Sites detail gaffes at care facilities• Sarasota Herald Tribune
BY BARBARA PETERS SMITH
Two government websites designed to help consumers compare hospitals and nursing homes are now easier to navigate, making it simple to learn with the click of a mouse even details such as what residents at a given Sarasota nursing home might have eaten for breakfast.
“The tray ticket in front of the resident and the aide included the resident’s food preference for breakfast to be 2 fried eggs with cheese and a banana,” reads the latest inspection report for Tarpon Point Nursing and Rehabilitation Center. “Observation revealed the eggs without the cheese and no banana.”
Narratives like this — including much more alarming infractions of the multitude of government rules for nursing homes — have long been accessible on the website of the Florida Agency for Health Care Administration, if you knew where to look. But posting of the reports was unreliable. Now the inspection details, updated monthly, will be more readily visible on the federal site, Nursing Home Compare.
Making performance measures of nursing homes and hospitals more transparent is a big part of the federal government’s drive to raise quality while holding down unnecessary costs. Evidence from the past two years suggests that it’s working — as hospitals police themselves in advance of public exposure.
The two websites that display the data were upgraded and enhanced Thursday by the Centers for Medicare and Medicaid Services.
New information on the sites include levels of imaging tests that involved radiation at hospitals, and rates of antipsychotic drug dosing at nursing homes — both areas singled out for high incidences of overuse. But the big change is that the usability and feel of the sites are less clunky and, well, bureaucratic.
“We’ve taken out a lot of the narrative you used to see, making it easier to read and more appealing to look at,” said CMS deputy chief medical officer Shari Ling. There are new glossaries for medical terms, she added, because “with some of these terms it may not be immediately clear to patients what they mean or why they’re relevant.”
The nursing home site, with its star rating system and more narrow focus on quality, staffing and patient safety, is the more immediately useful of the two.
“My initial impression is that this is a solid improvement,” said Larry Polivka, a specialist in long-term care with the Claude Pepper Foundation in Tallahassee who reviewed the new site Thursday. “It’s moving in the right direction, and has been for some time. The information on use of anti-psychotic drugs is a real enhancement.”
While not the final word, Ling said, the site is “a screening tool that allows you to focus on a few nursing homes you want to know more about. It raises the questions we suggest the family ask about a nursing home.”
The measures on antipsychotic drug use were added, she said, to encourage facilities to try alternative therapies for improving behavioral health.
Antipsychotics can have severe side effects, and research has shown they are used too often to control residents’ behavior — when something as simple as using brighter lighting might help.
“We’re really trying to get at the notion of what is inappropriate,” Ling said. “Zero will clearly not be the right number, because with antipsychotic agents — like any other type of medication — there will be circumstances where patient or staff safety is concerned.”
The hospital site, with its welter of arcane data on Medicare cases, is less handy from a consumer standpoint, Ling acknowledged — although patients with certain health conditions can find information that is personally applicable. The site aims primarily to encourage hospitals to look critically look at their own standards, knowing the world is watching.
“We all know the adage: What gets measured gets done,” Ling said.