CMS Acting Administrator Charlene Frizzera calls the revisions groundbreaking. “The improvements in the guidance are intended to support efforts underway to transform nursing homes into environments that are more like their homes through both environmental changes and resident-centered caregiving,” she was quoted saying in EmaxHealth.

The guidelines put much emphasis in making the nursing home environment much more homelike by no longer serving meals on institutional trays and eliminating noise from paging systems, alarms and large nursing stations. More focus will be put in individualizing care and building relationships with the residents. Residents will now have the right to make choices concerning their schedules such as daily walking, eating, bathing and bedtime.

The new guidance aims to be a roadmap for environmental and cultural change, and facilities are encouraged to be proactive in adopting the new guidelines. However, the guidance states: “many facilities cannot immediately make these types of changes, but it should be a goal for all facilities that have not yet made these types of changes to work toward them.”

SOURCE: Nursing Home Abuse › New guidelines aim to improve nursing home care

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The announcement was spurred by a recent state and Federal Center for Medicare-Medicaid Services inspection that found the center in violation of physician services, nursing services and medical records.

The inspection also raised questions about several patients whose weight had dropped dramatically. A spokesperson for the home says weight fluctuation among the elderly is not uncommon and oftentimes is unavoidable.

The state also claims a nurse did not keep proper medical records on a patient and didn’t notify the patient’s physician about problems with that patient’s health, which put that patient in immediate jeopardy.

Quality Care Health Center was ordered to put together a corrective action plan, which already has been approved by the state. The state will now perform another inspection of the facility. If no deficiencies are noted and the problems have in fact been addressed, the state will lift the suspension and Quality Care will be able to admit new residents. However, if the state inspection finds that action has not been taken to correct the problems that caused the admissions ban at the home by April 3, the Federal government will halt Medicare and Medicaid funds for residents.

“We are working with the state of Tennessee, as well as CMS to get this corrected immediately,” the nursing home spokesperson said to News Channel 5.

SOURCE: Nursing Home Abuse › Tennessee nursing home cited, residents in immediate jeopardy

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“Improving the quality of care in nursing homes is a constant challenge. More transparency, better enforcement and improved staff training are needed, and this legislation works to make changes in those areas and improve the quality of life of nursing home residents and to empower the family members and loved ones of those residents,” Grassley said.

Grassley and Kohl also released a U.S. Government Accountability Office (GAO) report entitled “Medicare and Medicaid Participating Facilities: CMS Needs to Reexamine Its Approach for Oversight of Health Care Facilities.” The report suggests that the survey and certification system is significantly under-funded relative to the scope of its oversight responsibilities, which have greatly expanded in recent years.

The report found that because of resource constraints, some facilities have been receiving inspections once every ten years rather than yearly. The Nursing Home Transparency and Improvement Act seeks to strengthen the federal government’s survey and certification system.

Grassley and Kohl have worked together previously to improve nursing home quality by heading up the government’s new five-star nursing home rating system and releasing the Special Focus Facility program participant list, which names the 135 worst nursing homes in the country.

SOURCE: Nursing Home Abuse › Grassley, Kohl reintroduce legislation to improve care at nursing homes

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According to a report in the Senior Journal, the Government Accountability Office estimated in a July 2004 report that automatic sprinkler systems can decrease the chance of fire-related deaths by 82 percent. In March 2005, CMS began requiring all long-term care facilities that did not have sprinklers to install battery-operated smoke alarms in all patient rooms and public areas, the publication reports.

By 2013, all nursing homes will have to have sprinkler coverage in areas including resident rooms, kitchen, dining and activity areas, corridors, attics, canopies, overhangs, offices, waiting areas, closets, storage areas for trash and linen, and maintenance areas.

SOURCE: Nursing Home Abuse › Lifesaving: not an option

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CMS is the federal agency that manages Medicare, the health insurance program for the elderly and disabled, and Medicaid, the health program for the poor.

On its web site, CMS says the new system is being designed as an easy way for the public to understand their assessment of nursing home quality, and will provide the public with a way to make meaningful distinctions between high-performing and low-performing homes. The rankings will be posted on the agency’s Nursing Home Compare Web Site, with plans to launch the program in December.

In June and July, the CMS is asking the public to visit its site and provide feedback about the new star rating system. A sample screen shot of the proposed star ratings also is available.

A press release on the agency web site quotes Kerry Weems, CMS acting administrator, as saying, “More than three million Americans rely on services provided by a nursing home at some point during the year. The new ‘five star’ rating system will provide a composite view of the quality and safety information currently on Nursing Home Compare to help beneficiaries, their families, and caregivers compare nursing homes more easily.”

According to CMS, this will be the first time the agency has offered a rating system for the fee-for-service, or traditional Medicare progra. Currently, the Compare web site assists beneficiaries and their families in making nursing home choices by providing information on individual measure of quality of care, staffing, and survey inspection information.

Medicare already lists troubled nursing homes in its online database, but that system can be hard for the general public to understand or to navigate. It is hoped that the new system will be easier to use, and therefore more effective for decision making.

Another hope is that by being listed as low performers with the easily identifiable star system, nursing homes that are below par will be motivated to improve, CMS officials say.

Descriptive information about the quality rating system and its progress may be obtained after June 22 on the CMS Hot Topics web page.

Comments and suggestions about the new nursing home rating system should be sent to BetterCare@cms.hhs.gov.

SOURCE: Nursing Home Abuse › Five-star care

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