Improving Nursing Home Compare

The Centers for Medicare and Medicaid Services (CMS) engages in a number of activities to improve the quality of care in nursing homes. Among these are activities such as consumer awareness and value-based purchasing. To promote consumer awareness, CMS seeks to provide an array of understandable information that can be readily accessed by the public. Thus CMS maintains a web site that features "Nursing Home Compare," a resource that gives consumers comparative information on nursing home performance. Among other things, this resource includes certain quality measures (QMs) that are derived from information collected via the minimum data set (MDS). Under the existing contract, CMS is planning to implement the Nursing Home Value-Based Purchasing (NHVBP) demonstration to improve the quality of care furnished to Medicare beneficiaries residing in nursing homes. CMS will assess the performance of participating nursing homes on selected quality measures, and then will make payments to nursing homes that have the best performance or the greatest improvement in quality of care. The domains of quality selected for the demonstration are: nurse staffing, avoidable hospitalizations, quality measures based on MDS, and information from state survey and certifications. CMS plans to improve Nursing Home Compare through the inclusion of a national nursing home rating system. We currently envision using a "five-star" rating system. The goal of the rating system is to provide useful information to consumers about how each nursing home performs in terms of quality. The rating system must be easy to understand while making meaningful distinctions in quality among nursing homes. CMS intends to implement the new system by the end of 2008. Future improvements to the system will also be considered.