Wound Care for Skilled Nursing Facilities
Wound Care for Skilled Nursing Facilities
Vohra is a group of specialty physicians who provide wound care to nursing homes and rehabilitation centers. Learn how partnering with Vohra to provide expert wound care in your skilled nursing facilities (SNFs), Assisted Living Facilities, and Long-Term Acute Care Hospitals can reduce rehospitalizations, improve healing times, and save tens of thousands of healthcare dollars.
Wound Care Management
Delivering focused wound care treatment at over 2,800 facilities in 27 states, Our specialty-trained physicians partner with facilities to deliver wound care expertise, to develop treatment plans, to consult and guide patient treatment, and to provide in-service education to nursing staff. Visiting your facility weekly, your Vohra physician becomes a consistent extension of your patient care – all at no cost to you.
Why Partnering with Vohra Makes Sense
Concerned about CMS penalties for high readmission rates? According to the Center for Medical Studies, of the 14,959 skilled nursing facilities subject to the CMS’ Skilled Nursing Facility Value-based Purchasing Program, 73% received a penalty while 27% got a bonus.
Conversely, facilities that work with Vohra as part of an interdisciplinary team were found to have less than 0.08% rate of wound-related rehospitalization per day and shorter wound episodes.*
*DaVanzo, et. al, A Retrospective Comparison of Clinical Outcomes and Medicare Expenditures in Skilled Nursing Facility Residents with Chronic Wounds, Ostomy and Wound Care, September 2010;
We have achieved outstanding health and financial outcomes – saving $19,000 on average per patient and reducing healing times by 21 days, with an estimated annual savings of over $100,000 for a 120-bed facility. Your Vohra physician improves outcomes and adds value to healthcare.
Occupancy & Retention
By excelling in wound care management, our facilities are considered preferred locations for patients with serious and/or chronic wounds. In light of the new regulations governing ‘discharge planning’ — the move from acute to post-acute care — patients have more access to quality measures than ever.
With respect to occupancy and retention of patients, facilities with proven outcomes have measurable data that shows an advantage over facilities with high rates of infection, amputation, and hospital readmission.
Delivering focused wound care treatment at over 2,500 facilities in 27 states.
Independent Lewin Group Study
Medical Outcomes For Patients Under Care Of Vohra Wound Physicians
Total average savings to Medicare: $19,287 per patient.
One patient story
Dudley Wilson is a resident of a nursing home in Chatham, Pennsylvania. He is 78 year old male who has hypertension and lymphedema. He had been in car crash two years ago which opened large wound on his right shin. He was treated Vohra’s physician, Dr Aaron Blom.
On Dr Blom’s first evaluation, he determined that the wound was quite large, 7cm x 6cm with exposed bone. Mr Wilson’s wife stated that this wound had been present for over two years and that all the other wound doctors were recommending leg amputation. Dr Blom believed there was a different course of action. He stated, “We will NOT discuss amputation as I think we could definitely heal the wound.”
He proceeded through many treatments from alginates with silver, to collagens to antibiotic solutions, changing treatments every two to three weeks based upon the level of improvement. On each visit, Mr Dudley’s wife would say “Please don’t let his leg get amputated.”
After about seven months of regular bedside wound care, we were able to heal this wound completely. The wife was elated and repeatedly told Dr Blom that “every other doctor said he would need an amputation and you were the only one who said he wouldn’t!”
This is one more example of Vohra Wound Physicians’ expertise and commitment to patient care.
Dressing Dispensing Program
Facilities also enjoy access to our Dressing Dispensing Program, which streamlines dressing delivery to patients
Wound Care Services for SNFs and LTACHs
- Participation in Quality Assurance & Performance Improvement (QAPI) and Care Planning
- MDS Compliant Staging
- Focus on Avoiding F-Tag Penalties
- Engaging with Family to set Realistic Treatment Goals
- Sophisticated Real-Time Outcomes Reporting
Compliance with State & National Regulations
The Department of Health and Human Services is responsible for inspecting and reporting of identified deficiencies within long term care facilities (this is a requirement for Medicare and Medicaid funding). A statement of deficiency document uses a federal tag numbering system that addresses the degree to which a facility meets minimal federal standards.
F-tags correspond to specific stipulations within the Code of Federal Regulations. Facilities that receive F-tags are required to display them in a public location within the facility and they are reported on federal websites and databases.
