Centers for Medicare & Medicaid Services (CMS) is considering possible changes to Nursing Home Compare to better capture patient safety concerns, according to an article in McKnight's Long-Term Care News. The current comparison tool captures only a “subset of harm” that is inflicted on residents in nursing facilities. CMS is seeking to reform the current system by developing a composite measure of healthcare-acquired infections, which would be incorporated into the rankings.
“While we view patient safety and quality improvement as a continuum, we agree that specifically ‘calling out’ facility performance on patient safety can resonate with and be beneficial to consumers,” wrote Kate Goodrich, M.D., the agency’s chief medical officer and director of the Center for Clinical Standards and Quality in a Health Affairs blog.
A recent study demanded that changes be made to the standard measure for capturing quality at nursing homes. The study concluded that the current five-star rating system failed to paint an accurate picture of patient safety. The study authors compared nursing homes’ performance in standard quality measures with six noted patient safety standards, including pressure sores, infections, falls and medication errors, and concluded that the relationship was weak between the two measures, “leaving consumers who care about patient safety with little guidance.”
Goodrich emphasized that SNF patient safety is a “crucial strategic priority” for the federal government. She countered the study’s conclusions by writing that Nursing Home Compare does contain measures that either directly capture harm or are highly correlated with it, such as inappropriate antipsychotic use, which may be linked to falls and other events.
Along with the infection-related composite measure, Goodrich wrote CMS will “continue to explore additional facets of and measures associated with safety in nursing homes going forward.” In addition, the agency recently developed measures to gauge the transfer of health information between providers and the patient. Those were designed to meet the requirements of the IMPACT Act, and CMS is intending to propose adopting them for the SNF Quality Reporting Program, Goodrich wrote: “[w]e believe these measures will address the important safety issue of improving the hand-off of medication information during critical care transitions.”
There is no discussion whether or when reporting of intentional actions such as sexual and physical assault by residents and staff will improve.
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