SENATOR KOHL JOINS CMS IN ANNOUNCING 5-STAR RATING SYSTEM FOR AMERICA'S NURSING HOMES
WASHINGTON - U.S. Senate Special Committee on Aging Chairman Herb Kohl (D-WI) today joined the Centers for Medicare & Medicaid Services (CMS) Acting Administrator Kerry Weems in a press teleconference to launch a ranking system for America's nursing homes, giving each a "star" rating. CMS is requesting comments on the system designed to provide patients and their families an easy to understand assessment of nursing home quality, making meaningful distinctions between high-performing and low-performing homes. The ratings will be published on the federal government's website,
Nursing Home Compare, by December 2008. During the summer and fall of 2008, the agency is soliciting ideas, comments, and suggestions from the public, consumer groups, nursing homes, and many others.
Senator Kohl's prepared remarks for the call follow, along with a summary of the Grassley-Kohl Nursing Home Transparency and Improvement Act of 2008:
Senator Kohl's Prepared Remarks for the Press
CMS' Announcement of Five-Star Rating System for Nursing Homes
June 18, 2008
Good afternoon. First I'd like to thank Acting Administrator Weems for inviting me to join today's call. A few months ago, I participated in a similar call on the Special Focus Facility program, which identifies and focuses government attention on some of the most troubled nursing homes. Administrator Weems took a bold step in making public the list of program participants, one that I supported wholeheartedly.
The creation of a new CMS five-star rating system for nursing homes is another welcome announcement. This rating system will do two very important things. First, it will distill quality measures into a format that is easy for American consumers to understand. This is a vital improvement. Currently, the government's website on nursing home quality,
Nursing Home Compare, is chock full of information. But making this information available to consumers is useless if we do not ensure that they can make sense of it.
Second, this rating system will identify those homes who are truly offering the best care to those who need it. It is my belief that many nursing homes in America offer exemplary care, and I'm pleased that this rating system will highlight them. As I understand it, the rating system will combine three sources: inspection data, staffing data, and a selection of the most critical quality measures. Some of this information is self-reported, and could be made more reliable, but we are moving in the right direction.
Administrator Weems and I agree that transparency is the key to nursing home quality. In February, Senator Grassley and I introduced the Nursing Home Transparency and Improvement Act, which AARP has called "one of the most significant nursing home reform initiatives" in two decades. We want Americans to have access to the type of information that matters on
Nursing Home Compare, such as the number of hours of care their loved one will receive from staff every day. We also want the website to link to state inspection results, and to allow consumers to lodge complaints of mistreatment or neglect. These are simple, effective ideas, and I hope that we can work together with CMS to incorporate these new measures into the five-star system.
I'd like to thank Administrator Weems once again for inviting me to participate in this call. I'd also like to commend him for ensuring that our working relationship is partnership. Administrator Weems, it is clear from today's announcement that when you testified before our Committee in November, you took the opportunity to not only share your expertise, but to also listen. A big thanks, as well, to the reporters participating in today's call.
Nursing Home Transparency and Improvement Act of 2008
Increases Transparency About Nursing Home Ownership and Operations
- Enables the residents and the government to know who actually owns the nursing home
- Strengthens accountability requirements for individual facilities and nursing home chains including annual independent audits for nursing home chains
- Improves Nursing Home Compare by including a nursing home's ownership information, the identity of participants in the Special Focus Facility program, a standardized complaint form and links to nursing home inspection reports
- Provides more transparency on a nursing home's expenditures by requiring more detail in cost reporting
- Brings uniformity and structure to the nursing home complaint process by requiring a standardized complaint form and complaint resolution processes that includes complainant notification and response deadlines
- Provides for improved reporting of nurse staffing information so that apples-to-apples comparisons can be made across nursing homes
Strengthens Enforcement
- Strengthens available penalties by making them more meaningful.
- Instead of imposing civil money penalties (CMPs) up to $10,000, the Secretary would be able to impose a range of penalties of up to $100,000 for a deficiency resulting in death, $3,000-$25,000 for deficiencies at the level of actually harm or immediate jeopardy and not more than $3,000 for other deficiencies.
- The Secretary would be able to reduce CMPs for facilities that do not appeal CMPs and for self-reporting deficiencies below the immediate jeopardy level or the actual harm level if the harm is found to be a "pattern" or "widespread" or those resulting in death.
- Equips the Secretary with tools to address corporate-level problems in nursing home chains by giving the authority to develop a national independent monitor program specific to multistate and large intrastate nursing home chains
- Provides greater protection to residents of nursing homes that close by requiring advance notice of the closure as well as the development of a transfer and relocation plan of residents
- Requires a study on the role that financial issues play in poor-performing homes
- Requires a study on bests practices for the appointment of temporary management for nursing homes as well as barriers
- Requires a study on barriers to purchasing facilities with a record of poor care
- Authorizes demonstration projects for nursing home "culture change" and for improving resident care through health information technology
Improves Staff Training
- Improves staff training to include dementia management and abuse prevention training as part of pre-employment training
- Requires a study on increased training requirements either in content or hours for nurse aides and supervisory staff
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