Showing posts with label The Centers for Medicare and Medicade Services. Show all posts
Showing posts with label The Centers for Medicare and Medicade Services. Show all posts

Wednesday, September 2, 2009

Bill Set to Require Nursing Homes to Post Quality Ratings

A bill introduced into the legislature this year could lead to quality improvements at the state's nursing homes and other long-term care facilities. At the very least, consumers would have another tool to assist them in the nursing home decision-making process.

Assembly Bill 215, by Feuer and Smyth, would require long-term health care facilities to post the overall facility rating given by the federal Centers for Medicare and Medicaid Services (CMS). If enacted, the CMS rating must be posted in an area accessible and visible to members of the public, employee break rooms, and dining halls, activity halls or other communal areas for the residents.

CMS initiated its five-star rating for nursing homes in December 2008. A five star rating equates to above average quality compared to other nursing homes in the state, while a one-star rating means the facility is operating below average yet still meeting Medicare's minimum requirements. Factors considered in determining the star rating are:

  • The results of health inspections
  • Quality measures, such severe pain and mobility of residents
  • Staffing levels of nurses and nursing assistants

The main purpose of this bill is to provide information on facility quality to consumers making the initial decision to place a loved one into a nursing home. If enacted, this bill could also have the effect of urging nursing homes to improve in order to achieve a higher star rating, since the rating will be prominent and reported to the state regularly.

Not surprisingly, the nursing home and hospital lobbies are opposed to this bill, arguing that the CMS rating is arbitrary, inaccurate and erroneous. Even if AB 215 does not pass, nursing home residents and families still have many other resources for information on nursing home quality, including the Health Facility Consumer Information System of the Department of Public Health, California Advocates for Nursing Home Reform, the California Health Care Foundation's California Nursing Home Search, and Healthgrades.com.

Originally introduced on February 3, 2009, AB 215 passed the Assembly Health and Appropriations committees and moved to the Senate, where it passed out of the Senate Health committee and was referred to Senate Appropriations. While not an appropriations measure, the bill will have a fiscal impact due to posting and reporting costs and a provision that subjects failure to post to a penalty, with the fines going into the Health Facilities Citation Penalties Account. The last action on this bill was on June 30, when it was placed for its third reading in the Senate.

Selection of a nursing home for a family member is an emotional decision with critical consequences for the patient and loved ones. Unfortunately, hardly any nursing homes in the state are in full compliance with federal standards of care, with one-third having been cited for serious or potentially life-threatening problems. If you believe that you or a loved one has suffered abuse or neglect in a nursing home, contact The Law Offices of James R. Gillen for a confidential consultation.

Tuesday, January 6, 2009

Medicare Nursing Home Five Star Quality Rating System

The Centers for Medicare and Medicaid Services created a system for comparing nursing homes throughout the United States. The ratings are accessible through a Nursing Home Compare search tool on the Centers for Medicare and Medicaid Services website. The ratings are determined by three categories:

  • Health Inspections
  • Staffing
  • Quality

These areas of data are then ranked with a star rating, which is then combined for the overall rating for a particular nursing home.

Health inspections involve an analysis of the major aspects of care offered by a nursing home. The rating is also based on visits by objective state surveyors, which are checked by federal surveyors. One limitation of this rating is that each state has a different inspection process and different licensing requirements, so a comparison of ratings between nursing homes from different states may not be accurate.

Staffing ratings look at the number of residents compared to the total staff and the number of nurses that are members of the staff. The data used to form this rating is self reported and only reflects nursing home staffing from a two week period of time during the year.

Quality measures how a nursing home rates on ten aspects of care, including how the facility helps residents dress and eat, efforts to prevent and treat skin ulcers, or steps taken to deal with the flu. The data used to form this rating is based on self reported information.

Overall, not-for-profit nursing homes received higher ratings than for-profit nursing homes, according to USA Today.

How to Use the Rating System
The rating system provides some preliminary information on a nursing home, but the ratings may not provide an entirely accurate picture of a particular facility. As a result, while going through the process of selecting a nursing home, it is highly recommended that you visit each nursing home that you are considering.

In many cases, selecting a nursing home in close proximity to family and friends has a large affect on a resident’s quality of life in the nursing home. The rating system may provide a starting point to determine which nursing homes in your area meet your basic criteria for a nursing home facility.

The Importance of Researching a Nursing Home
Complaints against California nursing homes to the California Department of Public Health rose from 5,742 in 2004 to 6,950 in 2008. This increase in complaints shows that nursing home residents and their loved ones are not entirely satisfied with the level of care provided by nursing homes state-wide. This increase in complaints indicates the importance of carefully selecting a nursing home, and the new rating system serves as a tool to help in this process.

Thanks for reading my blog. If you have a comment or question, please feel free to reply to this posting, or send me an e-mail. If you suspect that a loved one has been the victim of nursing home abuse or theft, contact me to schedule a confidential consultation and for immediate assistance.