Long term care facilities (LTCFs) include skilled nursing facilities, intermediate care facilities, adult day care, post-acute head injury retraining residential facilities, and assisted living facilities. They provide a wide range of medical and personal care services for those who cannot manage on their own within the community. More than three million Americans reside in nursing homes or skilled nursing facilities while an additional one million receive care in assisted living facilities (87). The Arkansas Office of Long Term Care (OLTC) licenses facilities in the state, which provide services and care to approximately 23,000 Arkansans each year. In addition to licensing facilities, OLTC delivers the following services (88):
- Grievance investigations
- TEFRA program administration
- Licensing of nursing facility administrators
- Criminal background checks on facility workers
- Administration of Certified Nurse Aide (CNA) training and certification program
- Eligibility determination for facility placement and waiver services
The quality of long term care has received more attention recently as federal and state governments have placed more emphasis both on cost containment and quality of life for the growing population requiring these services. Arkansas Medicaid, as a significant payer for long term care, has engaged in efforts to improve services within facilities and in individual homes where long term care is provided. One example is the Arkansas Innovative Performance Program (AIPP), a division of the Arkansas Foundation for Medical Care. AIPP works directly with Medicaid-certified nursing homes or assisted living facilities to help meet quality improvement challenges through the development, implementation, and monitoring of tailor-made quality improvement practices (89).
AIPP also offers research-based solutions related to resident quality of care, staff and family satisfaction, and survey performance. Specifically, AIPP works with long term care facilities to:
- Conduct data trending and preparation of customized reports.
- Identify and apply best practices.
- Offer support and training for Minimum Data Set coordinators.
- Provide skill building and training opportunities for Certified Nursing Assistants.
- Offer support and training on regulatory compliance.
- Create an atmosphere that promotes culture change and emphasis on person-centered care.