” she says. “It was kind of sad that we could not hug or have family there, but we did our best.”

As for what she would tell fellow providers about the award program, Martin says facilities should do it; even though it is not easy, it is well worth it. “We all learned so much through the process, and there were so many little things along the way, it has changed the way we live and work here.”

Driven by Necessity

Kristin Thrun, administrator, Burgess Square Healthcare and Rehab Centre, Westmont, Ill., says her nursing home got into the quality award world because back in 2012 when accountable care organizations and other value-based care entities emerged in her area, it became imperative for her facility to set itself apart.

“The focus became even more pronounced on overall performance outcomes and quality measures, and becoming part of the AHCA/NCAL award process helped us to do this in a systematic way,” she says.

After receiving some local awards for their work with residents, the facility earned Bronze from AHCA/NCAL in 2017 and then eyed going for Gold after that.

“I think the biggest challenge is continuing to push forward in terms of meeting the criteria and putting our programs in place and sustaining them despite the external challenges brought on by things like changes in payment models [Patient-Driven Payment Model] and keeping pace with those,” Thrun says.

An example she gives is the challenge it was to make the systemic change on medication reconciliation when a resident moved from the hospital to the nursing home.

“We worked with the hospital to change the process and reduce errors tied to these transitions of care and created a pharmacy position that just does admission reviews for new patients coming in,” she says.

New Skills Help Staff Adapt

The third achieving group says its journey to Gold began 18 years ago, according to Gail Cushing, RN, executive director, Applewood Center, Winchester, N.H.

“It has been a long journey for sure, but we continued to forge on throughout the time, but it did not prevent us from getting to where we wanted to go,” she says.

The greatest thing about the Gold process, Cushing says, is that it gave Applewood Center and its staff new skill sets to be able to adapt to new demands. “We can take new problems and adapt very quickly. An example is with COVID-19; I have said handling the pandemic was made more manageable because we went through a dress rehearsal with the Gold awards.”

For her, the award application has taught her and her people to communicate better, get feedback, educate, teach, and fix pitfalls. One example is that during the pandemic, her staff came up with a way to clean their goggles when there was no water source in an area where people were working.

“The whole Gold process is a concept really that provides a facility with new means to achieve success, and the more you practice, the better you become and the more ingrained it all becomes,” Cushing says.

Pride for the Gold

Katie Frederick, administrator, Heritage of Bel-Air, Norfolk, Neb., started out talking about the end game of achieving Gold, which was the joy she, her 160-strong staff, and residents felt at accomplishing so much. Even though the pandemic has made a true celebration difficult, she says the pride all in the community feel about making Gold is real.

For her, making changes to be more efficient and better at evaluating results and outcomes is the lasting impact going through the award process will have.

“Evaluating and learning are what this has all been about. And, really getting better at communicating, listening to each other, and putting ideas into practice. That has all worked for us,” Frederick says.