Medicare Compliance & Reimbursement

Nursing homes wondering how they'll look on CMS' enhanced "Nursing Home Compare."

Wake-up call for nursing homes: Consumers will have more information about the quality of care you provide than ever before, thanks to new revisions to the Centers for Medicare & Medicaid Services' Nursing Home Compare Web site. 

The updates, announced Jan. 22, include expanded quality measures and are intended to make navigating the site easier.  Consumers will also get more details when comparing the quality, deficiency and staffing stats of any Medicare- or Medicaid-certified nursing home. 

"By enhancing the quality measures, we can further improve our ability to provide valuable information to consumers," says Dennis G. Smith, acting CMS administrator, "in turn helping them make more informed decisions when choosing nursing home care."

Health and Human Services Secretary Tommy G. Thompson calls the website a "win-win situation" for the public and for nursing homes.  "Not only have consumers become better informed," Thompson says,  "but nursing homes themselves have been taking steps to improve their quality of care."

The move is the latest from CMS' National Nursing Home Quality Initiative, which has been stepping up public reporting on standards of nursing home care.  CMS credits the initiative, launched in 2002, with significant nation-wide nursing home improvements, such as 15 percent fewer residents being physically restrained and 30 percent fewer experiencing chronic pain. 

Nursing Home Compare is getting plenty of attention, receiving 9.3 million page views in 2003 and becoming the most popular tool at the Medicare Web site.  
 
The enhanced quality measures that consumers will be comparing include:
 1. Percent of residents whose need for help with daily activities has increased.
 2. Percent of residents who have moderate to severe pain.
 3. Percent of residents who were physically restrained.
 4. Percent of residents who spent most of their time in bed or in a chair.
 5. Percent of residents whose ability to move about around in their room got worse.
 6. Percent of residents with a urinary tract infection.
 7. Percent of residents who have become more depressed or anxious.
 8. Percent of high-risk residents who have pressure sores.
 9. Percent of low-risk residents who have pressure sores.
 10. Percent of low-risk residents who lose control of their bowels or bladder.
 11. Percent of residents who have/had a catheter inserted and left in their bladder.
 
The measures to be added are:
 12. Percent of short stay residents who had moderate to severe pain.
 13. Percent of short stay residents with delirium.
 14. Percent of short stay residents with pressure sores.

For more information on the enhanced measures, go to the CMS web site: www.cms.hhs.gov. For Nursing Home Compare, click on the link at www.Medicare.gov.