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Senior Living: Six New Ways to Compare Nursing Homes

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The Centers for Medicare and Medicaid Services (CMS) launched its five-star rating system of nursing homes, a web-based report card on the quality of care at all CMS-certified nursing homes, in 2008.
But are consumers using this resource, Nursing Home Compare, when deciding on a nursing facility?

Elderly man and woman in chairs.
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Health Affairs journal recently released a report that answers that question. The report discovered that, though consumers react positively to Nursing Home Compare, there’s a lack of awareness of and trust in the data.
“Useful additions to Nursing Home Compare might include measures of the availability of activities, information about cost, and consumer satisfaction,” wrote authors R. Tamara Konetzka, Ph.D., and Marcelo Coca Perraillon.
To help build trust and continue to raise awareness, CMS has begun sharing data for six new quality measures on Nursing Home Compare. CMS will use data from claims-based measures and Minimum Data Sets.
Minimum Data Sets (MDS) reflect information collected by nursing homes and self-reported to Medicare.
Claims-based measures are based on Medicare claims submitted by hospitals – the first time CMS is including quality measures not based solely on data reported by nursing homes.
Emergency room. Nursing Home Compare will consider outpatient ER visits.
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Six new nursing home measures

With that in mind, these new measures include:
Short Stay

  • Percentage of short-stay residents who were successfully discharged to the community (claims-based). This will measure residents discharged within 100 days and not readmitted to the hospital.  
  • Percentage of short-stay residents who have had an outpatient emergency department visit (claims-based). This identifies residents who visited an emergency room but did not require an inpatient or observation stay.
  • Percentage of short-stay residents who were rehospitalized after a nursing home admission (claims-based). This will identify residents who were readmitted to a hospital within 30 days of admission.  
  • Percentage of short-stay residents who made improvements in movement and walking  (MDS-based).  

Long Stay

  • Percentage of long-stay residents whose ability to move independently worsened (MDS-based).  
  • Percentage of long-stay residents who received an antianxiety or hypnotic medication (MDS-based).

“These new quality measures broaden the set of quality measures already on the site so that patients, their family members and caregivers have more meaningful information when they consider facilities,” said CMS Deputy Administrator and Chief Medical Officer Patrick Conway, M.D., MSc in a press release.
Starting in July 2016, five of the new measures will be used to calculate the Five-Star Quality Rating of nursing homes. The measure on antianxiety/hypnotic medications will not be used in the ratings because of concerns about the appropriate thresholds, the CMS said.

How the measures help nursing home consumers

Following a troubling New York Times article in 2015 that reported nursing homes were “gaming the system and misleading consumers about facility conditions,” CMS reacted by making the largest addition of quality measures to Nursing Home Compare since 2003.
These new measures bring several benefits. The number of short-stay measures will double, and claims-based measures should become more accurate than the current self-reported measures.
“We owe our families the peace of mind in knowing that the rating system they’re using to make a critical decision about the future of their loved ones is accurate,” said Sen. Bob Casey, Jr. in the Reading (Pa.) Eagle. “This system has the potential to make a substantial difference in the lives of vulnerable seniors and to help families locate the quality care that their loved ones deserve.”
The data from these new quality measures will show residents and their families the nursing homes that have helped short-stay residents improve physically and avoid going back to the hospital, as well as those that have the proper facilities and staff to assess residents. If a high percentage of residents are being sent back to the hospital, it may be an indication that the home isn’t qualified to take care of or assess residents.
With the new measures, if a resident was sent to the hospital for a severe case of the flu because the home did not provide a flu shot, that would decrease the rating of the home. Residents and their loved ones might then opt to select a different home.
This article was originally published on After55.com: What’s New With Nursing Home Compare Website?
Learn more about senior living and senior care options – from 55+ apartments to continuing care retirement homes – on After55.com.