|
|
|
E-mail this page to a friend!
Nursing Home Care Improving in Many Areas, Says CMS
Latest data from Nursing Home Quality Initiative
released
Dec. 23, 2004 – All states report a decrease in the
prevalence of chronic pain in nursing home patients in the latest report
from the Nursing Home Quality Initiative, which was launched two years
ago by Health and Human Services. The most negative statistic in the
report is that the percentage of patients with pressure ulcers has risen
slightly since measurements began in June 2002, from 8.5 percent to 8.7
percent.
HHS Secretary Tommy G. Thompson also reported fewer
physical restraints are being used, according to the new data released
yesterday by the Centers for Medicare & Medicaid Services. Fully 92
percent of states also show declines in the use of physical restraints,
according to the data collected by CMS.
Nationally, the prevalence of long-term pain
decreased by 38 percent and the use of physical restraints declined by
23 percent.
In addition to tracking quality measures as a way
to improve long-term care, CMS also announced a new phase of initiatives
to further improve care for senior citizens.
"By working together, we're creating a higher
quality of life for seniors in nursing homes and having a meaningful
impact on the care they receive," Secretary Thompson said. "Improvements
in quality mean improvements in the lives of nursing home residents as
well as peace-of-mind for their families. The improved outcomes are a
great first step, but we know much more can be done. In fact, we are
initiating an aggressive new phase in our quality initiative that will
further strengthen our enforcement actions when a nursing home fails to
measure up."
The HHS Nursing Home Quality Initiative includes
the following features:
> Strengthening CMS' regulatory and enforcement activities to better
track and address complaints and deficiencies;
|
Nursing Home Abuse, Medical Malpractice? Contact a lawyer.
click here
|
|
> Improving and expanding the consumer information available at
www.medicare.gov;
> Strengthening the community-based nursing home quality improvement
programs coordinated by the Medicare Quality Improvement Organizations
(QIOs) with local nursing homes; and
> Expanding partnerships with state survey agencies, nursing homes,
residents and their family members and staff members to accelerate
changes in nursing homes and how they deliver care.
"It is clear that the steps we are taking can help
achieve important improvements in nursing home culture, practices, and
results," said Mark B. McClellan, M.D., Ph.D., administrator of CMS. "In
this unprecedented effort to improve quality nationally, I am very
encouraged by the determination and effort of beneficiary groups, the
nursing home industry, health professionals, and our QIO partners to
make significant improvements in care for many of our nation's most
frail and vulnerable citizens."
As part of its aggressive action plan for nursing
home improvements, CMS says they are undertaking the following
initiatives:
> Expand the information on www.medicare.gov to help families evaluate
quality in nursing homes, including accurate information about staffing
levels and a new quality measure related to weight loss in long-term,
chronic care nursing home residents;
> Strengthen the investigation of complaints from residents, family
members, and others by requiring states to use a standard complaint
tracking system that will help to better track and analyze complaints,
building on increased complaint investigations conducted by CMS or
States in nursing homes (from about 45,700 in FY 2000 to about 48,900 in
FY 2003);
> Prevent neglect and abuse by implementing a pilot program with up to
10 volunteer states to pilot expanded and more effective systems of
background checks for individuals seeking employment in nursing homes
and other long-term care (LTC) providers;
> Improve fire safety by increasing the number of comparative
life-safety surveys and issuing a regulation requiring smoke detectors
in areas of nursing homes that do not have automatic sprinklers;
> Conduct annual performance reviews of state survey agencies to
assess whether complaints are investigated in a timely manner;
> Continue and expand partnership efforts with nursing home residents
and their family members, the nursing homes themselves, unions
representing nursing home staff, state survey agencies, and other local
and national organizations working to improve the quality of care
available in nursing homes;
> Improve the accuracy of the Medicare payment systems, to improve
access for those with the greatest care needs; Direct the appropriate
level of resources to nursing homes to furnish high quality care,
including performance incentives related to quality; and
> Develop a more refined indicator and better tracking of the
incidence of pressure sores to achieve greater nursing home progress in
that area.
"In many areas we are seeing marked progress in the
care that nursing homes provide, and now we are enhancing our quality
improvement efforts, " said Dr. McClellan. "We have established a task
force that will not just provide agency-level coordination and
leadership CMS, but will also work with states, consumer organizations,
providers, and others who share the goal of improving quality. We all
have vital roles to play if we are to be successful."
CMS is also working with the National Quality
Forum, a voluntary, standard-setting organization representing public
and private purchasers, providers, consumers, and researchers to
identify quality measures that are considered to be the most important
to consumers and nursing homes. The measures reported by CMS are in
eight clinical topics; five reflect care given to those with chronic
conditions (physical restraints, pressure sores, infections, pain
management, and declines in activities of daily living) and three
reflect post-acute care (delirium, pain management, and improvement in
walking).
Several of these measures showed marked improvement
since the beginning of the initiative, and the improvements are larger
in nursing homes that worked most closely with their QIOs. For example,
nursing homes working intensively with their QIO have decreased the
prevalence of pain in long stay residents by an average of 49 percent,
the use of physical restraints by 33 percent and the prevalence of pain
in short stay residents by an average of 18 percent.
Medicare is continuing to work aggressively to
improve performance on other measures. One area in need of improvement,
he said, is the prevalence of pressure ulcers. Data show nursing homes
working intensively with QIOs may be nearing a turning point for
decreasing the prevalence of residents' pressure ulcers. Nationwide, the
percentage of patients with pressure ulcers has risen slightly since
measurements began in June 2002, from 8.5 percent to 8.7 percent.
However, a smaller group of nursing homes that worked very intensively
with QIOs showed a decrease in pressure sores from 10.1 percent to 9.3
percent.
"We have clear evidence that improved quality of
care is an achievable goal," said Dr. McClellan. "We will keep building
on our initiatives until the all people who need nursing home care are
receiving the quality of care they deserve.
The updated information is available at Nursing
Home Compare –
click here. Those without Internet access may call 1-800-MEDICARE
(1-800-633-4227) for assistance.
New Background Check Programs Launched
As part of the quality initiatives, Dr. McClellan
also named seven states to participate in comprehensive background check
programs for new workers in long-term care facilities, as another way to
combat abuse and neglect in these facilities.
"Checking the backgrounds of those applying for
jobs involving direct patient care in long-term care facilities is a
good way to weed out those individuals who have criminal backgrounds or
other disqualifying factors in their histories," said Dr. McClellan.
The two-year pilot will help determine the impact
of national background checks for any new worker with direct patient
care duties on abuse and neglect in nursing homes and other long-term
care facilities. States named to conduct the pilots include Alaska,
Idaho, Michigan, Nevada, New Mexico, South Carolina and Wisconsin.
Questions about the background check pilot program
can be e-mailed to
backgroundchecks@cms.hhs.gov.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com
|
|
