New Report Finds Care Quality in America's Nursing and Rehabilitation Facilities Improving in Several Key Areas

New Annual Report from AHCA/Alliance Details Positive Trend in a Majority of Quality Indicators, While Others Require Ongoing Attention and Improvement

WASHINGTON, Sept. 21 /PRNewswire-USNewswire/ -- Emphasizing their long-standing public commitment to quality measurement, improvement and transparency, the American Health Care Association (AHCA) and the Alliance for Quality Nursing Home Care (Alliance) today released an annual report on the state of care in America's nursing and rehabilitation centers that finds a majority of key government-measured quality trends are improving, while others still require ongoing attention. Specifically, the overall report finds, measureable improvement has occurred in 16 of 26 quality indicators between 2000 and 2009.

The second annual report – utilizing publicly available data generated by the Centers for Medicare and Medicaid Services (CMS) – includes objective analysis from several of the nation's foremost experts on quality in long term, post-acute and rehabilitative care settings. As noted in the report, and underscoring the significance of the findings, nursing facilities are the most frequent site of post-acute care in America, treating a full 50% of all Medicare beneficiaries requiring post-acute care following hospitalization. Overall, AHCA and the Alliance said, the report provides a comprehensive, critical analysis of quality trends by closely examining the evolving role of nursing facilities, recent trends in patient outcomes, the value of person-centered care practices, and the positive impact of community-wide quality initiatives.

The leading research organizations and individuals involved in the new report include the independent health care advisory firm, Avalere Health; Leslie A. Grant, Ph.D., Associate Professor at the University of Minnesota in the Division of Health Policy and Management in the School of Public Health and Director of the Center for Aging Services Management; and Stefan Gravenstein, MD, MPH and Richard Resdine, MD with the Rhode Island-based Quality Improvement Organization (QIO), Quality Partners.

"Through this comprehensive report, we are demonstrating our commitment to improving U.S. seniors' quality of care by focusing attention not just on where we are succeeding, but where ongoing, sustained attention will be required," stated Bruce Yarwood, President and CEO of AHCA. "By releasing this analysis annually, we are challenging ourselves to move forward in taking the steps needed to continue providing high quality, compassionate care to the 1.4 million Americans we serve today, and the millions more we look forward to serving in the years ahead."

Alan G. Rosenbloom, President of the Alliance, stated, "Among the nation's health care providers, we are proud to be leaders in terms of our long-standing commitment to quality measurement, quality improvement, and providing consumers the transparency they require to help make critical decisions for themselves or their family. While it is clear we still have work to do, the general statistical trend is towards improving overall quality. Ongoing improvement must continue to be a significant focus for our sector, and the many stakeholders with whom we are successfully collaborating."

Health Affairs, in a recent brief entitled, "Public Reporting Drove Quality Gains at Nursing Homes," reported that researchers examined short-stay care provided at 8,137 nursing homes after the Nursing Home Compare public reporting requirements went into effect in 2002. They found "quality improved both because consumers chose higher-quality nursing homes, and because providers improved the care they delivered. These findings support the continued use of public reporting to improve quality." The national health leaders said the sector-driven voluntary initiative Quality First – a publicly articulated pledge to establish and meet quality improvement targets – has helped to heighten quality, boost transparency and enhance accountability in parallel manner with government initiatives.

Yarwood and Rosenbloom stated that the general positive trend in care quality – as well as publicly spotlighting areas of needed ongoing attention – demonstrates that a committed ongoing partnership with CMS and key congressional leaders can be effective in the nation's collective effort to care for growing numbers of aging Americans.

Key findings of 2010 AHCA-Alliance Quality report include:

• As nursing facilities treat diverse patients, and in some cases, become more specialized as they treat a targeted population, policymakers may consider how to measure quality based on a patient's needs, rather than setting of care;

• Since 2003, there has been an annual increase in the percentage of Medicare beneficiaries discharged to the community in 100 days.  Given the increasing complexity of this population, these numbers suggest the continued ability of nursing facilities to provide therapeutic and rehabilitative services that enable patients to return to their homes;

• More refined quality measures may foster greater consistency in state surveys and inspections as well as better target processes and outcome measure to more accurately reflect the care provided by type of patient;

• Data suggests that nursing facilities represent the lowest-cost institutional setting – indicating that nursing facilities may provide policymakers with an opportunity for shifting high acuity patients to nursing facilities with the goal of lowering program payments;

• Payment rates and quality are clearly linked, which may reflect the effect of payment levels on the intermediate variable, staffing;

• The overall trend in resident satisfaction since 2005 has been an increase in satisfaction, indicating that more providers are implementing practices recommended by national quality improvement initiatives;

• Person-centered care is associated with improved organizational performance, higher resident and staff satisfaction, better workplace performance and higher occupancy rates; and

• To better align financial incentives, reimbursement systems should take into account person centered care practice and/or performance metrics that are sensitive to culture change.

To view the entire 2010 Annual Quality Report visit http://www.ahcancal.org/ or www.aqnhc.org.

SOURCE American Health Care Association

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