Working Collaboratively to Improve Care
/ January 2018
2018 OPTIMISTIC Webinar Schedule Announced
The 2018 schedule for OPTIMISTIC's Learning Communities have been announced! You may click on the links below to register. As a reminder, the Operations Learning Community is targeted towards executive directors, DONs, billing and data contacts. The Providers Learning Community is targeted towards physicians, physician assistants, nurse practitioners, DONs and clinical contacts. Attendance at the Learning Community eventsis an expectation of your building's participation in OPTIMISTIC.
January 24, 2018
-Webinar for Operations: Implementation/Data Updates - @ 2pm
February 21, 2018
-Webinar for Providers: POST/Advance Care Planning - @ 7:30am
April 25, 2018
-Webinar for Operations: Implementation/Data Updates - @ 2pm
July 25, 2018
- Webinar for Operations: Implementation/Data Updates - @ 2pm
August 15, 2018
- Webinar for Providers: Hospice & Palliative Care in Long Term Care - @ 7:30am
October 24, 2018
- Webinar for Operations: Implementation/Data Updates - @ 2pm
November 14, 2018
- Webinar for Providers: Pain Management - @7:30am
Findings from OPTIMISTIC Chart Reviews
OPTIMISTIC would like to give a huge thank you to the nursing homes & practitioners who recently participated in a chart review and/or interview with SSS/Telligen or interview with RTI. All nursing homes will be visited at some point during the project – thanks to those who went first! We sent individual feedback to the nursing homes who participated.Overall, the site visitors were impressed by the ease of finding information and it went smoothly.
Following the site visit, we spent time debriefing directly with CMS to provide the clearest guidance possible. In addition to the best practices, opportunities for improvement were noted.Please see below for some guidance from this visit and the debrief afterwards.
Best practices SSS/Telligen found:
  • IDT meetings & Gemba rounds
  • Use of the OPTIMISTIC 6 Condition Diagnostic Checklist & Billing Form, found here.
  • Evidence of some comprehensive practitioner acute care visit documentation templates
  • Use of thePOST form
  • Use of hospice, when appropriate
Opportunities for improvement:
  • A physician/NP/PA note MUST be in the medical record to trigger billing. This note must contain history, exam, medical decision making, and plan for care elements relevant to the diagnosis.
  • Please see page 13 of CMS’ Guidance for Facilities, it is on our website here.
  • It is best practice to certify a resident within two days of an identified change in condition. However, the 4th day is the last day a certification is allowed.
  • See page 1-2 of CMS’ FAQ for Facilities here.
  • Documentation of change in condition must be noted in the medical record to trigger billing.
  • See page 6 of CMS’ FAQ for Facilities here.
  • You may bill for enhanced treatment for a UTI as you wait for urinalysis results as long as other qualifying criteria are met. However, if these results indicate that the patient does not meet the qualifying criteria after all, the facility should discontinue billing immediately.
  • See page 5 of CMS’ FAQ for Facilities here.
  • A physician/NP/PA note MUST be in the medial record in order for a physician to bill for a Care Conference. This note must contain a time of at least 25 minutes, no evidence of an exam, & the identification of at least one member of the interdisciplinary team. Documentation of an acute change in condition must, also, be in the medical chart.
  • Please see page 13 of CMS’ Guidance for Facilities, it is on our website here.

Thank you to all of those who participated! For any questions, please contact Christiana Graves via email at .
New OPTIMISTIC Implementation Guide
The OPTIMISTIC Phase 2 Implementation Guide has been created based on feedbackfrom the site visits,with the goal of assisting OPTIMISTIC facility leadership in successfully implementing the payment model. When turnover occurs, this is a great guide to orient new nursing home leadershipto this project. Included are tools specifically developed to assist you in meeting CMS requirements. The Implementation Guide can be foundhere, on OPTIMISTIC's website.

Facility Success Story: Golden Years Homestead
Golden Years Homestead is located in Fort Wayne, Indiana and is one of OPTIMISTIC’s 25 Payment Only facilities. The facility has been tremendouslysuccessful completing 6 condition certifications since the start of Phase 2, and has been one of the most successful utilizers of the new billing codes in the entire national demonstration. Director of Nursing Jenniffer Price and Nurse Practitioner Kim Smith have set up a unique system for OPTIMISTIC certifications within their facility that has provided substantial rewards. The procedure centers on the efforts of Smith, whose primary role in the facility is to identify and certify OPTIMISTIC qualifying residents. Once Smith certifies a resident, her documentation is then reviewed by the facilities’ nurses and submitted to the business office for billing. Jenniffer and Kim say that much of their success stems from the consistent use of OPTIMISTIC’s tools, like the SBAR and 6 Condition Checklist, as well as an integration of the educational tools provided by the OPTIMISTIC team.
With their additional revenue, Golden Years has been able to obtain new and improved resources such as a new patient lift, air mattresses, cushions for the resident’s wheelchairs, and bladder scanners, all of which improve care for their residents.
Thank you to Golden Years Homestead for their dedication and contributions to OPTIMISTIC’s goal of providing excellent acute care in place. To learn more about Golden Years, visit their website at
Respect Conference 2018
"Lets Talk Palliative Care: Caring for the Complex Patient"
March 2, 2018
This day-long statewide conference is designed to bring together health care clinicians and researchers to discuss best practices in palliative and end-of-life care. Conference objectives include:
1) Describe best practices in palliative and hospice care for improving care of patients with serious illness;
2) Discuss strategies to incorporate new and innovative techniques for caring for patients with serious illness of all ages;
3) Identify current challenges and opportunities in the field of palliative care.
The conference will offer:
  • Keynote Speaker by national expert, Dr. Tracy Balboni, MD, MPH, Associate Professor, Harvard Medical School
  • Networking opportunities with colleagues from across the region
  • Sessions featuring regional experts focused on Pediatric, Oncology and Geriatric Palliative and EOL Care issues
  • Posters displaying novel clinical program, quality improvement projects, or research related to palliative and end-of-life care.
To RSVP for this year's Respect Conference, click here.
OPTIMISTIC Buzz
- Project Director, Dr. Kathleen Unroe was featured in theCommonwealth Fundhighlighting innovative approaches to dementia care!Visit to read the fullinterview.
- OPTIMISTIC got a special shout out in an article from the AARP. The article discusses the United States nursing home status, and what OPTIMISTIC is doing to solve the problem. To read the article, visit
PROJECT INFO:

Director:
Kathleen Unroe, MD, MHA

/ Project Manager:
Laura Holtz, BS, CCRP

Project Coordinator:
Katie Rukes, BA

OPTIMISTIC is an innovative initiative developed by researchers and clinicians from Indiana University, the Regenstrief Institute, and University of Indianapolis. Funding is provided through the Centers for Medicare and Medicaid Services. Copyright © 2017 The Trustees of Indiana University.

/