New help in nursing home hunt

By Sharon Salyer

Herald Writer

Beginning in April, Washington will be one of the first five states in the nation where more information will be available to help consumers compare nursing home quality.

A number of factors, including computer tracking of patient care problems kicked off a decade ago, helped the state qualify for the national pilot project, announced by the Bush administration Monday.

"Our (state) was one of the first states to do a good job and establish a reliable database" to help track nursing home quality-of-care issues, said Kary Hyre, the state’s long-term care ombudsman.

"That’s why we’re one of the first states selected for this experiment to see if quality indicators are helpful to potential consumers," he added.

Families will be able to go online for information such as: prevalence of physical restraints, bedsores, weight loss, infections, pain management, declines in daily activity and use of anti-psychotic drugs without a psychiatric diagnosis.

Also available will be information on the way a nursing home manages delirium and pain, how it helps patients improve walking skills, and its number of patients who must re-enter a hospital.

Nursing homes in Colorado, Maryland, Ohio and Rhode Island will join Washington in the pilot project.

The information will be available at a federal Web site where some nursing home inspection data already is available under the heading "nursing homes compare" at www.medicare.gov or from its toll-free telephone number, 1-800-633-4227.

Health and Human Services Secretary Tommy Thompson said Monday that officials of the Centers for Medicare &Medicaid Services, which is part of his agency, will administer the program. The goal is to have information about nursing homes in all states published by October 2002.

Currently, consumers have to "look at a whole lot of information" on the federal Web site and "deduce what it means," said Larita Paulsen, chief of consumer services for the state Department of Social and Health Services residential care unit.

Under the new system, nursing homes will be rated on 11 performance measures, including staffing ratios, which are not now part of the Web site.

These quality indicators will be provided in addition to the results of regular nursing home surveys, Hyre said, "so potentially it will give consumers a second way" to evaluate a facility.

"Survey data is always iffy about what it means," Hyre said. "Suppose a facility has no complaints. Would you say it’s a perfect facility? (Residents) might be so intimidated they’re scared to complain."

Washington began automating reports on the quality of nursing home care in 1992 "so we have a long history of using information on residents to target areas that may be of concern," Paulsen said.

Washington is one of the few states nationally that has three ways of checking on nursing home care: annual formal inspections, complaint investigators who check out problems and quality assurance nurses who "go into building between surveys to help identify potential issues," she said.

Between these three programs, "we have the opportunity to be in most nursing homes probably 10 times a year," Paulsen said. "If you’re only able to get in once a year for a survey, there’s a lot that may go on that you may not know about."

A number of states are thinking about starting their own program to send nurses into nursing homes to look for potential problems, she said.

"Until about a year ago, we were one of the only states to have quality assurance nurses," Paulsen said

Hyre said that from talking to ombudsmen in other states, checks of Washington nursing homes "are more thorough and more timely" in finding problems that need correcting.

For this reason, as a group, nursing homes in Washington have a higher number of citations than most other states, he said, generally ranking in the top five nationally in number of citations given for care problems.

"What this means is our facilities are better because our surveyors are more thorough," Hyre added.

This report includes material from The Associated Press and The Washington Post .

You can call Herald Writer Sharon Salyer at 425-339-3486

or send e-mail to salyer@heraldnet.com.

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