One of the first nursing homes referred to Mountain-Pacific Quality Health (Mountain-Pacific) in December 2021 for assistance with improving its resident COVID-19 booster rate demonstrated a 44.1 percent increase following frequent and tailored one-on-one assistance. This increase occurred in the period between when the nursing home was referred to Mountain-Pacific for assistance and the last week they reported booster rates to the National Healthcare Safety Network (NHSN) database in April 2022.
Leverage Pharmacy Partners and Local Public Health Resources
During initial conversations with the nursing home, Mountain-Pacific, a Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organization (QIN-QIO), learned the facility’s residents preferred the Pfizer-BioNTech vaccine over Moderna. Nursing home staff believed that if they could access enough supply, they would be able to provide booster doses to more residents. However, the nursing home’s location on a reservation in a very rural area made accessing the vaccine extremely challenging. Mountain-Pacific leveraged its pharmacy partners and local public health resources to provide the nursing home with specific contacts in their county who had a supply of the vaccine. The nursing home connected the dots on its own and secured a supply from Indian Health Service.
Identify a Variety of Vaccine Education Resources
Mountain-Pacific also identified a variety of vaccine education resources to help the nursing home raise awareness about the importance of boosters and build residents’ receptiveness toward getting boosted. For example, Mountain-Pacific shared Centers for Disease Control and Prevention (CDC) general COVID-19 vaccine guidance and materials, including CDC interim clinical considerations and other training resources. The nursing home pulled posters and other educational materials and printed and mailed them to resident families and guardians. To reach residents who are less trusting of the government, Mountain-Pacific identified non-governmental resources which included YouTube videos created by a hospital doctor.
Host Weekly Clinician Open Office Hours Series
In January 2022, Mountain-Pacific launched its weekly clinician open office hours series called, “It’s Worth a Shot.” The nursing home was invited to participate and became a regular and very active participant. This platform allowed Mountain-Pacific to deliver substantial information on vaccine access, tracking, and infection control and answer questions from participants. After each session, specific resources related to the call topic were shared broadly with all nursing homes.
Provide One-on-One Virtual and in-person support
The most powerful intervention, however, was Mountain-Pacific’s proactive one-on-one virtual and in-person support. A simple, “How are you doing?” and “What can we do to help you and support you?” drove each conversation and helped Mountain-Pacific identify and address the nursing home’s unique needs. During its initial encounter with the nursing home, Mountain-Pacific made notes about the facility’s screening processes and resources. This kept the nursing home’s needs top of mind for Mountain-Pacific and opened the door for follow-up conversations when relevant tools and resources became available.
Remind the Nursing Home About the State’s Vaccine Access Tracking System
During an onsite visit that was part of a COVID-19 hot spot referral, Mountain-Pacific took the opportunity to remind the nursing home about the state’s vaccine access tracking system. The team reiterated that offering a booster vaccine on admission or readmission waives the quarantine period required by CMS and CDC. The opportunity to provide this education ensured the nursing home was able to assess vaccine status and promote booster uptake among new and returning residents.
Promote an Internal Culture with the Desire to Protect its Residents
Mountain-Pacific attributes the nursing home’s success to its internal culture and staff’s desire to protect its residents. The facility embraced the targeted vaccine referral process, was very open-minded, and willing to learn and take initiative. The one-on-one assistance and specific tools and resources Mountain-Pacific provided enabled the nursing home to do the work.
More broadly, all nursing homes in the four-state region served by Mountain-Pacific that were referred to the QIN-QIO for assistance between December 26, 2021 and May 15, 2022, saw a 10.6 percent net increase in resident vaccination/booster rates as compared to nursing homes in that region that were not referred to the QIN-QIO for assistance. In addition, the percentage of fully vaccinated and boosted residents in nursing homes in Mountain-Pacific’s four-state region referred to the QIN-QIO for assistance increased by 23 percent compared to fully vaccinated and boosted residents in nursing homes not referred to the QIN-QIO which increased by only two percent.
Mountain-Pacific’s Regional Nursing Home Resident COVID-19 Vaccination/Booster Rates Including Referrals from December 26, 2021 through May 15, 2022.The graph compares vaccination rates of CMS-referred facilities (orange) with never-referred facilities (blue) and only includes referrals made between January 9 and May 15, 2022. Never-referred facilities did not meet initial criteria for booster referral because CMS focused on facilities with significantly lower rates.
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This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1127-07/18/2023