Critical New Information Added To Nursing Home Compare Web Site

Main Category: Caregivers / Homecare
Also Included In: IT / Internet / E-mail;  Medicare / Medicaid / SCHIP
Article Date: 25 Apr 2008 - 4:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

Medicaid beneficiaries and families searching for top quality long-term care services can find critical new information added to the Centers for Medicare & Medicaid Services' (CMS) Web site "Nursing Home Compare."

For the first time, information about nursing homes on the Compare Web site will list whether a home is or has been on CMS' special focus facility (SFF) list. The agency's SFF initiative gives heightened scrutiny to nursing homes that have a history of poor performance or repeated violations of state and federal health and safety rules.

"Today's expansion of information on Nursing Home Compare will give beneficiaries a more complete picture of a nursing home's history of providing quality care," CMS Acting Administrator Kerry Weems said.

The SFF initiative was created because a number of facilities were consistently providing poor quality of care, yet were periodically instituting enough improvement that they would pass one survey only to fail the next (for many of the same problems as before). Such facilities with a "yo-yo" compliance history rarely addressed underlying systemic problems that were giving rise to repeated cycles of serious deficiencies.

In November 2007, the agency began publishing a list of Medicare and Medicaid participating nursing homes that have a history of serious quality of care problems and had failed to show significant improvement. In February 2008, CMS took the next step and published an updated, expanded list of nursing homes in the SFF initiative and included the category they fell within such as new additions, not improved, improving, recently graduated or no longer in the Medicare and Medicaid programs.

As of April 2008, there are 134 SFFs, out of about 16,000 active nursing homes. CMS works closely with states to select participants and as homes improve their quality of care and "graduate" from the program, or fail to improve and are terminated from Medicare and Medicaid, new homes are added to the list. This movement of homes off the list allows more facilities with problems to be added as the program continues.

Once a facility is selected as an SFF, the state survey agency conducts twice the number of standard surveys and will apply progressive enforcement until the nursing home either (a) significantly improves and graduates from the SFF initiative, (b) is granted additional time due to promising developments, or (c) is terminated from Medicare and/or Medicaid. CMS and the state can more quickly terminate a facility that is placing residents in immediate jeopardy.

Nursing homes that have the SFF designation, including information about that designation, will now be noted on Nursing Home Compare, which can be accessed at http://www.medicare.gov. The site helps families find nursing homes in their area. Information about the homes includes performance scores on quality measures, staffing information and a three-year history of the home's health, safety and fire inspection reports. The Web site will be updated with new information quarterly.

"Today's action is the next step in our commitment to bring transparency and accountability to the process families must go through to find the care that is best for them and their family member," Weems said.

Further Actions Planned

The publication of the SFF list was the first major step in CMS' latest efforts to improve nursing home care. A comprehensive, multi-year look at future actions the agency will take was also released today.

The "2008 Action Plan for Further Improvement of Nursing Home Quality" consists of several inter-related and coordinated approaches:

Consumer Awareness and Assistance: to include an increasing array of information about long-term care that will be written in an easy-to-understand format and available to the public at http://www.medicare.gov. Already posted there is the "Guide to Nursing Homes" and the "Compare" data. These tools can be used by Medicare beneficiaries and their family members to better understand the quality and value of Medicare's nursing home benefit.

Survey, Standards and Enforcement Improvement: several initiatives are being developed to improve the effectiveness of the annual nursing home surveys as well as those prompted by consumer complaints. The agency also plans to work in partnership with states to improve current enforcement efforts.

Quality Improvement: The agency is focusing on several key areas to improve health care quality in nursing homes including a special focus from the quality improvement organization (QIO) program on prevention of bed sores, reduction in the use of physical restraints and greater emphasis on developing individualized care plans to improve a resident's quality of life.

Quality Through Partnerships: Through its QIOs, CMS has coordinated an unprecedented, collaborative campaign, "Advancing Excellence in America's Nursing Homes" designed to improve both the delivery and measurement of quality care. Through its work with QIOs, state survey agencies, and the nursing home industry and consumers, CMS is well on track to achieve these goals.

Centers for Medicare & Medicaid Services