Working Together to Reach the Highest Stars

Providing the highest quality of care is every nursing facility’s goal. Residents and their families can see how well this goal is being achieved through CMS’ 5-star quality rating system. Earning the highest score tells residents and potential residents that facilities and their staff deliver the best care in a safe and respected environment. A low score can indicate that there is work to be done.

Qlarant offers quality improvement solutions to private and Veterans Affairs nursing facilities. Our customized process is designed to help facilities on their way to achieving higher ratings. In order to meet and maintain the best scores possible, nursing facilities often need support grounded in experience and root-cause analysis — support that Qlarant provides. Some examples of our Nursing Facility Solutions include:

  • Assistance improving processes, training, & resources
  • Ensuring the correct number of caregivers deliver the highest care in a safe environment
  • Access to subject matter experts to help navigate state and federal regulations
  • Facility-specific quality improvement process development
  • Pre- and post-evaluation assessments to prepare and guide facilities to higher ratings

Moving from 1 to 4 Stars: A Story of Success

Qlarant has real-world experience in helping a nursing facility reach the highest stars. A state agency tasked us to help a 1-star nursing facility determine how to improve their score. After consulting with Qlarant, performing a mock survey, and implementing recommended quality improvement initiatives, the facility achieved a 4-star rating. The following are some of the strategies used to help this facility.

Strategy 1: Enhancing Staff Competencies

Our on-site evaluations determined if current staff had appropriate competencies to provide quality care to residents. Working with the facility, we recommended they establish a competency-based training program designed to enhance staff abilities to assess and treat urgent care needs such as:

Female nurse visiting senior patient for checking blood pressure

  • Depression
  • Anxiety
  • Trauma
  • Loss
  • Mental Illness
  • Substance Abuse/Alcoholism
  • Adjustment Difficulties
  • Problems taking prescribed medications

The comprehensive, competency-based training program also targeted nursing aides. The program established goals, objectives, and evaluations to assure aides understood core competencies and included remedial training for performance issues and documenting outcomes.

Strategy 2: Promoting the Resident Grievance Process

Training nursing staff to understand residents’ specific needs is an important part of the ability to increase the quality of care for residents. Based on personal interviews with residents and members of their families, Qlarant discovered many were not familiar with their rights. Because of this discovery, we provided guidance for developing a presentation for Resident Council meetings to raise awareness of the facility’s grievance process. Qlarant also recommended the information be shared during the admission process, through the existing family newsletter, and as a part of routine training.

Cover of Nursing Facilities Booklet

Strategy 3: Establishing a Quality Assurance and Performance Improvement (QAPI) Program

Because the facility lacked a QAPI program and plan, Qlarant worked with staff to develop one that included strategies for improved communication and annual staff training in QAPI.

We assisted the facility in developing a reporting schedule, data analysis, and result trending from each department. Baseline measures, benchmarks, and goals were established for measurement and continued success.


Careful Planning + Pre-Audit Inspection = Facility Readiness

That’s Qlarant’s equation for nursing facility rating success. We conduct a comprehensive facility-wide Mock Survey before the actual facility annual survey. Our reviewers will assess the survey readiness of policies and procedures, and work with teams to identify and resolve issues to ensure nursing facilities are meeting regulations.

Our long-term care reviewers understand the needs of the residents as well as the constraints of the facility, and are able to develop and recommend strategies to improve outcomes while keeping day-to-day operations running smoothly. Working closely with staff, we can identify potential non-compliance and define the steps needed to resolve and improve the care provided to residents.

We begin the process by conducting a resident census to identify sample selection for medical record review. At the end of the on-site survey, Qlarant reviewers will meet with key personnel and conduct an exit conference to provide overall findings. During the post-site phase, we will provide a comprehensive report with specific recommendations.

Our on-site Mock Survey prepares facilities for assessment by covering topics such as:

  • Policy reviews
  • A facility tour
  • Resident interviews
  • Resident observations
  • Family interviews
  • Nursing practice observation
  • Dining experience assessment
  • Food service observation
  • Resident medical record review
  • Quality assurance program creation
  • Abuse prevention evaluation
  • Accident and incident review
  • Infection control procedure observation
  • Interdisciplinary department observation
  • Staff training and education review
  • Personnel file review

In the End: Quality Improvement Equals Better Care

And better care equals more stars.

Qlarant is a national leader in healthcare quality improvement, with a proven track record of helping organizations elevate their quality performance.

We are here to help you reach for the stars.

Let's Talk About Nursing Facilities Solutions

How can Qlarant help you improve quality and program ratings?