Complex data available about long-term care is often intentionally misused against providers — but providers can use that same data to defend themselves from legal challenges and poor public perception, two experts stressed Monday.
Data generated by the government, consumers and providers themselves can be misconstrued against the senior care sector, speakers said during a webinar sponsored by Simple and Reimbursement Reimagined.
“All that information historically has been used to hurt you — to hurt our industry,” explained Steven Littlehale, chief innovation officer at Zimmet Healthcare. “It’s been misunderstood unintentionally; it’s been intentionally misrepresented.”
Whether intentionally or unintentionally, though, it’s vital for providers to understand that few outside the industry have the expertise to properly parse all the complicated data in sources such as the Minimum Data Set, Five-Star ratings, survey results or simply online reviews from residents’ families.
“A call to action for everybody here is this idea that it is very difficult for your lawyers and then judges and juries and arbitrators to understand and use this data because it’s not within their normal experience and it’s very complicated,” said Drew Graham, partner at Hall Booth Smith. He noted how important MDS and similar data is to litigation in long-term care — and that it’s only “gaining in importance.”
Vital self-advocacy
Whether attempting to defend themselves from legal claims or trying to convince banks and healthcare partners to view them favorably, providers often need to lean on data experts within long-term care to address concerns that certain data points may raise, according to Littlehale.
“What we’ve discovered through our experiences is that you [subject matter experts in long-term care] are in the best position… to understand what the data truly represents and to shed some light where there might be confusion,” he told attendees.
This can especially be true when delayed state surveys leave providers stuck with old red flags that have since been fixed. In such situations, Littlehale emphasized, it’s vital to have kept not just complete and accurate data, but data that can provide context.
Littlehale elaborated on several case studies of nursing facilities that were struggling with legal cases or difficulties accessing new financing from banks. He explained that while some measures and incidents initially looked concerning, a further analysis of the facilities’ performance overall helped paint a fuller picture of an operator acting in good faith and improving care outcomes over time.
“Know the importance of integrity as you’re submitting your data,” Littlehale said. “Make sure that the data is connected and coherent — that it’s telling a very important, accurate story completely and that you’re not just focusing in on one specific data field.”
