2004.12.22: Nursing Home Care Improving in Many Areas New CMS Data Show, New Steps InitiatedSkip 
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      News Release
            FOR IMMEDIATE RELEASE
            Wednesday, Dec. 22, 2004CMS Media Affairs
            (202) 690-6145

      Nursing Home Care Improving in Many Areas New CMS Data Show, New Steps 
      Initiated
      HHS Secretary Tommy G. Thompson announced today that fewer nursing home 
      residents suffer from chronic pain and fewer physical restraints are being 
      used, according to data collected by the Centers for Medicare & Medicaid 
      Services (CMS) two years after the launch of the HHS Nursing Home Quality 
      Initiative (NHQI).
      In addition to tracking quality measures as a way to improve long-term 
      care, CMS is also beginning a new phase of initiatives to further improve 
      care for seniors.
      The new data show that 100 percent of states report a decrease in the 
      prevalence of chronic pain in nursing home patients statewide since 
      Secretary Thompson launched the NHQI in November 2002. Fully 92 percent of 
      states also show declines in the use of physical restraints, according to 
      the CMS data. Nationally, the prevalence of long-term pain decreased by 38 
      percent and the use of physical restraints declined by 23 percent.
      "By working together, we're creating a higher quality of life for seniors 
      in nursing homes and having a meaningful impact on the care they receive," 
      Secretary Thompson said. "Improvements in quality mean improvements in the 
      lives of nursing home residents as well as peace-of-mind for their 
      families. The improved outcomes are a great first step, but we know much 
      more can be done. In fact, we are initiating an aggressive new phase in 
      our quality initiative that will further strengthen our enforcement 
      actions when a nursing home fails to measure up."
      The HHS Nursing Home Quality Initiative includes the following features:
        Strengthening CMS' regulatory and enforcement activities to better track 
        and address complaints and deficiencies; 
        Improving and expanding the consumer information available at 
        www.medicare.gov; 
        Strengthening the community-based nursing home quality improvement 
        programs coordinated by the Medicare Quality Improvement Organizations 
        (QIOs) with local nursing homes; and 
        Expanding partnerships with state survey agencies, nursing homes, 
        residents and their family members and staff members to accelerate 
        changes in nursing homes and how they deliver care. 
      "It is clear that the steps we are taking can help achieve important 
      improvements in nursing home culture, practices, and results," said Mark 
      B. McClellan, M.D., Ph.D., administrator of CMS. "In this unprecedented 
      effort to improve quality nationally, I am very encouraged by the 
      determination and effort of beneficiary groups, the nursing home industry, 
      health professionals, and our QIO partners to make significant 
      improvements in care for many of our nation's most frail and vulnerable 
      citizens."
      As part of its aggressive action plan for nursing home improvements, CMS 
      is undertaking the following initiatives:
        Expand the information on www.medicare.gov to help families evaluate 
        quality in nursing homes, including accurate information about staffing 
        levels and a new quality measure related to weight loss in long-term, 
        chronic care nursing home residents; 
        Strengthen the investigation of complaints from residents, family 
        members, and others by requiring states to use a standard complaint 
        tracking system that will help to better track and analyze complaints, 
        building on increased complaint investigations conducted by CMS or 
        States in nursing homes (from about 45,700 in FY 2000 to about 48,900 in 
        FY 2003); 
        Prevent neglect and abuse by implementing a pilot program with up to 10 
        volunteer states to pilot expanded and more effective systems of 
        background checks for individuals seeking employment in nursing homes 
        and other long-term care (LTC) providers; 
        Improve fire safety by increasing the number of comparative life-safety 
        surveys and issuing a regulation requiring smoke detectors in areas of 
        nursing homes that do not have automatic sprinklers; 
        Conduct annual performance reviews of state survey agencies to assess 
        whether complaints are investigated in a timely manner; 
        Continue and expand partnership efforts with nursing home residents and 
        their family members, the nursing homes themselves, unions representing 
        nursing home staff, state survey agencies, and other local and national 
        organizations working to improve the quality of care available in 
        nursing homes; 
        Improve the accuracy of the Medicare payment systems, to improve access 
        for those with the greatest care needs; Direct the appropriate level of 
        resources to nursing homes to furnish high quality care, including 
        performance incentives related to quality; and 
        Develop a more refined indicator and better tracking of the incidence of 
        pressure sores to achieve greater nursing home progress in that area. 
      "In many areas we are seeing marked progress in the care that nursing 
      homes provide, and now we are enhancing our quality improvement efforts, " 
      said Dr. McClellan. "We have established a task force that will not just 
      provide agency-level coordination and leadership CMS, but will also work 
      with states, consumer organizations, providers, and others who share the 
      goal of improving quality. We all have vital roles to play if we are to be 
      successful."
      CMS is also working with the National Quality Forum, a voluntary, 
      standard-setting organization representing public and private purchasers, 
      providers, consumers, and researchers to identify quality measures that 
      are considered to be the most important to consumers and nursing homes. 
      The measures reported by CMS are in eight clinical topics; five reflect 
      care given to those with chronic conditions (physical restraints, pressure 
      sores, infections, pain management, and declines in activities of daily 
      living) and three reflect post-acute care (delirium, pain management, and 
      improvement in walking). 
      Several of these measures showed marked improvement since the beginning of 
      the initiative, and the improvements are larger in nursing homes that 
      worked most closely with their QIOs. For example, nursing homes working 
      intensively with their QIO have decreased the prevalence of pain in long 
      stay residents by an average of 49 percent, the use of physical restraints 
      by 33 percent and the prevalence of pain in short stay residents by an 
      average of 18 percent.
      Medicare is continuing to work aggressively to improve performance on 
      other measures. One area in need of improvement is the prevalence of 
      pressure ulcers. Data show nursing homes working intensively with QIOs may 
      be nearing a turning point for decreasing the prevalence of residents' 
      pressure ulcers. Nationwide, the percentage of patients with pressure 
      ulcers has risen slightly since measurements began in June 2002, from 8.5 
      percent to 8.7 percent. However, a smaller group of nursing homes that 
      worked very intensively with QIOs showed a decrease in pressure sores from 
      10.1 percent to 9.3 percent.
      "We have clear evidence that improved quality of care is an achievable 
      goal," said Dr. McClellan. "We will keep building on our initiatives until 
      the all people who need nursing home care are receiving the quality of 
      care they deserve.
      The updated information is available at Nursing Home Compare at 
      www.medicare.gov. Those without Internet access may call 1-800-MEDICARE 
      (1-800-633-4227) for assistance. 
      New Background Check Programs Launched
      As part of the quality initiatives, Dr. McClellan also today named seven 
      states to participate in comprehensive background check programs for new 
      workers in long-term care facilities, as another way to combat abuse and 
      neglect in these facilities.
      "Checking the backgrounds of those applying for jobs involving direct 
      patient care in long-term care facilities is a good way to weed out those 
      individuals who have criminal backgrounds or other disqualifying factors 
      in their histories," said Dr. McClellan.
      The two-year pilot will help determine the impact of national background 
      checks for any new worker with direct patient care duties on abuse and 
      neglect in nursing homes and other long-term care facilities. States named 
      to conduct the pilots include Alaska, Idaho, Michigan, Nevada, New Mexico, 
      South Carolina and Wisconsin.
      Questions about the background check pilot program can be e-mailed to 
      backgroundchecks@cms.hhs.gov.
      ### 



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      Last Revised: December 22, 2004

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