What Is the Texas Early Warning System (EWS) For Care Facilities?

The Early Warning System (EWS) was created back in 2003 and utilized s statistical analysis of different factors that the state of Texas gathered on long-term care facilities (LTCFs). The predictive modeling would look at factors like:

• Safety: For example, the number of falls and injuries that residents of LTCFs suffered.
• Complaints: For example, the number of complaints that were made against a nursing facility (NF) the investigations that followed those complaints.
• Additional Assessment Factors: The EWS may look at staff to resident ratios or how many specialized care staff a NF has available to residents.

The scoring for the EWS occurs quarterly to determine if a Quality Monitoring visit is required by the THHS. If a LTCF has been identified as a high-risk facility through the EWS scoring analysis, a QM visit will be arranged.

What Is A QM Visit?

A quality monitoring visit by the Texas Health and Human Services (THHS) is an inspection conducted by the HHS Regulatory Services Division to assess the quality of care and services provided by long-term care facilities in Texas. These visits are part of the state’s ongoing efforts to ensure that long-term care facilities are providing safe and appropriate care to their residents.

During these QM visits, the THHS will inspect and review multiple parts of each facility’s operation. Here are a few examples of the operation a QB visit can evaluate:

• Policy and Procedure Review: Are all of the policies up to date dealing with medication distribution or fall prevention?
• Staff Quality: Does the current staff to resident ratio meet the requirements set by the THHS?
• Physical Environment: Is the current environment clean and equipment meet satisfactory levels?
• Food: Are the food operations meeting proper quality benchmarks along with nutritional values?

After the inspection, the HHS inspector will provide the facility with a report that outlines any deficiencies or areas of improvement that need to be addressed. The facility will be given a specified amount of time to correct any deficiencies identified during the inspection.

How Did the Early Warning System (EWS) Adjust During Covid?

Covid changed normal daily life for everybody and that included how the EWS system was carried out to nursing facilities throughout Texas starting in March 2020. The QM staff switched to holding their QM visits via phone during that time and ran that way until April 2021. The Quality Measurement Program (QMP) staff began to conduct their in-person visits again during this time with a focus around infectious disease policies, preparedness, and cleanliness.

The EWS uses a color-coded system to indicate the level of risk for potential outbreaks. The colors range from green, which indicates a low risk of an outbreak, to red, which indicates a high risk of an outbreak. Facilities are required to take specific actions based on the level of risk indicated by the EWS, such as increasing screening of staff and residents or restricting visitation.

The EWS is just one part of Texas’ overall strategy to prevent the spread of infectious diseases in long-term care facilities. Other measures include increased testing, enhanced infection control protocols, and access to personal protective equipment for staff and residents.

If you have specific questions or concerns about the EWS or other measures to prevent the spread of infectious diseases in long-term care facilities in Texas, it’s best to contact the Texas Health and Human Services Commission or consult with a healthcare professional.