Feds Request Suggestions How Medicaid Services Can Expand To Community-Based Services

A notice published in the Federal Register this month, the Centers for Medicare & Medicaid Services (CMS) said it is seeking suggestions about reforms and policy changes that the agency could pursue in order to grow availability of community-based services. 

CMS is requesting feedback from stakeholders on ways to expand community-based services while continuing to ensure choice for those who prefer institutional care. The majority of Medicaid spending is on long-term services.

Medicaid officials want to know what more can be done to provide services that promote the health and safety of beneficiaries with minimal fraud, waste and abuse. The agency also is seeking feedback on ways to strengthen the home care workforce to ensure that providers are available for a growing number of individuals needing support.

CMS is accepting public comments through Jan. 9, 2016

Medicaid Program; Request for Information (RFI): Federal Government Interventions To Ensure the Provision of Timely and Quality Home and Community Based Services

U.S. Nursing Home Rating System Strengthened - online comparison & rating

The Centers for Medicare and Medicaid Services has updated the rating system used on its Nursing Home Compare website. The Five Star Quality Rating System for Nursing Homes helps families make informed decisions when choosing a nursing home. The new rating system includes information on how often anti-psychotic medications are given to patients, better ways of measuring staffing levels and higher quality standards. Read the fact sheet to learn more about this important development in delivering quality care. You may file a complaint if you are concerned about the health care, treatment or services that you or another person received or did not receive in a nursing home.

For the Centers for Medicare and Medicaid Services Nursing Home Compare website:
https://www.medicare.gov/nursinghomecompare/search.html

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as posted by Centers for Medicare & Medicaid Services

PRESS RELEASE Feb 20, 2015

CMS Strengthens Five Star Quality Rating System for Nursing Homes

The Centers for Medicare & Medicaid Services (CMS) today strengthened the Five Star Quality Rating System for Nursing Homes on the Nursing Home Compare website to give families more precise and meaningful information on quality when they consider facilities for themselves or a loved one. Today’s announcement also marks an important milestone to achieving the goal of implementing further improvements to the Five Star system in 2015, as the Administration announced last October.  

Star ratings allow users to see important differences in quality among nursing homes to help them make better care decisions. CMS rates nursing homes on three categories: results from onsite inspections by trained surveyors, performance on certain quality measures, and levels of staffing. CMS uses these three categories to offer an overall star rating, but consumers can see and focus on any of the three individual categories.

Beginning today, nursing home star ratings will:

• Include use of antipsychotics in calculation of the star ratings. These medications are often used for diagnoses that do not warrant them. The two existing quality measures – for short stay and long stay patients – will now be part of the calculation for the quality measures star rating.
• Have improved calculations for staffing levels. Research indicates that staffing is important to overall quality in a nursing home.
• Reflect higher standards for nursing homes to achieve a high rating on the quality measure dimension on the website.

“CMS is committed to improving Nursing Home Compare and the Five Star Quality Rating System to ensure they are the most trusted and easy-to-use resources we can provide,” said Patrick Conway, M.D., CMS Deputy Administrator for Innovation and Quality and Chief Medical Officer for CMS. “Consumers can feel confident that Nursing Home Compare’s star ratings include measures that matter most to nursing home residents and their families and challenge nursing homes to continuously improve care.”

Since CMS standards for performance on quality measures are increasing, many nursing homes will see a decline in their quality measures star rating.  By making this change, Nursing Home Compare will include more meaningful distinctions in performance for consumers and focus nursing homes on continuously improving care focused on residents, families, and their caregivers. About two thirds of nursing homes will see a decline in their quality measures rating and about one third of nursing homes will experience a decline in their Overall Five Star Rating.

For example, before the recalibration, about 80 percent of nursing homes received either a 4 or 5-star rating on their quality measures. Now, about 49 percent of nursing homes will receive a 4 or 5 stars on their quality measure rating. Also, the number of nursing homes receiving one star for their quality measures has increased from 8.5 percent to 13 percent after the recalibration.

CMS is also focusing changes in areas identified by consumers and other stakeholders as important. For example, by the end of 2013 nursing homes achieved a 15 percent reduction in the use of anti-psychotics compared to 2011 levels. As part of the National Partnership to Improve Dementia Care, CMS is working with the nursing home community, patients, families and other important stakeholders to achieve a 30 percent reduction by the end of CY2016.   

The Nursing Home Compare website was launched in 1998, and CMS added the Five Star Quality Rating System (“NH Compare 2.0”) in 2008.  Nursing Home Compare gets approximately 1.4 million visits per year and users report high satisfaction with the site. More than 85 percent of users have indicated that they found the information they were seeking. CMS recommends that consumers rely on multiple factors – including star ratings, visits and community reputation -- when selecting a nursing home.

To achieve better care, smarter spending and healthier people, the Department of Health and Human Services is focused on sharing information more broadly to providers, consumers, and others to support better decisions while enforcing patient privacy. The Five Star Quality Rating System for Nursing Homes is part of an administration-wide effort to increase the availability and accessibility of information on quality, utilization and costs for effective, informed decision-making by consumers.

To read a fact sheet on Nursing Home Compare 3.0, visit http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-02-12-2.html.

To search for nursing homes in local areas, visit Medicare.gov/nursinghomecompare/search.html.

For more information on the national partnership, visit CMS.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-14-19.pdf.

For more information on the Advancing Excellence campaign, visit nhqualitycampaign.org/news.aspx#17.

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http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-02-20-2.html

RELATED POST:
Rating System Helps Patients Compare & Choose Hospitals for 2015

This is a re-post from Feb. 2015. all links are up to date.

Nursing Home & Facility Initiative Annual Report

from a Press Release February 3, 2016
Centers for Medicare & Medicaid Services

By Patrick Conway, M.D., CMS Principal Deputy Administrator and Chief Medical Officer 

Nursing Facility Initiative Annual Report

Today we released the annual report summarizing impacts from the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents in 2014. This three-year-old initiative is designed to test ways to reduce avoidable hospitalizations among long-stay nursing facility residents. For such individuals, avoidable hospitalizations can be dangerous, disruptive, and disorienting. CMS research has estimated that 45% of hospitalizations among nursing facility residents could be prevented with well-targeted interventions.

The results in this report are based on experience during the second performance year of the initiative, calendar year 2014. During this period, all seven sites generally showed reductions in Medicare expenditures relative to a comparison group, with statistically significant declines in total Medicare expenditures at two sites. All sites also generally showed a decline in all-cause hospitalizations and potentially avoidable hospitalizations, with four sites showing statistically significant reductions in at least one of the hospitalization measures. These early results are promising.

As we plan for new Medicare payment incentives to reduce hospital readmissions from skilled nursing facilities, these results provide early indications that when the right strategies are in place, they may effectively reduce hospitalization rates and reduce overall Medicare spending.  We anticipate gaining an even more complete understanding of the initiative’s impacts as additional results from this initiative become available.

These promising early results come in tandem with impressive nationwide reductions in inappropriate use of antipsychotics for nursing facility residents through the National Partnership to Improve Dementia Care (http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-09-19.html). These results demonstrate additional progress on the nation’s path to a health system that achieves better care, smarter spending, and healthier people.

The full report is posted on the CMS website: [https://innovation.cms.gov/Data-and-Reports/index.html].

Additional information about the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents is available on the Medicare-Medicaid Coordination Office website: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/ReducingPreventableHospitalizationsAmongNursingFacilityResidents.html