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 Quality Report Shows Improvements In Nine Of 10 Measures since 2009

 

 

​Skilled nursing and post-acute care facilities have improved in nine out of 10 quality measures since 2009, but there is concern these successes will be threatened by reimbursement reductions in the Medicare and Medicaid programs, according to the latest quality report issued by the American Health Care Association (AHCA) and the Alliance for Quality Nursing Home Care.

Nursing facilities have improved in all short-stay measures, which include patient delirium, pain, and pressure ulcers and a vast majority of long-stay measures, including improvements in activities of daily living, high-risk pressure ulcers, resident mobility, and pain. “This report is one way we demonstrate our commitment to quality improvement and increased transparency in the facility assessment process,” said Gov. Mark Parkinson, AHCA president and chief executive officer.

“This report also calls attention to key issues that our provider community sees as priorities in ensuring we can continue to build upon the improvements we have made.”

The third annual report from  AHCA and the Alliance used data from the Centers for Medicare & Medicaid Services (CMS) to generate its findings.

Alan Rosenbloom, president of the alliance, noted that progress on the quality front is at risk from the continuing pressure on Medicaid reimbursement at the state level and even more notably the sharp reductions CMS approved for fiscal year 2012 that kicked in Oct. 1.

“There is good reason for concern that a lot of progress on quality is in jeopardy,” he said,  noting that when all is said and done, the Medicare reductions could amount to 15 percent for fiscal 2012, reminding him of the situation the industry faced in 1997 when the Balanced Budget Act was passed.
“Patients were most affected” by the cuts then, Rosenbloom said, with facilities having to trim staff in order to make ends meet.

As for the report, there were calls to alter CMS quality measures to better reflect the modern-day nursing facility role.

“Nursing facilities have seen a dramatic shift in patients requiring short-term therapy services intended to restore function so that patients can ultimately return to an independent living situation,” the report said.

Expert contributors to the report said current quality measures do not reflect this shift and do not allow for proper measurement of rehabilitation services for short-stay Medicare patients.

“Post-acute care has gravitated to a system of multiple transfers to different levels of care,” said Andrew Kramer, MD, of Paradigm Health and professor of medicine at the University of Colorado. “With this evolution, it is critical that measures of rehabilitation quality follow patients across these transitions over fixed time intervals rather than during individual stays.”

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