Kevin Freking of the Associated Press brings us the story of fifty four nursing homes around the United States that have been placed on a public list of the worst in their states.
Lawmakers and advocacy groups have been pushing the Bush administration to make it easier for consumers to identify poorly performing nursing homes. They complain that too many facilities get cited for serious deficiencies but don't make adequate improvement, or do so only temporarily.Today being Thursday I believe a link is in order, so here is the aforementioned list. Now that we have that handy, let us return to Mr. Freking:
The homes in question are among more than 120 designated as a "special focus facility." CMS [Centers for Medicare and Medicaid Services] began using the designation about a decade ago to identify homes that merit more oversight. For these homes, states conduct inspections at six month intervals rather than annually.Later on in the article he clarifies what the Special Focus designation means, as well as sharing the perspective of a U.S. Senator from Iowa:
The homes on the list got not only the special focus designation, but also registered a lack of improvement in a subsequent survey.
The nursing homes to be cited come from 33 states and the District of Columbia, according to a list obtained by The Associated Press. There are about 16,400 nursing homes nationwide.
Every nursing home receiving federal payments undergoes inspections about once a year. In such inspections, surveyors assess whether the facility meets standards focused on safety and quality of care. Among the things inspectors look for are giving residents the proper medicine, assisting them with daily living activities such as bathing, and assisting them with their medical needs and diet, as well as the prevention of accidents and infections.This is concrete progress towards a more standardized and publicly accessible measurement of how health care for the elderly is performing. The AARP thinks so, too. They have issued a statement applauding release of the list.
Typically, homes that get the special focus designation do show improvement. Federal data indicate that about half the special focus homes improve their quality of care significantly within 24-30 months. However, about 16 percent are terminated from Medicare and Medicaid.
Sen. Charles Grassley, R-Iowa, said he's concerned about those homes in between — the ones that don't make much improvement but still continue operating.
"The federal agency responsible for nursing homes is doing the right thing by letting the public know which homes yo-yo in and out of compliance with the minimum requirements of care," Grassley said. "It gives these nursing homes the incentive to get off of that list, and it lets consumers know what they're getting into."
Last month, the AARP's Public Policy Institute issued a new research report on Nursing Homes written by Ari Houser that is chock-full of info for seniors. In Health Care Reform Now! Mr. Halvorson offers the following as a major component of an "Optimal Health Care Market":
Consumers should have complete and easy electronic access to the information they need to make informed decisions about their care and caregivers.This is a positive step in that direction, although not a perfect one. There are some concerns over unevenness in the rating process. Mr. Freking's AP article includes a few statements on the subject of fairness:
One of the homes on the government's list was Franklin Hills Health & Rehab Center in Spokane, Wash. Brian Teed, the facility's administrator, said he did not have a problem with Medicare publicizing the list. But he said regional differences play a huge role in how nursing homes are graded. He said he recently helped run a facility in Portland, Ore., and nursing homes were graded much easier there. He took over the Spokane facility in September, and found it to be well run.Publicizing lists of underperforming nursing homes is another step toward greater transparency in health care. One day, if we're lucky, we'll be reaching nursing home age ourselves and glad for the efforts made today to review and rate these facilities.
"In the Portland, Ore., area, this facility would be deficiency free or close to it. Instead we got 15 tags. We got tagged because there was bird poop on the bench outside," Teed said.
"I would put my mother in here," he added.
SOURCE: "Government Outs Chronically Underperforming Nursing Homes" 11/29/07
SOURCE: "Certification and Compliance- Nursing Homes"
photo courtesy of borya and used under this Creative Commons license