Hearing of the Senate Special Committee on Aging - Nursing Home Transparency and Improvement

Interview

SEN. LARRY E. CRAIG (R-ID): Mr. Chairman, thank you very much, and a special thanks to you and our ranking member Senator Smith. Before Senator Grassley left the room there were either four former or currently serving chairmen, and I think once you've served on this committee a time, your passion for its mission never leaves you because we've always viewed our aging community as one of our more vulnerable communities, and thank you for the work you're doing and for the work Senator Smith has done.

The challenge of nursing home improvement is a prime example of aging committee's importance of putting a spotlight on issues that are of vital significance to our senior population and their families.

This committee also plays a valuable role in crafting solutions to challenges facing our aging population. During my tenure as chairman of this committee, I spent some time examining long-term care and issues relating to the well being of our vulnerable seniors.

And while our aging population is moving more towards home and community-based services, as Senator Smith has mentioned, there still is going to be a need for nursing home care. I look forward to the hearing and to our witnesses today and to all of your comments.

Transparency is an important factor in ensuring that our nursing homes are safe places. It is important for families to have the necessary background information when choosing a nursing home. Most people are not going to choose a poor performing facility for their loved ones.

So making inspection information readily available to the public is also a great incentive for nursing homes to meet their standards. Unfortunately, like all good ideas, the devil is in the details.

CMS' Nursing Home Compare is a great step for those who want more information about nursing homes; however, more can be done to make information on the website easier to understand so that families know what the deficiencies that are -- a facility receives actually mean. And how this actually impacts a senior in these facilities.

Families who are looking for a nursing home are often overwhelmed by this tremendous lifestyle change that is about to hit their family, and they do not have the time to become the expert in nursing oversight and inspection.

I also want to stress the importance of information on Nursing Home Compare being kept as up-to-date as possible. It is unfair to both the nursing home providers and seniors where only outdated information about the problem at the particular facility is available online.

With that said, I look forward to our hearing today, Mr. Chairman, it is an important one, as legislation moves forward on this issue. And I thank you.

BREAK IN TRANSCRIPT

SEN. CRAIG: Mr. Chairman, again, thank you.

Mr. Weems, thank you for being with us, your testimony is appreciated. In my opening comments, I talked about information and its value. How much of the information on Nursing Home Compare is -- I should say much of it is vague about what deficiencies actually mean for the patient. At least, that is certainly my interpretation of it.

Are there any initiatives underway to make the language easier for the average individual to read and actually understand what the practical effects of the information are on the patient?

MR. WEEMS: The website itself has been run through several focus groups to make sure that that information is more understandable. We work with focus groups to continue to improve, to try and make it as understandable as possible.

There is a lot of information on the website, and for each quality indicator that is given there is an explanation of what that means. We do strive to make it as user friendly as possible.

SEN. CRAIG: Do you have any idea how many people utilize Nursing Home Compare?

MR. WEEMS: Senator, we measure it in page reads, and last year we had about 12 million page reads, which is a significant number. Actually up until the Part D program it was our most visited website.

SEN. CRAIG: Good. What kind of outreach have you done or are you continuing to do as it relates to making more people aware of Nursing Home Compare?

MR. WEEMS: Well, we work with a number of partners at the local level to -- as somebody is being potentially moved into a nursing home so that they know that that potential exists.

We push it at the, you know, through our national site and there are also education efforts that go with physicians and discharge nurses who can help in education on this.

SEN. CRAIG: In your testimony, you talked about improvements in a nursing home in South Carolina that was about to be shut down.

Could some of these tough measures that were implemented in that situation, such as a root cause analysis, of the problem at the facility have been tried earlier in the process when the facility was failing?

MR. WEEMS: Senator, the method that we take with the special focus facility is progressive enforcement. So when they first enter we begin with some enforcement efforts, those enforcement efforts get more progressive as the facility fails to improve.

This last chance systems change that we announced really is sort of the end of the road. Even though the facility is going to improve or they are going to be terminated.

The thing about the special focus facilities and the sort of last chance, it is just highly resource intensive. So working out individual agreements with the nursing home, the way that one was worked out, is very, very resource intensive. So we try and spread our resources through progressive enforcement.

SEN. CRAIG: Thank you very much, Mr. Chairman.

BREAK IN TRANSCRIPT

Source