2 min read

So You Think You're Compliant? What's Keeping You Awake?

By Prime Care Tech Marketing on Wed, Dec 23, 2015 @ 01:27 PM

CompliantRest assured. LTPAC Clinical executives can know rather easily.

What keeps you up at night? When I ran SNFs, many things would intrusively leap onto the stage of my dreams, stealing the limelight. Their discordant presence would dash the quiet and restful performance currently playing, causing me to start into a sudden and unwelcome wakefulness. It was one thing to steal the limelight, it was another to completely take over the show and lock the stage door to my more sedate and slumber-inducing dreams. Stifling a cry, I would sit bolt upright in bed, beads of sweat on my furrowed brow. One of those frequent limelight-stealing imps was a nagging doubt about my facility’s compliance.

Compliant to what? Federal and State regulations? Fire and safety? The Fair Labor Standards Act? Safe Harbor? HIPAA? Corporate standards and objectives? The list goes on and on, each list member competing animatedly for my attention. “No sleep tonight,” I’d groan. But times have changed and so has technology potentially barring the stage doors to unsolicited dream disturbers.

In the days before automated data mining and business intelligence (BI)-generated dashboards and reporting, I would have to make a mental note to investigate if and how compliant we were, recognizing that the research alone would take quite a lot of time, assuming no interruptions (silly me), sorting through charts, files, and printouts. But today WITH BI at a manager’s fingertips, those with compliance concerns, including clinical managers, have ready access to critical Key Performance Indicators (KPIs). With Business Intelligence, clinical managers can conveniently view a variety of KPIs which they can make their own. (I’ll get to that shortly.)

Let’s take a look at some of the KPIs clinicians can view to discover in measurable terms if their areas of concern are compliant. With regular input either directly from the data which resides within their clinical application automatically “pumped” into the data warehouse or keyed in directly, clinicians have access to frequently refreshed information. This information can include such KPIs as in-house-acquired or community-acquired pressure ulcers with the number of residents with pressure ulcers at what stages and at what percent of the average daily census over a month’s period of time or trended over a 12-month period.

Restraints? Weight loss? Anti-psychotic use? Infections? Readmissions? Falls/Accidents? Sentinel events, such as dehydration or fecal impaction? Indwelling catheters? Pain management? Hour per patient/resident day compared to state standards and to budget? Overtime usage? And more. If the data exists, the information can be viewed in the BI dashboard.

Now, I referred earlier to managers making KPIs their own. How about comparing the KPIs against benchmarks the clinical team has created based on regulations and company/facility-established standards, usually set to exceed the regulatory requirements? It’s all in one dashboard. No longer do clinicians have to wait for reports to be researched, compiled, published, and distributed. Log in and find out. No more uncertainty. Just discover. Take action. Get results.

With BI, this potentially sleep-disruptive concern can be put to rest. It’s called peace of mind. Take a dose of BI every day and sleep well.

Business Intelligence

Topics: business intelligence Data Mining clinical KPIs Losing sleep KPI benchmarks data warehouse compliance
3 min read

Benefits of Business Intelligence to Long-Term Care Providers

By Prime Care Tech Marketing on Tue, Nov 03, 2015 @ 06:38 PM

To somewhat freshen up a term that can become stale due to overuse or, possibly, misuse, I would like to spinBusiness Intelligence “business intelligence” (or business analytics) and convert it to “intelligent business.” Sometimes, playing with words (which is fun for me at times) can reshape our paradigms. “Business intelligence” implies the use of systems and processes which simplify the retrieval of data and its conversion into actionable information readily accessible to decision makers in real time[1]. But business intelligence goes beyond technology tools; BI is indeed "intelligent business" decision making. But first, let’s talk about BI’s/Intelligent Business benefits.

BI’s Key Performance Indicators reflect the organization’s mission and objectives.

I like the concept of each organization focusing its decision making on its mission and objectives. BI helps significantly to do just that, because executives and management can identify and align Key Performance Indicators (KPIs) to the broader organization’s mission, goals, strategies, and culture as well as to each of its business units’ objectives. The magic of BI is that the information displayed can be rolled up or drilled down to specific levels of interest and responsibility within the organization. Let’s say that the COO, who likely would never log into his or her organization’s clinical application, can view a consolidated corporate view or an expanded view of all regions’ or facilities’ clinical KPIs. Likewise, a department head can view his or her specific KPIs benchmarked against department-specific goals.

