Programs

Skilled Nursing Facilities (SNF) Alliance

Promoting education, communication, and collaboration among hospitals and post-acute care providers to improve care transitions and patient outcomes.

The SNF Alliance is a learning collaborative convened and facilitated by Nexus Montgomery. The Alliance includes skilled nursing facilities in Montgomery County and in Prince George's County. The participating skilled nursing facilities and Nexus Montgomery hospitals are collaborating to reduce readmissions and improve patient outcomes by implementing best practices and sharing knowledge and experience to optimize patient care.

Nexus Montgomery provides data management and analysis for organizations participating in the SNF Alliance. Through this data driven process, Nexus Montgomery works with SNFs to track progress toward established goals to reduce hospital readmissions, provide training on how to integrate the use of data into their current workflows, and host meetings to share quality improvement best practices.

Engagement Steps for SNFs

Nexus Montgomery established seven engagement steps for SNFs to be part of the Alliance. Facilities that complete all seven steps achieve Nexus Montgomery Preferred Provider status on the referral list for post-discharge care.

Nexus Montgomery maintains a SNF preferred provider list based on engagement in the Alliance, participation, data collections and documentation, and participation in quality improvement activities and performance.

The steps for ongoing engagement include:

  1. Upload minimum data sets
  2. Regularly monthly attendance of SNF Alliance meetings
  3. Participate in data developing web trainings
  4. Participate in data driven technical assistance/office hours
  5. Integrate data into existing workflow
  6. Meet in person with Nexus Montgomery
  7. Implement a Quality Improvement Plan

Regional Partners

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Adventist HealthCare
Shady Grove Medical Center

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Holy Cross Germantown Hospital

White Oak Medical Center

Adventist HealthCare
White Oak Medical Center

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MedStar Montgomery Medical Center

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Holy Cross Hospital

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Suburban Hospital