Nursing
Home Quality
QIOs Expect Strong Demand For Their Help From Industry
Voluntary but oversubscribed?
That's the scenario that may come to pass in the Centers for Medicare and Medicaid
Services' soon-to-be-launched national nursing home quality initiative, American
Health Quality Association Executive Vice President David Schulke told reporters
April 12.
The initiative
has two main parts, one compulsory for facilities, the other voluntary. On the
compulsory side, in six selected pilot states CMS will begin this month to publish
detailed, standardized, risk-adjusted quality data for individual facilities based
on the so-called minimum data set that homes already collect. Publication of data
from all states that choose to participate is scheduled to begin this fall. Schulke's
group, the so-called Quality Improvement Organizations - formerly known as Peer
Review Organizations - that exist in each state, will be most closely involved
in the other part of the effort, which will be voluntary for facilities. QIOs
will offer quality improvement information, and in some cases individual assistance
and training, to help some homes improve the quality of their care and, consequently,
of their publicly available data.
Just one problem:
Given their limited resources, QIOs will be able to work closely with only a handful
of homes in each state - CMS seems to be predicting around 10 percent of facilities.
But at a meeting last week of QIOs from the pilot states the organizations said
they're already experiencing heavy demand from homes that want to get the special
intensive QIO assistance.
"Initially
we wondered, 'Is anybody going to pay attention?' Now, it looks like our problem
is going to be, Are QIO resources going to be adequate?" said Schulke.
To help deal with
the expected high demand, QIOs are developing a "third way" to offer
assistance, Schulke said. In some states at least, QIOs will facilitate formation
of collaborations among homes wherein top-performing facilities can share their
expertise.
State survey and
certification staff and QIOs will work together to ensure that both emphasize
similar concerns and that state inspections are based on evidence-based standards
in areas like pain control, said Schulke. However, the fact that a facility is
working with its state QIO will not constitute a defense against citation by state
inspectors, he said.
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