Improving COVID-19 Outcomes in Nursing Homes Across America

Centers for Medicare & Medicaid Services (CMS) Quality Improvement (QI) Voices: Improving COVID-19 Outcomes in Nursing Homes Across America is an audio series that gives you a closer look at the projects and the people who are improving health care quality and outcomes. These brief conversations include detailed show notes for even more insights into the process behind health care quality improvement – and how you might adapt these to your own organization.

Conversations with the Centers for Medicare & Medicaid Services (CMS) Chief Medical Officer (CMO)

The first three episodes, Conversations with the CMS CMO, provide nursing homes with the facts on COVID-19 vaccines and therapeutics that support better resident outcomes. In these conversations with Dr. Lee Fleisher, the CMS CMO, nursing home leaders will hear from Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA) experts.

From the Field: Lessons Learned About Improving COVID-19 Infection Control and Vaccination/Booster Rates

The remaining episodes explore how nursing homes and Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) have worked together to tackle COVID-19 vaccination and infection control challenges to improve resident outcomes.

To see more examples of how QIN-QIOs are working with nursing homes to improve resident COVID-19 booster rates, read the Quality in Action blog.

To access additional infection prevention and COVID-19 vaccination and booster resources, visit our Tools & Resources.

Episode 1: Conversations with the CMS CMO - The Facts Behind the Updated COVID-19 Vaccine: Safety and Efficacy

The new bivalent COVID-19 vaccine provides even greater protection against severe illness and death than the original primary series. In this episode, hear from Peter Marks, MD, PhD, director of the U.S. Food and Drug Administration (FDA) Center for Biologics and Research about what makes the new bivalent COVID-19 vaccine different. Get answers to common questions about the updated vaccine and facts about the risks and side effects for the nursing home and long-term care population. 

Speakers:

Lee A. Fleisher, MD

Chief Medical Officer and Director

Center for Clinical Standards & Quality

Centers for Medicare & Medicaid Services (CMS)

Dr. Fleisher is Chief Medical Officer and Director of the Center for Clinical Standards & Quality at CMS. He is responsible for executing all national clinical, quality and safety standards for health care facilities and providers, as well as establishing coverage determinations for items and services that improve health outcomes for people with Medicare. He is also professor emeritus and former chair of anesthesiology and critical care and professor of medicine at the University of Pennsylvania Perelman School of Medicine. Dr. Fleisher received his medical degree from the State University of New York at Stony Brook. 

Peter Marks, MD, PhD

Director, Center for Biologics Evaluation and Research (CBER)

U.S. Food and Drug Administration (FDA)

Dr. Marks joined the FDA in 2012 as Deputy Center Director for CBER and became Center Director in January 2016. He received his graduate degree in cell and molecular biology and his medical degree at New York University and completed internal medicine residency and hematology/medical oncology training at Brigham and Women’s Hospital in Boston. He has worked in academic settings teaching and caring for patients and in industry on drug development. 

Episode 2: Conversations with the CMS CMO – Long-term Care Treatment Options for COVID-19

Several treatment options are available for nursing home residents who are diagnosed with COVID-19. In this episode, learn from John Farley, MD, MPH from the U.S. Food and Drug Administration (FDA) and Meg Sullivan, MD, MPH from the Administration for Strategic Preparedness and Response (ASPR) about the risks, benefits and common side effects of these treatments.

Access resources for this episode:

Speakers:

Lee A. Fleisher, MD

Chief Medical Officer and Director

Center for Clinical Standards & Quality

Centers for Medicare & Medicaid Services (CMS)

Dr. Fleisher is Chief Medical Officer and Director of the Center for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS). He is responsible for executing all national clinical, quality and safety standards for health care facilities and providers, as well as establishing coverage determinations for items and services that improve health outcomes for people with Medicare. He is also professor emeritus and former chair of anesthesiology and critical care and professor of medicine at the University of Pennsylvania Perelman School of Medicine. Dr. Fleisher received his medical degree from the State University of New York at Stony Brook. 