BI fosters quicker data-driven solutions.

Yes, successful decisions are often based on “hunches”, but in today’s LTPAC world executives and managers have to make and report on specific data-driven KPIs. Before technology truly enabled BI, decisions were often hunches based on information manually extracted from old data, assuming that the information was possibly a trend. It was like trying to drive a car exclusively looking in the rearview mirror. But for businesses to function intelligently with BI, the information needs to be organized and displayed in ways that fosters comprehension, timely quality decisions, and, may I add, accountability. BI also enables managers and executives to retrieve and view data in ways that are specific to their responsibilities and needs.

BI crosses data silos for multi-dimensional views.

Let’s take labor management, for example. For years LTPAC providers have analyzed labor hours and dollars based on hours and dollars per patient per day. Manually, that would mean reconciling time card totals with the census tabulated and reported by the nursing department. However with business-critical enterprise-class software, providers are now using time and attendance applications for labor hours, payroll applications for labor dollars, and clinical applications for the census in aggregate, by payer type, by clinical unit within the facility, and so forth. But each application may be from a different vendor. To get them to talk to each other and to consolidate and convert that data into actionable information instantly requires data mining and BI technology.

BI displays convenient and useful information

BI can also display the information in ways useful to the decision makers. I’ve hinted at this throughout this blog, but the magic to BI is its intelligent use. It starts with identifying and aligning KPIs to the organization’s mission, objectives, strategies, and, yes, culture (but that is a topic for another day). Once selected, KPIs determine how data is be collected, combined into useful information, and displayed in consumable formats. Because the KPI-driven information is available in real time and actionable, executives can make data-driven decisions right now. Now that’s intelligent business.


[1] Lest we get off on a tangent here, I am going to use Merriam-Webster as my source for defining “real time”: “the actual time during which something takes place <the computer may partly analyze the data in real time (as it comes in) — R. H. March>.” (Italics added) In this instance, BI generates information in real time as soon as the system has access to the data (as it comes in).  In the case of most of our BI customers, that means refreshing the data available in their respective data warehouses several times a day – as frequently as each customer wants to have its data updated.

Business Intelligence

Topics: business intelligence Key Performance Indicators Data Mining BI KPIs data-drive decisions real time
3 min read

Complying with CMS reporting requirements can be easy

By Prime Care Tech Marketing on Fri, Dec 05, 2014 @ 07:30 AM

iStock_000017497645Small_Buried_in_Paper_Transp_BkgdLikely you read the article in the November 14, 2014 McKnight’s Daily Update entitled, SNF staffing data will be submitted quarterly, payroll vendors might be responsible, CMS officials say, which reported that CMS has launched a pilot to solicit information directly from providers’ payroll systems. The crux of the matter is the lack of confidence in the accuracy of the information providers are reporting to CMS annually to comply with Five Star Rating information requests.

Further, in a previous McKnight’s article, dated November 13, 2014, entitled 80% of nursing homes report misleadingly high staffing levels, Center for Public Integrity claims, the Center for Public Integrity claims that “more than 80% of skilled nursing facilities might have inflated registered nurse staffing levels on the Nursing Home Compare website.” I have a hard time believing that reported registered nurse staffing levels were double that which Medicare cost reports reveal. If that is the case, some providers must be extremely short sighted. Or the investigative journalists at CPI don't know how to read cost reports. The New York Times further fanned the flames of controversy by claiming that providers “ramp up” their staffing levels before a known inspection, allegedly using that time period as the sample for reporting purposes. These two articles seem to indicate that providers have two issues to deal with when it comes to reporting labor information, e.g., accuracy and integrity.

Technology can ensure reporting accuracy and timeliness

iStock_000017497645Small_Feet_on_Desk_Transp_BkgdSo what’s a provider to do? Assuming providers have integrity, let’s discuss accuracy. In the past, when I was running buildings, I had to collect the data and create the reports manually, cross-checking multiple times to make sure the reports were accurate - a laborious, tedious, and time-consuming task. Providers today, however, have a much easier and time-saving alternative - automated data mining and business intelligence (BI). Retrieving, compiling, and repurposing the data into useful, relevant, timely, accurate, and actionable information is fully automated through data mining and BI technologies. The data comes directly from the provider’s time and attendance and payroll systems, combined with its clinical and financial software. The BI tool retrieves that data and stores it in a data warehouse from which it creates reports usually viewable in a dashboard. Further, the reports can be as “real time” as the provider needs them to be. As soon as an employee punches in or out that data is stored and therefore information can be retrieved and reported throughout the day.

