CMS Releases Online Quality Ratings For Nation’s Nursing Homes

As expected, CMS yesterday released a guide detailing quality of care at all 17,000 of the nation's nursing homes as part of its Nursing Home Quality Initiative, the Salt Lake Tribune reports (Adams, Salt Lake Tribune, 11/13). The guide rates nursing homes based on 10 "quality indicators," including number of residents with an "unexpected" loss of ability in basic tasks; residents with bed sores; residents with pain; residents in physical restraints; residents with infections; limited-stay residents with delirium; and short-stay residents with an improved ability to walk. The guide also will include information regarding deficiencies discovered in annual inspections and data on complaint investigations. Such information is based on data collected routinely by nursing homes as a requirement to participate in Medicare. The ratings will be updated every three months (California Healthline, 11/12). The federal government has collected nursing home quality data since 1987; this is the first time it is being made public. The information, which is available in English and Spanish, can be searched by state, county, city, zip code or name of facility and includes state and national comparisons (Salt Lake Tribune, 11/13).

CMS began publicizing the guide today with a $2.3 million newspaper advertisement campaign (Heath, Detroit News, 11/13). The full-page ads will run in more than 70 newspapers nationwide (California Healthline, 11/12). The ads, which read "How do your local nursing homes compare?" and are tailored to each state, provide statistics from individual nursing homes in a particular state, as well as state averages (Ad text, Baltimore Sun, 11/13). The ratings guide, an expansion of a pilot program that began earlier this year in Colorado, Florida, Maryland, Ohio, Rhode Island and Washington, will spend $120 million over the next three years to help nursing homes address quality issues (Penner, Indianapolis Star, 11/13). CMS has contracted with private companies, such as the Virginia Health Quality Center, to assist nursing homes in the improvement effort (Simpson, Virginian-Pilot, 11/13).

Some nursing home executives say that improving nursing home quality will be difficult in light of funding cuts, the Boston Herald reports. As a result of the Balanced Budget Act of 1997, nursing homes will experience a $2 billion reduction in Medicare payments next year, Ned Morse, president of the Massachusetts Extended Care Federation, said. That cut means that nursing homes will receive between $35 and $50 less per day on bills that usually amount to between $250 and $350 per patient. Medicare pays for about 12% of all nursing home beds, the Herald reports. Morse said, "The timing of this is unfortunate. At the same time we're talking about these measures of quality and data, we need to be talking about reimbursements." CMS Administrator Tom Scully said, "I'm very concerned about nursing home funding ... but by all accounts, Medicare's margins for nursing homes are high" (Heldt Powell, Boston Herald, 11/13).

The guide is available online at http://www.medicare.gov and by calling 1-800-MEDICARE. MPR's "Marketplace" yesterday reported on the nursing home data. The segment includes comments from Scully, AARP Policy Director John Rother and National Citizens' Coalition for Nursing Home Reform Director Donna Lentoff. A transcript and audio of the segment in RealPlayer are available online (Palmer, "Marketplace," MPR, 11/12).