John Farley, MD, MPH

Director, Office of Infectious Diseases

Office of New Drugs, Center for Drug Evaluation and Research

U.S. Food and Drug Administration (FDA)

Dr. Farley’s work at the FDA within the Office of Infectious Diseases is responsible for the review of new antiviral and antibacterial drugs and engaged in the FDA’s COVID-19 response focused on development of monoclonal antibody and small molecule therapeutics. Dr. Farley trained at the George Washington University School of Medicine, Children’s National Medical Center and the Johns Hopkins University Bloomberg School of Public Health.

Meg Sullivan, MD, MPH

Chief Medical Officer

Administration for Strategic Preparedness and Research (ASPR)

U.S. Department of Health and Human Services (HHS)

Dr. Sullivan is a board-certified pediatrician with extensive experience in public health, health equity, primary care, infectious disease prevention and control and emergency response. Prior to joining ASPR, she served as the medical lead for COVID-19 response for the largest county in North Carolina as part of her role as the medical director at the Mecklenburg County Health Department. Dr. Sullivan completed medical school at the University of California, San Diego and her residency at New York Presbyterian/Columbia University Medical Center. She received her Master of Public Health degree from Johns Hopkins Bloomberg School of Public Health.

Episode 3: Conversations with the CMS CMO - CDC Programs for COVID-19 Infection Prevention and Vaccination in Nursing Homes

Infection prevention and the use of vaccines is key to reducing the spread of COVID-19 in nursing homes and long-term care facilities. In this episode, Nimalie Stone, MD, MS and Arjun Srinivasan, MD from the Centers for Disease Control and Prevention (CDC) discuss CDC programs and collaborations that support nursing home efforts to promote infection prevention and vaccination and how health care providers can access the new vaccine for their facilities. 

Access resources for this episode:

Speakers:

Lee A. Fleisher, MD

Chief Medical Officer and Director

Center for Clinical Standards & Quality

Centers for Medicare & Medicaid Services (CMS)

Dr. Fleisher is Chief Medical Officer and Director of the Center for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS). He is responsible for executing all national clinical, quality and safety standards for health care facilities and providers, as well as establishing coverage determinations for items and services that improve health outcomes for people with Medicare. He is also professor emeritus and former chair of anesthesiology and critical care and professor of medicine at the University of Pennsylvania Perelman School of Medicine. Dr. Fleisher received his medical degree from the State University of New York at Stony Brook.  

Nimalie Stone, MD, MS

Medical Epidemiologist for Long-Term Care

Division of Healthcare Quality Promotion

Centers for Disease Control and Prevention (CDC)

Dr. Stone is a senior advisor for long-term care partnerships within the CDC Division of Healthcare Quality Promotion. In this role, she works closely with long-term care providers, state and local health departments and other stakeholders, such as the Centers for Medicare & Medicaid Services, to implement infection prevention and control practices and increase quality and safety for residents and staff in nursing homes and other long-term care settings. Dr. Stone is a board-certified infectious disease physician with more than 10 years of experience developing guidance, surveillance resources and programs to track and prevent infections and antibiotic-resistant pathogens in post-acute and long-term care settings. She completed an internal medicine residency at Johns Hopkins University and a fellowship in infectious diseases at Emory University. 

Arjun Srinivasan, MD

Associate Director for Healthcare Associated Infection Prevention

Division of Healthcare Quality Promotion

Centers for Disease Control and Prevention (CDC) 

Dr. Srinivasan currently leads CDC efforts to coordinate activities to prevent healthcare-associated infections and to improve the use of antibiotics in hospitals. His research and investigative areas of concentration include outbreak investigations, infection control, multi-drug resistant gram-negative pathogens and antimicrobial use. 

Episode 4: From the Field - Addressing Vaccine Hesitancy in a High-Turnover Population

High resident turnover challenges skilled nursing facilities as they seek to achieve and maintain high resident COVID-19 booster rates. In this episode, learn how motivational interviewing and education addressed vaccine hesitancy and increased resident COVID-19 booster rates within a high-turnover population.

