Bush Plans Nursing Home Reforms

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The Bush administration announced a pilot project in five states Monday to help elderly and disabled Medicare recipients find good nursing homes.

In January, the Centers for Medicare and Medicaid Services will begin collecting information on nursing homes in Colorado, Maryland, Ohio, Rhode Island and Washington state. The data will be published in April "to help make people aware of how performance differs across nursing homes," officials said.

Families will be able to go online for such data as the prevalence of physical restraints at a facility and the frequency with which residents contract new infections.

Medicare hopes more states will opt into the program over the next year, although participation is not mandatory.

The agency has been accused of attempting to weaken nursing home inspection standards. In a letter to Medicare chief Tom Scully on Friday, Sen. Charles Grassley, R-Iowa, and Rep. Henry Waxman, D-Calif., complained about a proposal that would allow federal inspectors to cite violations at a nursing home as "widespread" only if they are able to document that 75 percent or more of a facility's residents are affected by a problem. The lawmakers cited a letter circulated by an agency official.

State and federal inspections are based on a representative sample of a nursing home's population. The lawmakers said a sample is used because "it would be too time-consuming and costly to review the records of every nursing home resident."

"If your proposal is finalized, thousands of nursing homes with serious violations could receive lesser citations," the lawmakers.

The administration was criticized in September after reports surfaced that the agency was considering fewer nursing home inspections. Agency officials denied the reports.

Scully this week again denied any change was in the works. But the lawmakers warned in the letter that any attempt to change inspections "will confuse and potentially mislead residents and family members seeking to learn about nursing homes."

Health and Human Services Secretary Tommy Thompson said the program announced Monday will improve patient care. "If you're compared with your peers and you're not measuring up, you're going to do everything you can to improve it," Thompson said. He said he would like to eventually offer similar information on hospitals and other clinics.

Scully said "better information on quality" will give the elderly and disabled a voice in their health care decisions.

The National Citizens' Coalition for Nursing Home Reform lauded the increased information but warned that it is not a substitute for vigorous enforcement of health and safety standards.

"Quality indicators can never substitute for annual onsite inspections," said Donna Lenhoff, the group's executive director.

Seniors can get Medicare information by calling 1-800-MEDICARE.



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