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Elder Care News
Nursing Home Report Card by CMS Makes the Grade and
Improving Care
‘..study provides evidence that quality report
cards are useful tools’
By Katherine Kahn, Contributing Writer
Health Behavior News Service
 Jan. 23, 2008 - A national, Web-based report card
on nursing homes is improving some aspects of nursing home care, a new
study finds. The Centers for Medicare & Medicaid Services began
publishing the “Nursing Home Compare” report card results on the Web in
2002. The site gives detailed information about the past performance of
every Medicare- and Medicaid-certified nursing home in the country.
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Elder Care News |
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“to investigate the impact of a report card on
quality of nursing home care.” Previous such studies have focused on
health plans, hospitals or physicians.
The study will appear online and in the upcoming
issue of Health Services Research.
Mukamel, a researcher at the Center for Health
Policy Research and the Department of Medicine at the University of
California at Irvine, said that the report cards can have a policy-level
impact:
“If patients, physicians, social workers and state
regulators use these report cards, nursing homes will see strong
economic incentives to invest in quality care,” Mukamel said.
Mukamel and colleagues sent out surveys to a random
sampling of Medicare- and Medicaid-certified nursing homes that had had
at least one quality measure published on the first “Nursing Home
Compare” report in 2002. About 700 facilities responded to the survey.
The researchers looked at changes in five of the
most important quality measures of nursing home care.
For long-term nursing home residents, quality
measures included the percentages of residents
(1) with worsening ability to perform daily living skills,
(2) with new infections,
(3) with pressure ulcers and
(4) who were physically restrained.
For short-term residents, the quality measure was
percentage of residents with moderate daily pain or any episodes of
excruciating pain.
Researchers found that the quality measures of
physical restraint and short-term pain improved after the publication of
the report card. Both showed about a 10 percent improvement from the
study’s starting point.
However, the other measures did not show
improvement. “This may reflect the longer lead time required before
improvement can be observed in these other areas of care,” Mukamel said
Marilyn Rantz, Ph.D., R.N., a researcher in nursing
home quality at the University of Missouri, concurred: “The lack of
improvement in infections, pressure ulcers and the ability to perform
living skills doesn’t mean the report cards aren’t useful. These quality
measures are more clinically complex and require greater intervention
for improvement.”
Rantz was not associated with the study.
“Report cards are not perfect, but we’ve got to
have some sort of measurement not only for the nursing home industry to
use, but for consumers to compare nursing homes,” Rantz said. “This
study provides evidence that quality report cards are useful tools.”
According to Mukamel, the report cards provide
patients and families with information that was unavailable just four or
five years ago.
“When they are at the point where they need to
choose a nursing home they can go to the Web and compare nursing homes
available in their neighborhoods. They can see which ones have better
outcomes.”
>>
Click here to Nursing Home Compare by CMS
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