Access resources for this episode: 

Read more about Alliant Health Solution’s work with Kindred Hospital East- Greensboro on the Quality in Action blog, Alliant Health Solutions Helps Skilled Nursing Facility with High Turnover Population Achieve a 100 Percent COVID-19 Booster Rate

Speakers:

Colleen Frey, RN, MSN, CPHQ, ACHE

Acting Director, Division of Community & Population Health

Center for Clinical Standards & Quality

Centers for Medicare & Medicaid Services (CMS)

Ms. Frey is certified in health care quality with a background in infectious disease nursing informatics, infection control and emergency management. Prior to joining CMS, Ms. Frey was the administrative director of quality and patient safety at the Detroit Medical Center’s Adult Central Campus. She has a bachelor’s degree in nursing from Oakland University and a master’s degree in nursing from the University of Michigan.

Cassandra Thornton, RN, LNHA

Executive Director/CEO 

Kindred Hospital – Greensboro Subacute Unit

Ms. Thornton has worked for Kindred Hospital for more than 35 years and has held many roles, including nurse educator, director of nursing and administrator. She believes continued communication and that her unit is led by a facility plan and the Quality Assurance Improvement Process are key to their success.

Lisa Davies, CPHQ, LNHA, RD, LD

Quality Improvement Initiative Manager

Alliant Health Solutions

Ms. Davies has more than 20 years of experience in long-term care, including facility administration, implementation of quality improvement frameworks, legislative affairs and project management. Her current work applies quality improvement methodologies to support improved outcomes across health care organizations.   

Episode 5: From the Field - Boosting Vaccine Confidence Using Motivational Interviewing and Peer Ambassadors

Cultural experiences within a resident population can contribute to vaccine hesitancy. In this episode, learn how motivational interviewing and peer ambassadors helped one California nursing home increase COVID-19 vaccine confidence and its resident COVID-19 booster rate.

Access resources for this episode:

Learn more about HSAG’s work with Broadway Manor Care Center in the Quality in Action blog article, Nursing Home Boosts Vaccine Confidence and Improves Resident COVID-19 Booster Rates with Assistance from Health Services Advisory Group. 

Speakers:

Colleen Frey, RN, MSN, CPHQ, ACHE

Acting Director, Division of Community & Population Health

Center for Clinical Standards & Quality

Centers for Medicare & Medicaid Services (CMS)

Ms. Frey is certified in health care quality with a background in infectious disease nursing informatics, infection control and emergency management. Prior to joining CMS, Ms. Frey was the administrative director of quality and patient safety at the Detroit Medical Center’s Adult Central Campus. She has a bachelor’s degree in nursing from Oakland University and a master’s degree in nursing from the University of Michigan

Stephanie Vazquez, IPN

Infection Preventionist

Broadway Manor Care Center

Ms. Vazquez’s primary goal is maintaining high vaccination rates at Broadway Manor Care Center. She works closely with her team to create a comprehensive infection prevention plan for each resident and is dedicated to the continuing education of staff and residents about infection control. 

Lindsay Holland, MHA

Director, Care Transitions

Health Services Advisory Group (HSAG)

Ms. Holland has more than 14 years of health care industry experience with expertise in quality management, quality improvement, care coordination and community building. She directs and develops the strategic coordination and implementation of a range of collaborative and community activities, including supporting nursing homes in improving vaccination rates.

Episode 6: From the Field - It Starts with Your Staff: Stopping the Spread of COVID-19

Nursing home staff play a critical role in preventing COVID-19 spread and mortality in long-term care facilities. In this episode, learn about the infection prevention barriers staff face and what they need to continue doing to be successful in preventing the spread of COVID-19.

Access resources for this episode:

Speakers:

Colleen Frey, RN, MSN, CPHQ, ACHE

Acting Director, Division of Community & Population Health

Center for Clinical Standards & Quality

Centers for Medicare & Medicaid Services

Ms. Frey is certified in health care quality with a background in infectious disease nursing informatics, infection control and emergency management. Prior to joining CMS, Ms. Frey was the administrative director of quality and patient safety at the Detroit Medical Center’s Adult Central Campus. She has a bachelor’s degree in nursing from Oakland University and a master’s degree in nursing from the University of Michigan.

