Press Release

Quality Improvement Organizations to Play Key Role In New Federal Nursing Home Initiative Contact: Richard Deutsch 202-261-7573 For Immediate Release November 19, 2001 Washington, D.C.-A new federal initiative to improve nursing homes assigns a central role to Medicare Quality Improvement Organizations (QIOs), formerly known as Peer Review Organizations. Today at a Virginia nursing home, HHS Secretary Tommy G. Thompson launched the initiative to help people who rely on Medicare and Medicaid find the best nursing homes for their needs. Under the initiative, the Centers for Medicare and Medicaid Services (CMS) at HHS will begin next year to publish risk-adjusted quality information about nursing homes in every state. The initiative calls on Quality Improvement Organizations to help consumers interpret quality data published by CMS. It also specifically relies on QIOs to provide nursing homes with technical assistance and guidance for providing better care. "The role of the QIOs is critical," said John Rother, director of policy and strategy at AARP. He noted that when quality data indicate a nursing home has problems, then QIOs can step in and help resolve these problems. QIOs will spur rapid improvement by helping nursing homes assess the quality of their services compared to other facilities and spur improvement by providing information on the best practices of other providers. "The initiative depends on the proven ability of QIOs to help providers improve care," said David Schulke, Executive Vice President of the American Health Quality Association (AHQA) which represents QIOs nationwide. "This kind of information-sharing dramatically speeds the adoption of quality-enhancing techniques, compared to what happens when providers are left entirely to their own devices to figure out what is wrong and what they can do about it." The federal initiative will begin early next year with pilot projects by QIOs in Colorado, Maryland, Ohio, Rhode Island and Washington. The pilot projects-and the subsequent rollout of the national nursing home improvement effort-will build on expertise gained by QIOs currently working to improve nursing home quality in 26 states. Current QIO nursing home projects are focusing on: Prevention and Treatment of Pressure Sores: QIOs in Arkansas, New Jersey, Puerto Rico and Texas are using nursing home data to test interventions and improve the prevention and treatment of pressure sores. Fall Prevention Program: QIOs in Alabama and Missouri are working with skilled nursing facilities with high incidence of falls to implement programs reducing the incidence of new falls without increased use of physical restraints. Pain Management in End of Life Care: North Dakota's QIO and nursing homes are testing quality improvement plans to reduce and manage pain, especially during end of life care. Rehabilitation Measures: QIOs in Colorado, North Carolina, Maryland, and Arizona are working jointly to develop quality improvement measures for rehabilitation services in nursing homes. Improving Diabetes Outcomes: QIOs in South Carolina and South Dakota are collaborating with skilled nursing facilities to improve monitoring and care for nursing home residents with diabetes. QIOs in Indiana and Alaska are also working on diabetes improvement projects. Immunization: QIOs in the District of Columbia, Florida, Hawaii, Kentucky, Massachusetts, Minnesota, Montana, New Mexico, and Oregon have teamed with skilled nursing facilities to implement standing orders for flu/pneumococcal vaccinations. QIOs in Alaska, Arizona, Mississippi, Washington, and Wyoming are conducting a range of innovative projects designed to increase the number of Medicare beneficiaries who receive flu/pneumococcal vaccinations. Medicare QIOs work with hospitals and other health facilities to organize care delivery systems so that patients get the right care at the right time. QIOs-independent private firms that work under contract to CMS-maintain a network of licensed physicians to review and improve care in a broad range of specialties and subspecialties, and QIOs have consumer representation on their governing boards. QIOs measure how often care is delivered in accordance with the quality indicators. When there is a gap between science-based standards of care and the actual care provided, QIOs collaborate with doctors, hospital personnel, and other health professionals to examine their practices and change how they provide care.