Maryland Launches Nursing Home Comparison Web Site

Maryland officials this week released a report card on the state's 200 nursing homes that will allow consumers to compare homes in categories such as prevalence of bed sores and use of restraints, the Baltimore Sun reports. The online report card covers "four basic areas": facility information, resident demographics, deficiencies reported in state inspections and "quality measures," ranging from prevalence of pain to weight loss. State officials intend to update the report card scores every six months; the current report contains quality data from the second half of 2000 and the first half of this year. The report card does not include information on nursing home staffing or costs, nor does it cover assisted-living facilities (Sugg/Salganick, Baltimore Sun, 8/8). According to Barbara McLean, interim executive director of the Maryland Health Care Commission, Florida and Texas are the only other states that have "similarly ambitious Web sites devoted to nursing home performance." In 1999, the Maryland General Assembly ordered the commission to create the guide to help improve state oversight of nursing homes, increase sanctions against poor-performing facilities and encourage a general improvement in quality. To create the report card, the commission used information from the Centers for Medicare and Medicaid Services (formerly HCFA) and "core data" involving 27 quality indicators that homes report every three months (Montgomery, Washington Post, 8/8).

The commission did not tally scores for the homes or designate "best" and "worst" facilities, but reported for each category whether homes performed in the top 20% in the bottom 10% or "somewhere in the middle" (Baltimore Sun, 8/8). According to the report card, 93% of the facilities ranked in the top 20% statewide in at least three quality indicators, and 86% ranked in the bottom 10% in three or fewer categories (Washington Post, 8/8). Analysts said it would be premature to use the report card to make "broad comments" on nursing homes' performance. However, the Sun reports that state inspectors and nursing homes already have used some of the data contained in the report card to "identify problems" in various homes. For example, noting that more than half the state's homes had rates "significantly" higher than state or national averages in use of restraints, bed sores and patients' limited range of motion, Carol Benner, director of the state health department's Office of Health Care Quality, asked 165 nursing homes to determine why their rates were so high. Some nursing home administrators have expressed concern about "whether the report card would be understandable to the public" and whether the report's information could be "misleading." Mindy Stewart, director of communications for Sykesville, Md.-based Copper Ridge Nursing Home, noted that her facility accepts only patients with Alzheimer's disease, which skews the facility's rates for patient weight loss and percentage of patients taking anti-psychotic drugs (Baltimore Sun, 8/8). The report card is available at http://www.mhcc.state.md.us.