Shannon Finegood

Patient Safety Manager

Comagine Health

Ms. Finegood oversees vaccine education, support, promotion and resource development for long-term and post-acute care centers within Comagine Health’s Quality Innovation Network-Quality Improvement Organization (QIN-QIO) region. Throughout the COVID-19 pandemic Shannon worked on the frontlines in nursing homes experiencing the impacts of COVID-19 on vulnerable populations.  

Donna Thorson, MS, CPHQ, CPPS

Patient Safety Manager

Comagine Health

Since joining Comagine Health in 2001, Ms. Thorson has worked with providers and the community to improve the quality and safety of health care. She convenes and facilitates collaborative groups across the QIN-QIO region to identify and implement evidence-based strategies to improve health care processes and systems using human factors science to enhance intervention effectiveness.

Thuan Ong, MD, MPH

Clinical Medical Director

Comagine Health

Dr. Ong practices and provides clinical leadership in many nursing home environments and has practiced inpatient and outpatient medicine at Harborview Medical Center since 2008. He has a broad background developing and implementing policies to improve clinical care delivered to patients discharging to nursing homes. His scholarly work reflects a commitment to improving care delivery to older adults and a passion for teaching geriatric medicine to interprofessional clinicians.

Episode 7: From the Field - Best Practices for Cohorting and Infection Prevention

Understanding how to adapt basic infection prevention practices during a public health emergency like COVID-19 and how to identify residents who need to be cohorted is vital to reducing the spread of COVID-19. In this episode, learn about best practices for cohorting and COVID-19 infection control.

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Speakers:

Paul Rosen, MD

Medical Officer, Quality Improvement and Innovation Group

Center for Clinical Standards & Quality

Centers for Medicare & Medicare Services (CMS)

Dr. Rosen is a medical officer in the Quality Improvement and Innovation Group in the Center for Clinical Standards & Quality at CMS. He also serves as Professor of Pediatrics at West Virginia University.

Deborah Smith, MLT (ASCP), BSN, CIC, CPHQ

Consulting Manager

Health Quality Innovators (HQI)

Ms. Smith has dedicated her career to health care quality improvement and patient safety. As a consulting manager at HQI and infection prevention expert, Ms. Smith supports multiple settings of care across the U.S. as they implement infection prevention strategies. Under her leadership, health care facilities have reduced health care-associated infections, implemented antimicrobial stewardship programs, enhanced their patient safety programs, addressed social determinants of health by adopting health equity protocols and adopted programs to engage patients and families in their care.

Episode 8: From the Field - A Culturally Inclusive Approach to Address Health Equity and Increase Vaccine Confidence

Increasing COVID-19 vaccine confidence among culturally diverse populations from a health equity perspective is critical to ensuring uptake of the COVID-19 vaccine and booster. In this episode, learn how the OARS+ Model for Motivational Interviewing and other tools helped one nursing home serving Native American residents increase its resident COVID-19 booster rate. 

Access resources for this episode:

Learn more about Great Plains QIN’s work with Medicine Wheel Village in the Quality in Action blog article, Nursing Home Improves Resident COVID-19 Booster Rates with Assistance from Great Plains Quality Innovation Network. 

Speakers:

Paul Rosen, MD

Medical Officer, Quality Improvement and Innovation Group

Center for Clinical Standards & Quality

Centers for Medicare & Medicare Services (CMS)

Dr. Rosen is a medical officer in the Quality Improvement and Innovation Group in the Center for Clinical Standards & Quality at CMS. He also serves as Professor of Pediatrics at West Virginia University.

Deb Arbogast, RN

Administrator

Medicine Wheel Village

Ms. Arbogast is the Administrator at Medicine Wheel Village in Eagle Butte, South Dakota. She obtained her Nursing Facility Administrator license to serve in this role nearly five years ago. She has extensive experience working in a variety of health care settings throughout her career.

Keri McDermott

Communications Director

Great Plains Quality Innovation Network

Ms. McDermott is the Communications Director for Great Plains Quality Innovation Network; she has served in this role for nearly 20 years. McDermott oversees production of internal and external communication tools and resources. She also works with her team to develop and implement communication strategies to improve care and quality in the Dakotas.