As the new year begins, so does a new Medicare law that will help patients and their families make better informed choices for nursing home care.
Nursing Home Compare, the 5-star rating system for nursing homes on the Medicare website, fell short when providing consumers a true picture of the quality of care the facility is providing. The Improvement Medicare Post Acute Care Transformation Act of 2014 was signed into law last October to expand and strengthen the rating system.
Previously, only one of the three categories complied for the rating was verified information. Health inspections were conducted by the state surveys and reported to Medicare. That was the core of the rating system.
Staffing and quality measures were self-reported by the nursing homes with no verification. The rating system doesn’t take into account any state complaints, such as abuse, and fines or actions against a facility. Patient advocates have long criticized the deception in self-reporting by unscrupulous facilities.
Onsite inspections will be expanded to include verified information. Staffing will now be verified directly with payroll. The information that will be included, as the process develops, is staff turnover, retention, type of staffing and levels of different types of staffing. It’s been determined staffing has a direct effect on quality.
Quality measures will now include falls, use of restraints and anti-psychotic medications, and the prevalence of pressure ulcers. State complaints and actions will be eventually part of quality measures as the data systems are set up.
Unfortunately, this information will be collected in 2015, but not reflected in Nursing Home Compare until 2016. Additional measures, such strengthen patient rights, and other proposals are set for comments for final rulemaking in 2015.
Since the Nursing Home Compare was established, the number of 4- and 5-star facilities grew to over 50 percent nationwide. Yet, nursing homes have a much higher rate of medical errors than hospitals.
Last summer, a Congressional hearing, looking into the state of our healthcare, revealed that 400,000 patients die a year from preventable mistakes in hospitals.
According to the Agency for Healthcare Research and Quality, 37 percent of staff are afraid of speaking up about potential harm to patients in fears of retaliation. Policies that will protect ethical staff members need to be established.
Illinois is 44th in the nation for quality nursing homes as reported by Families for Better Care. Patients and their families deserve better treatment. Medicare dollars need to be spent on a system that is set up to give facilities the incentives to do better, not a system to create more profit by their negligence.