CMS to Issue Nursing Home Quality Guide for Six States
CMS next week plans to release a guide that rates nursing homes in six states -- Colorado, Florida, Maryland, Ohio, Rhode Island and Washington -- as part of a pilot program to allow patients to compare the quality of the facilities, the Washington Post reports. The guide will rate nursing homes in nine quality areas, such as their treatment of pain and infection, whether they use physical restraints on patients and whether patients have lost an inappropriate amount of weight. Although the guide will not rank the nursing homes, patients can use the information to compare the facilities with each other and with state averages. CMS Administrator Tom Scully, who developed the pilot program, said that the agency will publish the guide -- "How do your local nursing homes compare" -- next week in full-page newspaper ads and on the Internet. "People are entitled to know more about the quality of nursing homes. My view is this is 15 years overdue," he said. Scully hopes to expand the pilot program next year to cover nursing homes nationwide and predicted that the guide will lead to increased competition in the industry, which he said would help improve overall quality of care.
The Post reports that the nursing home guide has "sent shock waves through an industry that feels battered by bad publicity and fears that low ratings will have severe financial repercussions." Larry Minnix, president and CEO of the American Association of Homes and Services for the Aging, which represents 5,600 not-for-profit nursing homes, said, "Nobody's going to be happy with this for a while. There's just lots of potential for controversy." Minnix said that information in the guide "can be misinterpreted and wreak economic havoc on providers." For example, a nursing home with a number of terminally ill cancer patients may "score poorly" in the part of the guide that measures weight loss if several patients have asked the facility not to take "extreme measures" in their treatment, such as the use of feeding tubes. CMS officials said that the guide uses risk adjustment to account for "unique factors" at the nursing homes, such as the severity of patient illnesses. However, most providers warn that the guide has "large gaps," and they urge patients to conduct additional research before they select a nursing home. Paul Willging, a professor at Johns Hopkins University and president-elect of the Assisted Living Federation of America, has asked CMS to add "quality-of-life indicators" that "probe deeper into the environment of the home and residents' satisfaction levels." According to a report released last month by the General Accounting Office, the guide includes "numerous errors and omissions" in the information about nursing homes. The report also found that the errors have "implications for the identification of quality problems and the level of nursing home payments." Bill Roper, dean of the School of Public Health at the University of North Carolina, said, "The public should not use the information in isolation," but added that "the public is better off with this knowledge than without it" (Connolly, Washington Post, 4/7).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.