Business Intelligence can be a tool to use to take action, to make sure that labor is compliant with budgetary and regulatory requirements. It can also be a reporting tool readily disseminating accurate reports to stake holders, managers, and even to regulatory agencies. Even better, such BI tools already exist, such as our primeVIEW dashboard. With it providers throughout the day are able to view staffing levels, observe overtime, identify who’s on the clock and who’s not, review part-time employee hours, and assess labor trending. It can also generate the CMS 671 report for the Long Term Care Facility Application for Medicare and Medicaid. This kind of rich reporting goes beyond CMS requirements and has proven useful to providers across the country to help them save money and improve business processes.

If you haven’t already, I encourage you to look into Business Intelligence to not only run your business, but to comply with such reporting requirements as CMS will mandate for all providers. Through business intelligence, such information is accessible, accurate, and painless…well, at least the process is; the results may not be. But that is why you want BI in the first place. Address the pain before it gets out of hand. But that is for another blog posting.

Topics: business intelligence Data Mining
3 min read

Providers Discover Hidden Treasures through Data Mining

By Prime Care Tech Marketing on Wed, Oct 03, 2012 @ 07:00 AM

data mining yields treasures of actionable knowledgeData mining represents wealth, a wealth of opportunity, action, and success. Directly put, data mining (the process of centralized data management and retrieval) helps LTC providers find hidden treasures of knowledge, not just data. Just as rare gems or precious minerals are only valuable when processed from the ore that is unearthed, so too is knowledge when refined from countless bytes of data. Refined data transformed into information becomes knowledge and knowledge – the power to act. Data mining, therefore, helps executives discover what is happening now, track trends, anticipate with some accuracy what may happen in the future, and explore the strengths of possible actions.

In real terms, providers today have the ability to mine their own data and, yes, to share the data and knowledge with others at practically a simple click of a button. They can view and act on Key Performance Indicators (KPIs) in real-time* and, based on the information collected, take action or create their own predictive models or what-if scenarios. Some vital KPIs, among others, include:

  • Census Information, such as actual-to-budget census by payer type
  • Admissions and Discharges trending, including admissions sources and discharge destinations, lengths of stay, and readmissions to hospitals
  • Labor information, including actual-to-budget as well as actual-to-flex budget (by which providers can determine staffing needs based on the actual census)
  • A review of overtime hours so that providers can schedule staff and minimize overtime pay
  • Cash and accounts receivable comparing actual payments to targeted collection dates by payer, also cash trending by payer, reconciliation of collections to bank statements, DSO, periodic aging reports
  • Regulatory reporting, such as the 671 report, detailed discharge reports, reports for uploading to other systems, such as AHCA’s Trend Tracker
  • Clinical  SNF and assisted living KPIs, including relevant trending

The strength of data mining for operators of multiple facilities lies in its ability to drill down from a consolidated dashboard view configured by the provider to the region, facility, department, individual employee, or resident. Administration of such a system is provider driven to determine who shall have access to what within the system.

A viable data mining system is responsive to the ever-changing long term care environment, such as data and information-hungry ACOs, remaining top of mind for hospital discharge planners by maintaining hospital readmissions at an acceptable level, involvement in policy-determining studies, or meeting HIT requirements (Stage 2 meaningful use) to be eligible for the federal electronic health-record financial incentive program.

Data mining is more than a curiosity; it is the Mother Lode of vital information in today’s health care environment. Talk to us during the AHCA/NCAL 63rd Annual Convention and Expo, booth #1317, or during the 2012 LeadingAge Annual Meeting and Exposition, booth #530,to discover for yourself how providers like you have benefited in real dollars from data mining using our primeVIEW business intelligence tool.

*Let’s talk about “real-time” for a moment. The term, real-time, can mean “without perceivable delay.” So, in this case, the data is processed as soon as it is received. How often is the data pulled? That is directly driven by the provider’s need to know. You could say that “real-time” reporting is driven by the need for “real-time” decision making. For example, labor hours require perhaps a greater frequency of reporting during a given day than collections or census. Our primeVIEW customers determine data pull frequency.

Topics: business intelligence Data Mining real-time reporting BI
3 min read

It’s time for IT to step up and save the game!

