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Rhonda RichardsAARP
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Nursing Home Quality
Quality of care and quality of life
Improvements since OBRA ’87
Still progress to be made
AARP Government Relations & AdvocacyJune 5, 2008
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Nursing Home Quality Issues Include
Poor performing facilities and “yo-yo” facilities Lack of sufficient staff for quality and
continuity of care Lack of accurate staffing data Need for greater accountability and
transparency Need for improved quality measures Need for better transitions across settings
AARP Government Relations & AdvocacyJune 5, 2008
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How Does Ownership Impact Quality?
New York Times Sept. 2007 article found that private investor owned nursing homes: ► Cut expenses and staff; ► Scored worse than national rates in 12 of 14 quality
indicators; and► Created complex corporate structures obscuring who
controlled them & who is ultimately responsible for quality of care
AARP Government Relations & AdvocacyJune 5, 2008
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How Does Ownership Impact Quality?
Complex ownership structures can make it more difficult to hold facilities accountable
More research is needed to determine the relationship between private equity ownership and quality
Quality problems occur regardless of ownership – quality is broader than just ownership
AARP Government Relations & AdvocacyJune 5, 2008
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Nursing Home Transparency and Improvement Act (S. 2641)
New ownership reporting and auditing requirements
More and better information on Nursing Home Compare about facilities and their performance
Reporting of staffing information based on payroll data; better Medicare data on spending for staff and services
Complaint resolution process and standard complaint form
AARP Government Relations & AdvocacyJune 5, 2008
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Nursing Home Transparency and Improvement Act (S. 2641)
Improvements regarding civil monetary penalties
Smoother resident transition when facilities close
National independent monitoring program – interstate and large intrastate chains
Demonstration projects on culture change and use of IT in facilities
AARP Government Relations & AdvocacyJune 5, 2008
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Other Ideas and Solutions Include
Steps to address poor performing nursing homes – such as ways to identify them earlier and prevent future quality problems
Workforce issues – sufficient staff, higher wages, improved benefits, greater respect, training and educational opportunities, safer working conditions, reducing turnover
AARP Government Relations & AdvocacyJune 5, 2008
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Other Ideas and Solutions Include
Expansion of successful culture change efforts and encouraging greater resident choice and control
Greater coordination across care transitions – IT could be part of this
Better quality measures
AARP Government Relations & AdvocacyJune 5, 2008
