Study evaluates nursing homes

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http://www.denverpost.com/framework/...674%2C00.html#

Denver Post
Study evaluates nursing homes
Breakdown of federal data available online or via phone
By Karen Auge
Denver Post Medical Writer


Thursday, April 25, 2002 - Consumers can learn which of Colorado's 224 nursing homes are best at managing pain or worst at preventing bed sores simply by going online or to the phone and tapping into the results of a federal study released Wednesday.

Colorado's nursing homes, and those in five other states, were evaluated on nine criteria as part of a pilot survey done by the Centers for Medicare and Medicaid Services, or CMS.

The results are intended to help families choose a nursing home and to help nursing homes improve their care, Health and Human Services Secretary Tommy Thompson said as he unveiled the findings.

"We are empowering consumers with information on how to get the best care possible for their loved ones, and we are empowering the industry with information on how to meet those needs," he said.

Larry Minnix, chairman of the American Association of Homes and Services for the Aged, called the survey "a watershed."

"Many of our members will shine in this process. Others will will see that they need to improve, and others will get out of the business," he said.

Nursing home operators in Colorado, as well as their counterparts in Florida, Ohio, Washington, Maryland and Rhode Island, have been nervously awaiting the survey results. While most say they endorse the concept, some worry that the findings aren't a complete picture or don't take into account how severely and chronically ill many of their patients are.

"Am I frightened? Yes," said Jay Moskowitz, chief executive of Quality Life Management, which operates four nursing homes in Colorado.

Moskowitz said his staff has sent letters to the families of all his nursing home residents, explaining the survey, the categories examined and inviting them to call if they have any questions.

"Until consumers are educated about this, I think some will misinterpret this data," he said.

And some nurses complain that the surveys lack information about the individual care they pride themselves on. "You don't hear that we do their hair, that we buy them clothes," said Lorraine George, a nurse at Littleton Manor Nursing Home. "We cry when they pass away."

At the same time, some residents questioned why the federal government didn't include pricing as a measure of homes.

"It is something I think about," said Bob Howe, an 81-year-old retired engineer who lives at Littleton Manor. "Sometimes I get thinking I want to leave, but I can't because of price."

Though the CMS website gives state figures on staff-to-patient ratios, many consumer groups are concerned that the CMS did not include that in its evaluations.

A study on nursing home staffing will be added to the agency's website later this year, along with substantiated complaints against nursing homes, said Tom Scully, CMS director.

Thompson and Scully stress that the survey is not a report card, not intended as a comparison between states, not meant to spark punitive action and is not the only source families should use to choose a nursing home.

It is, Scully said, a means to compare, one of many pieces of information families should gather.

"This is not something people should use alone to pick a nursing home," Scully said. "This is a tool."

Laura Landwirth, executive director of the Colorado Association of Homes and Services for the Aging, agreed.

"I would say use your common sense, but use your senses, too," she said. "Look around, see if there's activities for the residents. Smell the place. Contact the ombudsman and speak to staff and residents to find out what their experience is."

Families who compare what state inspectors have found at Colorado nursing homes may find themselves more confused than helped, however.

Several nursing homes that appeared to score badly on the federal survey got high marks from state health department inspectors. And vice versa.

For example, Red Rocks Healthcare Center scored about average in the percentage of residents with bed sores and scored very well in its pain management in the federal survey. But when state inspectors visited last July, they found so many problems - the facility got 21 citations for deficiencies - that state officials temporarily withheld Medicaid and Medicare reimbursements for new patients.

Scully said that is because the inspectors and the survey are not looking at the same things.

The federal data, from the fourth quarter of 2001, is information that nursing homes are required to provide the federal government in order to collect reimbursements.

The agency hopes to expand the survey and have findings from all 50 states available by this fall. The survey cost more than $11 million, including the expense of running advertisements on the results in 30 newspapers.

Denver Post medical writer Allison Sherry contributed to this report.