By Prime Care Tech Marketing on Mon, Aug 29, 2011 @ 11:19 AM

IT must demonstrate its ROI in LTC nowIn the Spring of this year, I used baseball as a metaphor for the “game of Long Term Care.” At that time I said that providers were “going to have to step up to the plate and respond swiftly and powerfully to the curve balls of regulatory changes, the sliders of reimbursement, the change-ups of market pressures, and the fast balls of competition.” Little did I know at the time that the term, “sliders of reimbursement,” was going to be uncomfortably prophetic. Because of the drastic “adjustments” to Medicare reimbursement and declining Medicaid rates, the slider is real – a potential slide downhill, that is; they’re game changers. I would like to take the baseball metaphor one swing further.

A successful swing at the plate requires not only skills, talent, great vision, quick reflexes, good upper body strength, and sound judgment, but a solid bat as well, one that each batter can handle comfortably and confidently. It’s the tool that hitters rely on. In the case of LTC, the “bat” I am referring to is IT (information technology). And it’s time for IT to prove its worth as a tool to identify savings without cutting quality and to prevent unnecessary revenue leakage through automated tools and processes.

Savings – the IT Infrastructure

Let’s start with IT itself. Article upon article and one study after another have clearly identified that the “cloud” offers the scalability, flexibility, reliability, and savings that other methods of IT deployment may not offer. Cloud-based computing means lower initial costs and TCO, because all IT-related procurement, maintenance, management, and upgrades are handled remotely. Further, the cloud’s monthly subscription-based model enables providers to use their capital for other critical areas of their business. Earlier this year, the CIO Consortium identified that, “Reasonable, five-year costs to deploy currently available EMR technology and eliminate paper records range from $254,000 per facility for third party hosted solution (italics and color added for emphasis), $259,000 for vendor hosted Software as a Service (SaaS), and $356,000 for an in-house hosted solution.” Clearly, now is the time to carefully consider the cloud as a solid source for immediate and long-term savings.

Real Savings through IT Tools

What specifically does IT offer that will help providers identify savings, stop revenue leakage, and ensure that they are in compliance with regulations? The answer is automation - automated claims management to stop revenue leakage; automated MDS and RUGs reporting; automated procurement to make sure that purchases are per contract pricing, timing, and quality; automated labor management; and automated real-time Key Performance Indicator (KPI) reporting.

Automated claims management helps providers not only to generate, review, edit, and transmit claims, but to identify and act immediately on issues when and where they occur. This includes incorrect claims codes, codes changes and regulations, missing codes, poor communication between clinical and billing staff, poor pricing practices, and inefficient and ineffectual internal review processes.

Automated MDS and RUGs reporting lets providers identify facilities most "at risk" with poor survey performance; discover how each of their facilities ranks among its peers; pinpoint facilities which are operating below or above critical primary care staffing levels; detect residents/patients who are clinically at risk; observe the financial impact of MDS submissions by facility, region, and corporation; scrutinize QM/QI’s at a facility, region, or corporate level, and analyze reimbursement rates (RUGs).

Automated procurement involves complete commerce automation (purchase orders, invoices, and product and contract maintenance) and reporting with intelligent direction and feedback for procurement decisions.  It connects multiple facilities, satellite locations, and branch offices to the vendors, products, pricing, delivery terms, and service providers carefully negotiated and selected by their parent company. Automation allows flexibility and customization for each corporate entity to support their partner selection, the business rules negotiated with each partner, their internal G/L structure, and their purchasing chain of command.

Automated labor management gives providers the tools necessary to manage and control that which amounts to almost 60-70% of a provider’s spend – labor. Automation offers applicant tracking, time and attendance, payroll, and human resources management. Not only can providers reduce costs wisely, but also increase productivity.

Automated real-time Key Performance Indicator (KPI) reporting, or a digital dashboard, translates into business intelligence, which to LTC providers means they can quickly analyze and act on census levels, admissions, and discharges; labor hours and costs; and receivables and collections. Armed with this incredibly valuable information, providers are able to monitor how well they are saving money and increasing revenue in real time and take action, when necessary, with surgical precision.


IT through the cloud will not only help providers survive, but ultimately win, by confidently hitting whatever is thrown at them out of the park.

Topics: long term care business intelligence dashboard cloud computing IT infrastructure Key Performance Indicators Data Mining human resources automated claims management automated procurement labor management MDS RUGs revenue leakage cloud-based computing


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