Strategy for Skilled Nursing Facilities: Data Management and Predictive Analytics

Reliable, quality data related to the impact of COVID-19 in skilled nursing facilities (SNFs) is critical for the Center for Health Care Quality (CHCQ) to ensure that SNFs meet safety guidelines, have adequate resources, and protect residents' lives during the pandemic. CHCQ uses daily SNF COVID-19 reporting data to track and respond to urgent needs, and integrates this data with high-risk priority level indicators to project the spread and severity of COVID-19 in SNFs across California. 

CHCQ links the daily SNF reporting and urgent needs entries into a live geographic map dashboard that District Offices use to monitor the needs of SNFs in real time. This allows staff to reach out to SNFs regarding resource requests, send a team onsite, or make a referral to the CHCQ Healthcare-Associated Infections strike team.

Provided below are the SNF Urgent Needs daily reports. Being listed on these reports does not imply wrongdoing on the part of the facility.

CHCQ is using predictive analytics to daily identify and monitor SNFs at high risk of outbreaks and increased infection spread by a list of indicators that flag facilities for immediate attention. Provided below is a primary list of indicators used and is periodically updated to include additional indicators as the COVID-19 pandemic evolves:

• Absent Staff: A SNF that has staff who did not show up to work;

• Administration Change: The number of Nursing Administrator and Director of Nursing changes within a SNF from January 1, 2017;
  

• COVID-19 Mitigation Plan Compliance: A SNF that is not in compliance due to failure to implement one or more elements of their facility-specific COVID-19 mitigation plan. All SNFs are required to develop and implement a CHCQ-approved mitigation plan that expands their existing infection control policies;

• Healthcare-Associated Infections (HAI) program: A SNF in the HAI program receiving active intervention on behalf of the State to improve infection prevention control and mitigate spread in the facility;
  

• Historical Infection Control Deficiency: The number of infection control-specific deficiencies within a SNF;

• New Incidence: A SNF that has a new positive case (resident or health care professional) in the facility that did not previously have any positive cases;

• Personal Protective Equipment (PPE) Shortages: The number of reported days left of PPE supplies in a SNF;

• Proximity: The proximity of a SNF to other SNFs with identified outbreaks;

• Staffing Ratio: The SNF ratio of staff to total residents in the facility.

CHCQ is currently working to provide an updating dashboard on these predictive analytics, including a list of facilities flagged for additional monitoring. The dashboard will be published as soon as it is available, and it will be updated daily. Please note, a facility being placed on the predictive analytics list does not imply wrongdoing on the part of the facility.