Nursing Home Compare

[debRN0417]

Have you all heard of this site? Thought some may be interested if you were not aware that it is there.

This section of Medicare.gov provides detailed information about the past performance of every Medicare and Medicaid certified nursing home in the country.

* http://www.medicare.gov/​nhcompare/​home.asp

Some of the information may be a little behind, but it gives the stats that alot of folks look at when searching for a nursing home.

[CapeCodMermaid, RN]

Nursing home compare is starting a 5 star rating system of nursing homes...yah...like we're hotels or something. Trouble is, the information is based on the QI which is an indication of what we are NOT so good at instead of being based on our successes. And, if you don't know how to read it and realize that sometimes the information is not what it seems....say your facility admits a lot of serious wounds...that'll show up as a high number of pressure sores. Not fair..not right...but it's the way it is.

[noc4senuf]

This site has been around for a long time. I have used it in the past to screen potential places of employment. In MN, they also post the actual surveys on the Dept of Health website.

As an added comment, hospitals also have a compare site.

[debRN0417]

We had training that it will be based on survey results...maybe that is just for our state...but it could be inaccurate as the results are slow to get posted, but at tleast it gives you a history.

[Mrs. M.]

The 5 Star Rating system went into effect today. It starts with your annual survey results, then adds and subracts stars based on your QM data and your staffing.

I am also very frustrated with the pressure ulcer information. Our Transitional Care unit specializes in wound care, so we admit many patients with pressure ulcers which we heal very successfully. Unfortunately, it shows up as a bad mark on our facility, because there is no differentiation between "admitted with" and "acquired in facility"

[gdpawel]

State Surveys are independent evaluations of nursing facility performance. Annual surveys are conducted by state survey agencies, usually the state's department of health, using protocols, procedures, and forms developed by the Centers for Medicare & Medicaid Services (CMS).

A consumer concern about surveys is the repeated finding by the Governement Accountability Office (GAO), in a series of reports issued since 1998, that surveys understate deficiencies and cite deficiencies as less serious than they actually are.

The survey component of CMS's proposed ranking system provides a more positive statement about quality than justified. States are increasingly using their state enforcement systems, instead of the federal system, to sanction facilities for noncompliance with standards of care. State enforcement actions do not appear on Nursing Home Compare.

The National Senior Citizens Law Center recommends that consumers use the new rating system with caution, and only as an aid while also pursuing other information and strategies. Consumers need to understand that the five-star system is a beginning, not an end.

A nursing home's quality can shift from month to month, so you have to be savvy in asking the right questions. Existing residents and their family members should be asked for their opinions.

Inspection data is mostly based on a once-a-year survey and may not accurately reflect the nursing home's performance today. Staffing information and quality measures are "self-reported" data by the nursing homes themselves. Self-reported data makes nursing home quality "appear" to be better than it actually is. It cannot easily be reduced to a star rating.

A recent GAO study found that nursing homes over-report staffing levels compared with staffing reported on audited Medicaid cost reports. Over-reporting of nursing coverage is associated with for-profit ownership of nursing homes.

Researchers recommend more careful scrutiny of staffing levels in for-profit facilties during the survey process and that improvements be made to the process of public reporting of staffing levels.

CMS should provide more and better information on Nursing Home Compare, including links to the actual survey forms and information about staff turnover. Also, CMS should use payroll data to report staffing information.

Anything to do with "quality indicators" is bogus. When de-regulation failed under the present adminitration, they wanted, among other things, the "quality indicator" process to eventually replace traditional annual surverys because it relies upon self-reported, unaudited data supplied by the facilities themselves and is without consequences for failures.

It leaves you with that warm-n-fuzzy "we'll-help-them-fix-their-problems," even though 99% of their failures are failures of practices they should already be experienced in before they are granted a license. It is part of the "kid-gloves," don't be-so-hard-on-the-poor-poor-nursing-homes" from the Bush administration.