Vohra Wound Physicians has created this F-Tag resource to assist the long-term care community with understanding and preventing costly state survey citations. In many cases, these can be easily preventable by following the proper guidelines and implementing a well-designed wound care program.
(CFR 42 § 483.30(a)(1)(2)) – Physician Services. Ensure the Resident’s Medical Care is Supervised by a Physician. Adequate physician supervision must be provided for wound care.
(CFR 42 § 483.25(b) Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.
Based on the comprehensive assessment of a resident, the facility must ensure that; A resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable. A resident who has a pressure ulcer receives care and services to promote healing and prevent additional ulcers.
483.21(b)(3) – Comprehensive Resident-Centered Care Plans
Services Provided Meet Professional Standards. Correct wound dressings must be used on different wound types
483.10 (g)(14) – Resident Rights
Notify of Changes (Injury/Decline/Room, Etc.). A physician must be notified of any changes to wound health.
F-Tag 315 – Incontinence
1) A resident who enters the facility without an indwelling catheter is not catheterized unless the resident’s clinical condition demonstrates that catheterization was necessary. §483.25(e)
2) A resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections and to restore as much normal bladder function as possible. §483.25(e)
Naso-gastric tubes” is considered to include any feeding tube used to provide enteral nutrition to a resident by bypassing oral intake. Since the regulation was promulgated, use of naso-gastric tubes has become extremely rare, and use of other types of enteral feeding tubes (such as those listed in the definitions section) has become prominent. §483.25(g)
(1) Maintains acceptable parameters of nutritional status, such as body weight and protein levels, unless the resident’s clinical condition demonstrates that this is not possible.
(2) Receives a therapeutic diet when there is a nutritional problem. §483.25(g)(3)
The facility must provide each resident with sufficient fluid intake to maintain proper hydration and health. The intent of this regulation is to assure that the resident receives sufficient amount of fluids based on individual needs to prevent dehydration. §483.25(g)(2)
Dressing Dispensing Program
Facilities also enjoy access to our Dressing Dispensing Program, which streamlines dressing delivery to patients.
Centers of Excellence:
The Standard of Wound Management
At Vohra, we strive to ensure that the facilities we partner with are the best facilities to send patients with acute and chronic wounds (pressure, diabetic, venous, arterial, lymphedema, neoplasm, burns and many others).
To that end, we created the Vohra Center of Excellence for Wound Management Program to identify and highlight facilities that have developed a superior wound management program.
A growing number of Nursing Facilities have achieved the special designation of Vohra Center of Excellence based on low wound related rehospitalization rates and demonstrated in-house wound care expertise. Our holistic approach provides a unique and effective path to better wound care.
This national certification is earned by those facilities that demonstrably improve the quality of life for their patients with wounds. It is a recognition of staff members’ compassion, dedication to optimizing patient outcomes, and ongoing efforts to educate not only themselves, but their patients.
Hospitals can be assured that when they discharge their patients to a designated Vohra Center of Excellence, the patients will be attended to by a wound physician that provides bedside wound services, a wound care nurse who has been educated and trained on chronic wounds, and a multispecialty interdisciplinary team approach to wound closure.
The certification processbegins with a Director of Nursing (DON) or the Administrator applying online to designate their facility as a Center of Excellence in Wound Management. The application is then reviewed by a panel of physicians and senior executives, looking for high performance in the following criteria:
- Designated, accountable Vohra Wound Certified Nurse(s) seven days a week
- A verified outcomes-focused, Vohra Physician led Wound Care Program
- A wound related hospitalization rate of less than 1%
- Regular team meetings with a focus on Quality and Process Improvement (QAPI)
Applications from facilities who
meet these criteria
are then approved. If a facility applies but does not yet qualify, we will provide guidance and help them work towards achieving the designation.
For example, if the hospitalization rate for wounds is higher than required, we will look at the patients in question to see if some of those wound related hospitalizations could have been avoided, and put further education and protocols in place so that the facility can heal their patients without the need to send them to the hospital. Or, if they have no nurse on staff that is Wound Care Certified with Vohra, then we’ll help prepare and educate those nurses to become wound care certified.
Currently, only around 15% of facilities hold the distinction of being a Vohra Center of Excellence in Wound Management. The complete list of certified facilities, as well as education modules and the program’s online application, can be found on our Center of Excellence Directory.