PROBLEM NURSING HOMES TO FACE IMMEDIATE SANCTIONS

Nursing homes that fail to protect residents from harm will face immediate penalties, and consumers will have access to more information about the quality of nursing-home care, the Health Care Financing Administration announced today.

HCFA Administrator Nancy-Ann DeParle today said these new steps represent the latest in an on-going effort to ensure that Americans receive quality care in nursing homes.

HCFA, the agency that administers Medicare and oversees the state Medicaid programs:

• instructed states to impose immediate sanctions, such as fines, against nursing homes in more situations -- including any time that a nursing home is found to have caused harm to a resident on consecutive surveys;
  
  
• increased states' flexibility to encourage speedier action to stop payments for new admissions and to impose other sanctions when nursing homes violate federal health and safety requirements;
  
  
• enhanced Nursing Home Compare, its consumer Internet resource found at www.medicare.gov, to include information about the prevalence of bedsores, weight loss and other health conditions among residents in individual nursing homes;
  
  
• and updated its "Guide to Choosing a Nursing Home" to take families and friends step-by-step through the process of identifying an appropriate home for a loved one.
  

"We are taking these actions to make sure that residents get the quality care and safe environment that they deserve," DeParle said. "HCFA and the states owe it to residents and their families to prevent problems where we can and address them quickly when they occur."

Today's actions extend the Clinton Administration's aggressive initiative to improve enforcement of federal and state standards and to promote quality care for 1.6 million elderly and disabled Americans in nearly 17,000 nursing homes. HCFA strengthened the inspection process to increase its focus on preventing bedsores, malnutrition and abuse, and it now requires states to crack down on homes that repeatedly violate health and safety requirements.

For Fiscal Year 2000, the President requested and secured more than $50 million in new resources to support the nursing-home initiative, including $18.1 million more for states' Medicare survey efforts and another $15.6 million in Medicaid matching funds available to states. Other resources will support federal oversight activities and increased legal activity related to enforcement.

Making State Inspections More Effective

HCFA today issued additional instructions to the state agencies that conduct nursing-home inspections for Medicare and Medicaid. The instructions require immediate sanctions, such as fines, against nursing homes in more situations -- including any time that a nursing home is found to have caused harm to a resident on consecutive surveys. Nursing homes that do not fix the problems will lose their ability to receive Medicare and Medicaid payments.

To encourage sanctions to be imposed more quickly, states also received expanded authority to notify nursing homes when they would be denied payments for new admissions and other sanctions for failing to meet health and safety requirements. In addition, HCFA provided guidance for the use of a new enforcement tool that allows fines of up to $10,000 for each serious incident that threatens residents' health and safety. In the past, fines could only be based on the number of days that a nursing home failed to meet federal requirements.

HCFA this year has conducted an extensive training campaign for nursing-home inspectors to help states enforce federal requirements more effectively and consistently. Since this spring, HCFA has directly trained more than 600 federal and state survey managers, who have conducted training for their staffs.

These actions follow other steps taken by HCFA this year to strengthen the state inspection and enforcement process. These improvements include: HCFA instructed state inspectors to increase their focus on preventing bedsores, malnutrition and abuse in nursing homes.

HCFA also is piloting education campaigns to prevent abuse, neglect and malnutrition in nursing homes. HCFA established a new requirement for states to focus on complaints alleging harm to residents and conduct investigations within 10 days. In addition, states will continue to be required to investigate complaints alleging the most serious violations within two days, and other complaints in a timely manner.

States now must conduct more frequent inspections of nursing homes that have repeated serious violations without decreasing inspections of other facilities.

State inspectors now must make the timing of inspections unpredictable and must conduct some visits on weekends, early mornings and nights to look for quality, safety and staffing problems at those times.

Empowering Consumers to Make Educated Decisions

To help consumers and advocates, HCFA also has added more data about residents' health status at all Medicare-certified and Medicaid-certified nursing homes to Nursing Home Compare at HCFA's consumer website -- www.medicare.gov.

The website now includes statistics reported by individual nursing homes about the prevalence of bedsores, incontinence and other health conditions, which can help consumers select an appropriate nursing home. The website, which already included state inspection results about those homes, gives families and friends even more valuable information to help them make educated choices about nursing homes.

Users can search nursing homes by state, county or ZIP code, and compare data from two or more homes. The information comes from HCFA's Online Survey, Certification, and Reporting (OSCAR) database, which comprises survey data provided and updated by states. HCFA will continue to refine Nursing Home Compare to make it even more useful for consumers. Since testing began in September 1998, the web site has recorded nearly 2.5 million pageviews.

The website also includes an updated version of HCFA's "Guide to Choosing a Nursing Home," which is designed to take families step-by-step through the selection process. The guide includes questions to ask, a nursing-home checklist, contact information and other resources, as well as expanded information about preventing abuse and neglect. Consumers can obtain a printed copy of the guide by contacting the Medicare Choices Helpline at 1-800-MEDICARE (1-800-633-4227).

"Offering comparative information not only helps families and friends to make informed health-care decisions, but also provides incentives for nursing homes to improve the quality of care," DeParle said. "No one should choose a nursing home based solely on an inspection report or statistics, but Nursing Home Compare makes it much easier to weigh that information in these decisions."

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