Jonathan Rosenfeld's Nursing Homes Abuse Blog : Jonathan Rosenfeld's Nursing Homes Abuse Blog | Lawyer & Attorney : Strellis & Field Law Firm | Bed Sores, Senior Neglect, Elder Abuse, Sexual Abuse: Chicago, Illinois

Nursing homes will now have one more reason to improve patient care--they will be paid for doing so. The Centers for Medicare & Medicaid Services (CMS) will initiate a new pay-for-performance program to inspire nursing to provide improved care to residents.

The plan formally known as,  Nursing Home Value-Based Purchasing Demonstration Project, will begin in July and run for three years.  All Medicare-certified nursing homes in Arizona, Mississippi, New York and Wisconsin are eligible to participate.  CMS anticipates at least 100 nursing homes in each state will participate in the program.

Nursing homes who elect to participate in the program will receive points based on: staffing levels, avoidable hospitalizations, resident outcomes, and deficiencies identified during inspections. Facilities that receive the highest number of points and demonstrate the most improvement will receive payments.

CMS hopes the costs associated with implementing the program will be offset by reduced payments related avoidable hospitalizations and other cost reduction measures associated with improved performance. 

Read more about this new program intended to help improve nursing home care here.

Related Nursing Homes Abuse Blog Posts:

Does Pulling Medicare Funding From Underperforming Nursing Homes Help Residents?

Medicare No Longer To Pay For 'Reasonably Prevenatable' Medical Errors

Even The Worst Nursing Homes Can Turn It Around

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If you haven't been to Joliet's Sunny Hill Nursing Home lately, you may not recognize the facility. Physical and cultural changes are being made to the nursing home owned by Will County with the hope of providing a more comfortable, home-like environment for the residents.

The Chicago Tribune reports that the 40-year-old facility is joining the national trend of re-shaping the way nursing homes operate by taking into account resident preferences.  Sunny Hill is revamping the way it provides care to its residents.  Flexible schedules allow residents to wake-up, eat, bathe and exercise according to the individuals time schedule as opposed to uniformly ordering all residents to do the same thing at the same time. 

"This really is a no brainer, but I think the fear of the unknown had long kept nursing home from evolving this way," said Karen Isberg Sorbero, the Chief Administrator at Sunny Hill.  "This represents a whole new philosophy about how to care for some of the most vulnerable in our society," Sorbero added.

Changing the way nursing care is provided is not always easy.  According to Nancy Flowers, an Evanston nurse and past president of the Illinois Association of Long Term Care Ombudsman, "We're talking about more staff involvement and that creates a lot of pressure on nurses and orderlies if there isn't a complete buy-in to the philosophy from the top down."

To help bridge the gap to the new way of operation, Sunny Hill has assigned one nurse to care for a group of residents compared with the old way of rotating multiple nurses to care for the same resident.  

The other part of the change at Sunny Hill consists of a renovation of the facility--changing the way the facility looks and how care is provided.  The capacity of the facility has been reduced by almost 70 beds to allow for a more spacious atmosphere.  New social meeting areas where residents can meet, private areas for families of residents and enlarged hallways and bathrooms are part just part of the changes at Sunny Hill that make it a more enjoyable place to live.

"Big rambling nursing homes are just about a thing of the past.  They're not very personalized, and you can't have the type of individual care that these changes will allow.  This is the way of the future," according to Becky Haldorson, Sunny Hill's assistant administrator.

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Bloomberg reported that more than 90 percent of U.S. nursing homes in each of the past three years were cited for violating federal standards, according to a government report.  The article substantiates that many nursing homes are simply not doing an adequate job caring for our nations elderly population.  According to the inspector general's report for the Department of Health and Human Services:

• For-profit facilities had a higher percentage of violations than other nursing homes-94% of for-profit nursing homes surveyed were cited for deficiencies, compared to 88% of not-for- profit and 91% of government nursing homes
• The most common violations related to improper storage and distribution of food, accident hazards and lack of services necessary for residents' mental and physical well-being

• The rate of violations differed by state, with every nursing facility surveyed in Alaska, the District of Columbia, Wyoming and Idaho reporting citations compared with a low of 76% in Rhode Island.

There are 1.5 million people living in 16,000 nursing homes in the United States.  The facilities are reliant on government payments for the vast majority of their operating budget.  In order for the facilities to be reimbursed by Medicare and Medicaid, the nursing homes must be certified as meeting certain federal standards.

According to Susan Feeney, a spokeswoman for the American Health Care Association, a Washington advocacy group for 9,000 nursing homes, nursing home inspections are too subjective.  ``We're looking to work with Congress and the administration to implement a process that's less subjective and has incentives for quality improvement,'' Feeney said.

Federal and state regulation of nursing homes provides essential guidelines for the safety and well-being of nursing home residents.  In order to provide the safest environment for nursing home residents, all aspects of the facilities need to be properly monitored.  Any efforts on the part of the nursing home industry to relax or eliminate the standards should be considered self-serving.

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