A Quality Assessment and Performance Improvement Plan Using MDS 3.0 to Enhance Activities of Daily Living for Long-Term Care Facility Residents with Late Loss

Introduction: Late loss of activities of daily living (ADLs) can affect the quality of life and outcomes of residents in long-term care facilities. This article proposes a quality assessment and performance improvement (QAPI) plan that utilizes the Minimum Data Set (MDS) 3.0 assessment tool to identify residents with late loss and develop individualized care plans. The plan outlines steps to evaluate the current state of late loss quality management (QM), establish goals and objectives, develop an action plan, implement the plan, evaluate and monitor progress, adjust the plan as needed, and sustain improvements over time.

Assessing the Current State:

1. Review Star Rating and QM reports to identify areas for improvement in late loss QM and ADLs. •
   1. Analyze the facility's Star Rating and QM reports to identify areas where improvement is needed, such as a high percentage of residents with late loss or a low overall ADL score. •
   2. Use these reports to identify specific areas for improvement and establish goals and objectives for improving late loss QM and ADLs in the facility.
2. Review MDS assessments to evaluate the accuracy of ADL coding and identify individual residents with late loss. • Review MDS assessments to ensure accurate coding of ADL status and identify residents with late loss. • Evaluate the MDS assessments to identify areas where residents' ADLs have declined and determine the specific needs and goals of each resident with late loss. • Use the information from the MDS assessments to inform the development of a comprehensive care plan for each resident with late loss.

Establish Goals and Objectives: 3.

Establish specific goals and objectives for improving the ADLs of residents with late loss. These may include increasing the number of residents who show improvement in ADLs, reducing the number of residents who experience a decline in ADLs, or improving the facility's overall ADL score.

Develop an Action Plan: 4.

Develop an action plan for achieving the established goals and objectives.

This may include: •

• Providing staff training on evidence-based interventions for improving ADLs in residents with late loss •
• Implementing a comprehensive care plan for residents with late loss that addresses their specific needs and goals •
• Using standardized assessments to monitor the progress of residents with late loss and adjust their care plans accordingly 
• Providing residents with late loss access to assistive technology, such as walkers or wheelchairs, to help them perform ADLs more easily •
• Offering education and support to residents and their families to help them understand and manage the effects of late loss

Implement the Action Plan: 5.

Implement the action plan by providing staff training, revising care plans, acquiring assistive technology, and providing education and support to residents and their families. Monitor progress toward achieving the established goals and objectives.

Evaluate and Monitor: 6.

Regularly evaluate and monitor the success of the action plan. Collect data on ADLs, resident satisfaction, and other relevant metrics to measure progress. Analyze the data to identify areas where the action plan has been successful and areas where further improvement is needed.

Adjust the Plan: 7.

Based on the evaluation and monitoring, adjust the action plan as needed to achieve the established goals and objectives. Continuously monitor progress and adjust the plan accordingly.

Sustain the Improvements: 8.

Ensure that the improvements in late loss QM for increased ADLs are sustained over time. Incorporate the revised care plans and evidence-based interventions into the facility's standard operating procedures, provide ongoing staff training, and regularly monitor and evaluate progress