SAN FRANCISCO, Dec. 22 /PRNewswire/ -- Lumetra, the Medicare Quality Improvement Organization (QIO) for California, announced today that new data released from the Centers for Medicare & Medicaid Services (CMS) indicate nursing homes in California have improved the quality of care they provide to residents based on several key measures.
Overall, in the two years since Medicare launched the Nursing Home Quality Initiative (NHQI) in November 2002, California has shown improvement in the three clinical areas the state chose to focus its quality improvement efforts upon: chronic pain, short-term pain, and pressure sores (bedsores).
Lumetra President and CEO Jo Ellen Hylind Ross said, “For more than two years, nursing homes have been working hard to improve the quality of care they deliver, and the recent data from Medicare show their efforts are paying off, benefiting California’s nursing home residents and taxpayers.” Ross adds, “We are especially proud of the nursing homes that have worked intensively with Lumetra because they’ve shown greater rates of improvement in these three areas than most nursing homes across the country.”
Improvements have led to better quality of life for nursing home residents in many ways. Working with Lumetra, many nursing homes saw their rates improve. For example:
-- Over a two-year period (June 2002-June 2004), Venturan Convalescent Center, Ventura, dramatically decreased the percentage of residents who had pressure sores from 10% to 0%. Specifically, the team at Venturan improved their pressure sore prevention program by adopting a valid pressure sore assessment tool (Braden scale) and repeating pressure sore risk assessment on days three, five, and fourteen after admission. As a result of comprehensive changes in the system of care delivery that staff learned while working with Lumetra, during that same timeframe, reports showed residents also free from chronic pain and restraints.
Baseline data of more than 1350 California nursing homes were taken from the measurement period ending June 30, 2002. In comparison, the most recent data available through the measurement period ending June 30, 2004 show significant improvements for California nursing homes in the following areas assessed by CMS:
-- California’s pain measure related to long-term residents has also steadily improved in the past two years. Those nursing homes that worked with Lumetra have shown a relative improvement rate of 53%, compared to the relative improvement rate for the state average of 39% and for the national rate of 38%. For example, in a 100-bed facility where 30 residents reported moderate to severe pain two years ago, only 14 residents would report experiencing similar pain today.
-- California’s pain measure related to short-term residents has steadily improved in the past two years. Those nursing homes that worked with Lumetra showed a relative improvement rate of 25%, which is more than double the relative improvement rate for the state average of 10% and for the national average of 11%.
-- California’s measure related to pressure sore management has also improved in the past two years, while the national average has not. Those nursing homes that worked with Lumetra have shown a relative rate of improvement of 7%, compared to the state’s average relative rate of improvement of 3%, and compared to the national average relative rate of regression of 2%.
“We commend the nursing homes for their success, and we thank our partners at the California Association of Homes and Services for the Aging (CAHSA), the California Healthcare Association, the California Association for Health Facilities, the Office of the State Long-Term Care Ombudsman, and at the state Department of Health Services, Licensing and Certification for their support of the Nursing Home Quality Initiative,” Ross said.
Lori Costa, CAHSA Regulatory and Clinical Consultant and member of Lumetra’s Nursing Home Advisory Group, commended the Initiative. Costa said, “The results of the Nursing Home Quality Initiative show what a successful partnership between nursing homes, government, trade associations, and QIOs like Lumetra can accomplish.” She added, “It is the first time in history the government, providers, and professional partners have collaborated to focus on quality, rather than on regulatory compliance. And the results show that a proactive approach is bringing about positive results.”
While California saw improvements in the three areas of focus, Lumetra’s Ross said there is much work ahead. “We recognize this is a great first step, and Lumetra is encouraged by results and knows California nursing homes can show further improvement.” Ross stated. “For example, California has a higher rate of physical restraint use compared to the rest of the nation,” she explained, " and although our state rates for this measure are improving, our rates are not yet acceptable.”
In the next three years, Lumetra will focus its nursing home quality improvement efforts on improving the rates of physical restraint use, pressure sores, and helping nursing homes achieve greater focus on patient-centered care.
Ross noted that more than 10% of the state’s 1,350 nursing homes volunteered to participate in Lumetra’s intensive, yearlong training program to provide better care to their residents. Intensive work includes hands-on training with quality experts, instruction in best practices, and sharing in- depth resources. Additionally, Lumetra reached more than 410 nursing homes and 1200 professionals by conducting a series of one-day workshops, teleconferences and other educational activities. Every California facility received educational materials from Lumetra and was invited to participate in the free training programs.
Medicare recently released a comprehensive plan to accelerate the pace of quality improvement in nursing homes around the country. One component of this plan is a more coordinated approach to linking the work of state survey agencies and QIOs. In California, Lumetra has been working with California’s Department of Health Services Licensing and Certification Program to develop ways to make each other more successful in their shared mission to improve nursing home quality.
The national Nursing Home Quality Initiative was launched in 2002 by CMS, an agency of the U.S. Department of Health and Human Services, to improve the quality of nursing home care across the nation. The program is part of a national Quality Initiative that also focuses on improving the quality of care delivered by home health agencies and hospitals.
Medicare posts information on 15 quality of care measures and valuable information about nursing homes by clicking on the “Compare Nursing Homes in Your Area” link on http://www.medicare.gov/. Seniors, caregivers, and others can find tips for making informed decisions about healthcare on the site. People without Internet access may call 1-800-MEDICARE (1-800-633-4227) for assistance.
Lumetra is the federally funded, non-profit organization charged with improving the quality of care received by California’s 4.1 million Medicare beneficiaries. Based in San Francisco, Lumetra works with providers, consumers, and purchasers to improve the quality, safety, and integrity of healthcare through review, analysis, information dissemination, and consultation. For more information please visit Lumetra on the Web at http://www.lumetra.com/.
Statement
Lori Costa, Regulatory and Clinical Consultant, California Association of Homes and Services for the Aging (CAHSA), member Lumetra’s Nursing Home Advisory Group.
“The results of the Nursing Home Quality Initiative show what a successful partnership between nursing homes, government, trade associations, and Quality Improvement Organizations like Lumetra can accomplish. It is the first time in history the government, providers, and professional partners have collaborated to focus on quality, rather than on regulatory compliance. And the results show that a proactive approach is bringing about positive results.
The regulatory compliance mode that the government has traditionally operated on hasn’t really improved quality that much. Once we focused on education, support services and technical assistance, and other services Lumetra provides, and partnered with the trade associations, we truly have seen quality improvement.”
Mary Jann, Director Developmental Programs and Regulatory Affairs, California Association of Health Facilities, member Lumetra’s Nursing Home Advisory Group.
“Our member facilities collaborating with Lumetra in the Nursing Home Quality Initiative are enthusiastic about the positive results they are seeing as they implement changes within their facilities. CAHF continues to support the efforts of Lumetra and we applaud its success in California.”
Lumetra
CONTACT: David Schneider of Lumetra, +1-415-677-2020, ordschneider@caqio.sdps.org; or Peter Bauer of Centers for Medicare & MedicaidServices (CMS), +1-415-744-3664, or peter.bauer@cms.hhs.gov
Web site: http://www.lumetra.com/
