WBB's Thought Leadership

Proposed Rule Requires Hospitals to Share Quality Data on Nursing Homes

December 6

A Medicare rule drafted in October 2015 would require hospitals to assist patients in selecting post-acute care providers by sharing relevant quality data.

The rule would apply to patients selecting nursing homes as well as other post-acute care at home or care at other health facilities. The timing for finalizing the rule is unknown, and its fate in the next administration is uncertain.

Excerpt: “Hospitals have long been reluctant to share with patients their assessments of which nursing homes are best because of a Medicare requirement that patients' choices can't be restricted.

“For years, many hospitals simply have given patients a list of all the skilled nursing facilities near where they live and told them which ones have room for a new patient. Patients have rarely been told which homes have poor quality ratings from Medicare or a history of public health violations, according to researchers and patient advocates.

“’Hospitals are not sure enough that it would be seen as appropriate and so they don't want to take the chance that some surveyor will come around to cite them’ for violating Medicare's rules, said Nancy Foster, vice president for quality and patient safety at the American Hospital Association.

“As a result, patients can unknowingly end up in a nursing home where they suffer bed sores, infections, insufficient staffing or other types of substandard care.

“But hospitals' tight-lipped approach to sharing quality information may soon be changed. The Obama administration is rewriting those rules, not just for patients going to nursing homes but also those headed home or to another type of health facility.

“Hospitals will still have to provide patients with all nearby options, but the new rule says hospitals "must assist the patients, their families, or the patient's representative in selecting a post-acute care provider by using and sharing data" about quality that is relevant to a particular patient's needs for recovery. The rule was drafted in October 2015.

“The administration hasn't said when it will be finalized. Should it not be enacted before the end of President Obama's term, its fate becomes uncertain. President-elect Donald Trump has pledged not to approve new regulations unless two existing ones are eliminated.”

Source: NPR

WBB Take: The increased visibility and attention to quality proposed in the new rule will enable consumers to make informed choices regarding quality of care at nursing homes. The rule builds on existing initiatives that focus on measuring and improving quality at healthcare facilities. Under section 6102(c) of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) launched the Quality Assurance and Process Improvement (QAPI) initiative to measure quality in nursing homes, to reduce adverse events, and to increase consumer engagement.

Jerry Stefanko

Jerry Stefanko



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