Press Release

Embargoed for release until: Noon, Eastern Time, August 1, 2002 Contact: Richard Deutsch 202-261-7573 Partnerships Seen As Key To Success Of Federal Nursing Home Quality Drive Washington, D.C.— Cooperation among nursing homes, quality experts, consumer advocates, and government regulators is emerging as critical for success of the federal nursing home quality initiative scheduled for national launch in October. The federal initiative, sponsored by the Centers for Medicare and Medicaid Services (CMS), begins with the publishing of information on the quality of care in individual nursing homes in leading newspapers around the country. A central ongoing component of the initiative involves providing technical assistance to nursing homes through independent Quality Improvement Organizations (QIOs). Leaders of provider associations, QIOs, consumer groups, and government health care agencies met in Baltimore last week to evaluate the pilot stage of the initiative—which began in April in six states (OH, MD, FL, WA, CO, RI). The meeting presented a rare opportunity for all nursing home stakeholders to come together at a national forum focused on improving the quality of care. Many of the speakers agreed with Mary Ousley, head of the American Health Care Association (AHCA), who said it should be a common goal "to build a platform of trust" needed to design a better health care system. QIOs are playing a catalytic role in the development of key state-level partnerships among providers, quality experts, regulators, and consumers. These partnerships focus on the development of communication and technical assistance to facilitate broader adoption of best clinical practices in nursing home care. From 1999-2002, QIOs partnered with nursing homes in more than 30 states to implement projects directed at prevention of pressure sores, falls prevention, pain management, development of quality measures for rehabilitation services, improved diabetes outcomes, improved anticoagulant use, reduction in the use of restraints, immunization campaigns, and treatment for depression. Results show many of these projects are making a difference. A few examples: Rhode Island Quality Partners improved pain assessment procedures in all 18 nursing that participated in a statewide project. The Indiana QIO, Health Care Excel, conducted a project with nursing homes to improve the rate of blood glucose testing to prevent complications of diabetes. Testing rates in participating facilities improved from 57% at baseline in May 2001 to 87% in February 2002. The Pennsylvania QIO worked with 12 nursing homes to test interventions designed to reduce incidence of pressure ulcers. The percentage of residents with appropriate ulcer care plans rose from 57% to 90%. Health Services Advisory Group conducted a project in 127 Arizona nursing homes that increased resident vaccination for pneumonia from 52% to 72%. The Virginia Health Quality Center conducted a project that increased immunization rates for pneumonia from 26% to 52% in 15 participating nursing homes. Alabama Quality Assurance Foundation reduced resident fall rates in 13 of 14 facilities participating in a highly structured falls reduction project. Falls declined at a rate equivalent to 3 fewer falls per month at a 100-bed facility. "QIOs have years of experience improving health care in hospitals and have demonstrated skill at boosting the quality of care in hundreds of nursing homes. Now, QIOs are linking with the appropriate partners to expand on that mission," said AHQA Executive Vice President David Schulke. "While there have been a few bumps in the road, all parties continue to support the quality initiative and they are keeping their eyes on the prize—helping nursing home residents receive higher quality care." Surveys conducted by QIOs in more than a dozen states in recent months show far stronger demand for assistance from nursing homes than anticipated by CMS when it designed the initiative. Original plans called for QIOs to provide information on quality improvement to all nursing homes and to provide intensive, on-site training to 10% of the facilities in each state. However, reports from the six pilot states so far show 25-40% of all nursing homes participating in statewide workshops and 10-20% of all facilities seeking intensive training. CMS responded positively at last week’s meeting, announcing a substantial increase in funding for QIO nursing home training programs. The initiative’s architect, CMS Administrator Thomas Scully, praised conference attendees for having the courage to work together to tackle a difficult task.

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