WASHINGTON - U.S. Senate Special Committee on Aging Chairman Herb Kohl (D-WI) released a statement today as the Centers for Medicare & Medicaid Services (CMS) launched their new ranking system for America's nursing homes, which gives each facility a "star" rating. CMS Acting Administrator Kerry Weems announced the creation of the rating system in June, allowing six months for the public, consumer groups, nursing homes, and many others to submit comments and suggestions on the system designed to provide patients and their families an easy to understand assessment of nursing home quality. The ratings will be published on the federal government's website, Nursing Home Compare.
Senator Kohl's statement follows, along with a comment from Administrator Weems and a summary of the Grassley-Kohl Nursing Home Transparency and Improvement Act of 2008:
Statement from Special Committee on Aging Chairman Herb Kohl (D-WI)
"When it comes to nursing home quality and transparency, I firmly believe two things. First, that Americans should have access to as much information about a nursing home as possible. This information should include the results of independent safety inspections; the health status of residents, which is closely tied to the quality of services provided; the number of direct care staff responsible for providing hands-on care; and basic information about a home's management and ownership. Second, I believe that the federal government has a responsibility to ensure that consumers can readily obtain this information in a clear manner, so that it can be used to help in making the best possible decision about which home is right for their loved one.
"CMS meets the first obligation fairly well, posting much of this data on the government's website Nursing Home Compare. And with the implementation today of their five-star rating system for nursing homes, they are getting closer to meeting the second.
"Transparency is the key to nursing home quality. When Nursing Home Compare succeeds in delivering comprehensible and reliable information on nursing homes nationwide, I believe that the power of public opinion will motivate facility owners, managers, and staff to provide the best possible care and meet the kind of standards they would be proud to see posted online. As the 111 th Congress gets underway, Senators Chuck Grassley (R-IA) and Ron Wyden (D-OR) will join me in working to bolster this type of transparency through the Nursing Home Transparency and Improvement Act, which AARP has called "one of the most significant nursing home reform initiatives" in two decades. Americans seeking care in any health care or long-term care facility deserve to know that the care they expect is going to be provided.
"We can make that happen by ensuring that the information on Nursing Home Compare is based on credible, auditable data. As this five-star rating system is implemented and improved upon, I trust that CMS will strive to make these nursing home rankings as accurate and timely as possible. I have recommended that CMS make it a priority to compare the inspection records of long-term care facilities within states. I have also urged the agency to rapidly move toward using a payroll-based system for reporting staffing levels, as opposed to the flawed self-reporting mechanism currently in place.
"Finally, I agree with Administrator Weems that it is critical that families understand that the very best way to choose a nursing home is to visit it - more than once, with and without an appointment. Invaluable information can be gleaned by simply speaking with residents, their family members, administrators, and the state long-term care ombudsman's office.
"The need for a rating system of this kind was discussed at an Aging Committee hearing last November, at which Administrator Weems testified. I would be remiss if I did not thank him again for coming before the Committee with an open mind, ready to exchange ideas. I commend Administrator Weems today and, as always, appreciate the opportunity to work together to improve our nation's nursing homes." 
Statement from CMS Acting Administrator Kerry Weems
 "Our goal in developing this unprecedented quality rating system is to provide families a straightforward assessment of nursing home quality, with meaningful distinctions between high and low performing homes. The new information will also help consumers and families identify important questions to ask nursing homes and challenge nursing homes to improve their quality of care. I especially want to thank Chairman Kohl for his leadership and actions to help improve the care that millions of nursing home residents - and their family members - rely on for their well-being."
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 homes in the Special Focus Facility program, and links to inspection reports 
  • Provides more transparency on a nursing home's expenditures by requiring more detail about staffing expenditures 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 payroll-based nurse staffing information so that apples-to-apples comparisons can be made across nursing homes
Strengthens Enforcement
  • Equips the Secretary with tools to address corporate-level quality 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 best practices for the appointment of temporary management for nursing homes
  • 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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