News Release Nov. 19, 2001

CONTACT: 
Donna Lenhoff
Janet Wells
202/332-2275                                                 
 

Leading Consumer Coalition Lauds New Nursing Home Information, Warns Against Weakening Federal Health & Safety Standards

  WASHINGTON, D.C. -- The National Citizens’ Coalition for Nursing Home Reform (NCCNHR) today welcomed a federal plan to provide the public with new quality indicators to compare nursing homes.  However, the group said, families should not rely solely on this data, and improved information is no substitute for vigorous enforcement of health and safety standards.

  “NCCNHR supports the new quality initiative because Centers for Medicare and Medicaid Services (CMS) Administrator Tom Scully has given his personal assurance that the initiative will not reduce or replace any part of the nursing home survey and enforcement system,” said NCCNHR Executive Director Donna Lenhoff.  “Quality indicators can never substitute for annual on-site inspections – NCCNHR firmly believes the best way to ensure quality nursing homes is to enforce federal quality standards vigorously and require sufficient nursing staff.

  “Nevertheless, QI data can help consumers and states monitor nursing home care, and it can be helpful to nursing homes themselves in identifying areas in which they need to improve. We also believe this data will give many nursing homes an incentive to do better.”

  The Henry J. Kaiser Family Foundation last week released a National Survey on Nursing Homes in which two-thirds of those surveyed said the government is not doing enough to enforce quality standards and want regulation to be increased.  One in four respondents with nursing home experience said they knew a resident who had been neglected or abused.

  Vigorous enforcement is needed because consumers often do not have the opportunity to choose a good nursing home on the basis of quality indicators. For example:

• Families often make decisions hastily when a loved one has a medical emergency. Almost 45 percent of residents are admitted to a nursing home from a hospital, where a discharge planner may pick the facility.
• Government policies often restrict choices. Half of state ombudsmen interviewed for an Inspector General’s report last year said Medicaid beneficiaries’ access to nursing homes is limited by CMS’s policy of allowing facilities to limit their Medicaid beds.  One-third of hospital discharge planners said it is “very difficult” to place Medicaid patients in nursing homes.
• Poor care is so widespread that consumers may have no choice but to enter a poor quality nursing home.  A 2000 CMS study found that more than half of nursing homes do not have enough nursing staff to avoid harm to their residents.
• Nursing home quality changes rapidly and information quickly becomes outdated.  A facility that fares poorly on one inspection may improve significantly (particularly if enforcement is strong); on the other hand, a facility that was a model under one owner may decline rapidly if it is sold.

    For those who have the luxury of “shopping for” a nursing home, NCCNHR recommends visiting several facilities, assessing the adequacy of staffing, asking the state or local long-term care ombudsman about complaint histories, and reviewing state survey reports. CMS currently provides consumers some QI and staffing data and summaries of deficiencies cited by state inspectors on its website, www.hcfa.gov, as part of Nursing Home Compare. In March, CMS also authorized states to release QI data it collects for inspection purposes to ombudsmen and individuals looking for a nursing home, although this data has not been validated for consumer use.

  Lenhoff praised CMS for being responsive to consumers’ need for information and said it was her understanding that existing data would continue to be made available to consumers.

  Lenhoff serves on the steering committee advising the National Quality Forum (NQF) on selection and validation of improved QIs for CMS. One of her concerns, she said, is ensuring that the methodology used to develop the QIs does not mask problems or create misleading information. She also noted that QIs must be updated frequently and reported in a way that is accessible to consumers.

  NCCNHR has provided information, technical assistance, and a voice in Washington for nursing home residents, citizen advocacy groups, and long-term care ombudsmen for more than 25 years.  The second edition of its widely acclaimed book for consumers on nursing home quality, Nursing Homes: Getting Good Care There, has just been published.  Price and ordering information, as well as other information for consumers, can be found on the NCCNHR web site at www.nursinghomeaction.org.