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of the Commonwealth of Pennsylvania

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    Long Term Care Transformation Office (LTCTO)

    The Pennsylvania Department of Health Long Term Care Transformation Office (LTCTO) is a new office within the Department, established in early 2023. Working directly with the Office of the Secretary of Health, the LTCTO is tasked with providing guidance and assistance to long term care communities across Pennsylvania by working with other state agencies and external partners to understand industry challenges and implement positive change.

    Purpose

    Build resiliency through relationships.

    Vision

    Build sustainable resiliency in long term care facilities by fostering initiatives that promote workforce development and retention, infection prevention and control, healthcare emergency preparedness, and health equity for residents and staff.

    Mission

    Facilitate crisis response while building resiliency in preparation for present and future pandemic threats.

    Objective 1: Identify and solidify key stakeholder relationships that facilitate bidirectional content sharing towards mission accomplishment
    Objective 2: Identify the factors related to poor outcomes that could advise quality improvement addressing health disparities in long term care facilities in Pennsylvania
    Objective 3: Develop measurements of workforce empowerment and inclusion to combat moral injury and promote job satisfaction
    Objective 4: Elevate working in long term care as a noble profession by empowering and enhancing the nursing home workforce
    Objective 5: Develop facility mentorship programs across all areas of the workforce that improve resident outcomes through greater workforce empowerment, expertise, and training
    Objective 6: Identify metrics that should be used to incentivize resiliency building in alternative payment models
    Objective 7: Promote best practices that transform the long-term care community by advising legislation, presenting in appropriate forums and publishing accomplishments to public health audiences​

    LTCTO Initiatives

    At the beginning of the pandemic, a Long-Term Care Task Force was established to respond to the COVID-19 pandemic that disproportionately affects long term care settings.

    In March 2020, a multi-agency group created the Regional Response Health Collaborative Program (RRHCP). The RRHCP was a partnership between the Pennsylvania Department of Human Services (DHS), Department of Health (DOH), Pennsylvania Emergency Management Agency (PEMA) and 10 health systems. This program provided clinical and operational supports, and an educational platform (based on the Educational Support and Clinical Coaching Program (ESCCP) for long term care providers) as they responded to the COVID-19 pandemic.

    In January 2021, the initiative was relaunched as the Regional Congregate Care Assistance Teams (RCAT), a more limited version of the RRHC Program, with additional state and federal funding. The RCAT program provided operational and administrative support to long term care facilities to prevent and respond to COVID-19 outbreaks. The RCAT Program ended December 31, 2021.

    In January 2022, DOH formally launched LTC RISE (Long-Term Care Resiliency Infrastructure Supports & Empowerment). Building upon the success of the prior programs, LTC RISE is designed to help the facilities and residents pivot from COVID-19 response efforts to resiliency-focused initiatives, with the intent of affording a higher quality care.

    With funding provided by the U.S. Centers for Disease Control and Prevention (CDC) under the 2019 Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) – Enhanced Detection Expansion (EDE) grant, DOH transitioned from the Regional Congregate Care Assistance Teams (RCATs) to a new program, LTC RISE (Long term Care Resiliency, Infrastructure Supports, and Empowerment), effective January 1, 2022.

    LTC-RISE 1.0 (January 2022 - July 2023)

    • Outbreak support consultation and access to resources was provided to PA LTC facilities
    • A simplified version of the Outbreak Vulnerability & Resource Needs Index (OVRNI) was used to target the vulnerable facilities for recruitment
    • Needs assessments were completed for facilities to assess emergency preparedness readiness
    • Tailored preparedness planning through engagement in structured quality improvement activities was implemented

    LTC-RISE 2.0 (beginning August 2023)

    The most promising quality improvement activities from RISE 1.0 were identified and organized into 6 themes:  (Leadership Improvement; Frontline Staff Assessment and Skill Building; Infection Prevention & Control; Immunizations; Emergency Preparedness; Resident Care). These quality improvement activities offered regionally in RISE 1.0 a are recommended to be offered statewide in RISE 2.0.

    • The program will be scaling back on crisis response to COVID-19 infection activities, however preserving the response capability to respond in the event of another COVID-19 surge
    • An all Hazards approach will now be employed - quality improvement initiatives will focus on building resilience for preventing, mitigating, responding and recovering from all potential hazards.
    • RISE partners will also function complimentarily to the Quality Investment Pilot (QIP) program through providing support towards ensuring awarded facilities complete projects and evaluations.

    The QIP allocated $14.2 million of federal Centers for Disease Control and Prevention (CDC) funding directly to 125 facilities to invest in the following categories of interventions that improve quality of care: workforce development and retention, infection prevention control, emergency preparedness, and infrastructure enhancement

    This funding opportunity was open to skilled nursing facilities (SNFs), personal care homes (PCHs), assisted living facilities (ALFs), and intermediate care facilities (ICFs) enrolled in the LTC RISE program. There is a special focus on disadvantaged facilities. Social vulnerability index (SVI) measures, percent Medicaid or Supplemental Security Income (SSI) resident days was used to prioritize investment funding for the facilities that would benefit most.

    The Philadelphia Department of Public Health received separate federal funding for facilities in Philadelphia County.  Therefore, facilities in Philadelphia were excluded from applying .