With approximately $20 billion being spent a year on advanced wound care supplies, cost containment is a sought after goal. Long-term care facilities battle cutting costs under one reimbursement system like everyone else, but I assure you this challenge can be simplified, while continuing to bolster quality of care. I have learned that to contain cost, you must use experience, knowledge, and strong project management. So how do we accomplish this? I have broken down a cost containment plan for your long-term care facility. These key points will help you.

What are the goals of your long-term care facility?

1. Quality products for your residents
2. Resident-centered approach
3. Develop a user-friendly formulary for your nursing staff
4. Cost-effectiveness of care, while providing continuity of care
5. Evidence-based wound dressings per NPUAP guidelines/CMS regulations
6. Less labor intensive woundsdressings, while avoiding three plus day dressings
7. Enhance wound healing outcomes
8. Documentation support to reduce discrepancies
9. Wound Care Specialist clinical and educational support
10. Medical Director and Provider involvement (F-tag 385 – Physician Monitoring)

Helpful Wound Management Program Tips to Contain Costs

1. Keep wound dressing selection simple. I always suggest shopping for one specific vendor. Compare prices, evaluating unit cost, usage, and outcomes of the products.
2. What is the vendor’s delivery method? Do they drop ship?
3. Do you have the inventory space?
4. Select and stock wound dressings from each category (i.e., gauze, hydrocolloid, calcium alginate, silver alginate, collagen, honey, bordered and non-bordered foam, composite, transparent, and bacteriostatic foam). Educate your staff on the wound dressing categories, NOT brand names. Use a simple algorithm, placing it in every treatment record book.
5. Does the vendor offer free education for your staff? Is there clinical support? You will not only improve quality of care and enhance wound healing progress, but will also save your facility an abundance of money.
6. Is there a free wound care app or EMR system that will track wound healing progress, and produce trend QAPI reports? This is perfect for being prepared when State Surveyors walk in the building.

How Vendors Can Support Long-Term Care Facility Cost Savings

I have been in approximately 1,500 long-term care facilities during my wound care career. I have seen many F-tag citations avoided when utilizing a skin and wound care management program approach. Utilizing a vendor that offers the "whole package" will not only save you thousands of dollars, but bolster quality of care at the same token. Below are some examples of features and services that you may want to look for in selecting a primary vendor for your wound dressings and supplies.

1. Wound Documentation and Ordering System (with training and system hardware provided such as a tablet). Having a streamlined wound documentation and supplies ordering system reduces documentation discrepancies.
2. Wound Care Education Resources (wound management and product information). Vendor provided wound care reference material and product education helps facilities gain easy access to key treatment and application information for consistency of care delivery.
3. On-site Certified Wound Specialist clinical consultants, providing education as needed as well. Education is key to a successful skin and wound care management program.
4. Capitation programs for skin and or wound care products, also Part B billing provided. This approach to payment structures saves money and time.
5. 2-3 days shipping, and/or stocked products. Many times dressings are written out on orders as a "brand name". Using dressing category names will reduce citations as well. You will also have dressings readily available.

There are many resources out there to utilize in helping make quality of care five stars. Identifying your facility goals, evaluating your wound care formulary, and using a vendor that covers the full spectrum of your skin care and wound dressing needs will help your long-term care facility contain wound management costs.

A good decision is based on knowledge, not on numbers.
- Plato

About the Author
Cheryl Carver is an independent wound educator and consultant. Carver's experience includes over a decade of hospital wound care and hyperbaric medicine. Carver single-handedly developed a comprehensive educational training manual for onboarding physicians and is the star of disease-specific educational video sessions accessible to employee providers and colleagues. Carver educates onboarding providers, in addition to bedside nurses in the numerous nursing homes across the country. Carver serves as a wound care certification committee member for the National Alliance of Wound Care and Ostomy, and is a board member of the Undersea Hyperbaric Medical Society Mid-West Chapter.