The OPTIMISTIC model of care has proven to be immensely beneficial to facilities and residents who have participated in the program. The resident-centered approach to care ensures that residents in LTC facilities get the personalized care they need. The implementation of on-site RNs and NPs has not only helped to keep residents out of the hospital — it has also enhanced the interdisciplinary and collaborative care practices in facilities and has expanded the abilities of staff members. The RNs and NPs are under the guidance of geriatricians who train them on how to better care for their patients, allowing them to then pass these skills on to the clinical staff. These aspects have enabled OPTIMISTIC facilities to better care for their patients because of their extended resources and skill sets.

The OPTIMISTIC model is also beneficial from a financial standpoint. Phase II of the CMS demonstration project is testing payment reform which would allow a facility to be reimbursed for providing on-site treatment of qualifying conditions that are often common in elderly people, including pneumonia, urinary tract infections (UTI), congestive heart failure (CHF), dehydration, skin ulcers (cellulitis), chronic obstructive pulmonary disease (COPD), and asthma. It also includes practitioner payments under Medicare Part B for the treatment of conditions onsite and for care coordination and caregiver engagement.

OPTIMISTIC Benefits

Resident-centered approach to care

Enhancement of interdisciplinary and collaborative care practices in facilities

Augmentation of facility staff’s skills

Consultative care by highly skilled NPs under the guidance of geriatricians

Focus on high-impact areas including risky transitions, end-of-life care, and polypharmacy

Favorable reimbursement models