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The six-state pilot project -- involving nursing homes serving Medicare and Medicaid beneficiaries in Colorado, Florida, Maryland, Ohio, Rhode Island and Washington -- is part of HHS' Nursing Home Quality Initiative to further improve the quality of care received by the 2.9 million Americans who live in nursing homes nationwide.

"A key step towards improving quality is getting consumers the information they need to make informed health care choices," said Secretary Thompson. "Later this year, we will begin reporting quality measures for nursing homes nationwide. By generating and publishing quality data, we are both helping consumers to make decisions that best meet their needs and creating market incentives for nursing homes to further improve quality."

Tomorrow, HHS' Centers for Medicare & Medicaid Services (CMS) will publish advertisements in 30 newspapers in the six states that include some of the quality data. The complete quality data, along with other information about individual nursing homes, are available at Medicare's consumer Web site, www.medicare.gov, and through Medicare's help line, 1-800-MEDICARE (1-800-633-4227).

HHS' Nursing Home Quality Initiative is a three-pronged effort:

• CMS' continuing regulatory and enforcement efforts conducted by state survey agencies;
• new and better consumer information on the quality of care in nursing homes; and
• new community-based, quality improvement programs offered to nursing homes by Medicare's Quality Improvement Organizations (QIOs).

"Improving the quality of care available in nursing homes is one of our top goals, and we are all in this together -- residents, families, homes, nurses, employees and patient advocates," CMS Administrator Tom Scully said. "Our first step is this pilot program for nursing homes. Next year we plan to expand our public education efforts to other health care providers."

The data for the pilot project involves nine measures of nursing home quality that were recommended by a broad-based steering committee of the National Quality Forum, an independent standard-setting organization representing public and private purchasers, consumers, providers and researchers.

The nine measures are designed to allow consumers and nursing homes to make an "apples-to-apples" comparison. The data have been risk-adjusted to take into account differences in certain health care needs of individual residents, allowing for a fairer comparison of nursing home performance. The measures indicate actions that nursing homes can take to improve care.

The quality measures fall into two categories -- six for chronic care patients (long-term stay residents) and three for post-acute care patients (short-term patients).

The measures for chronic care patients are:

• percentage of residents who need more help from staff doing daily activities,
• percentage of residents who have certain types of infection in the nursing home,
• percentage of residents who have lost too much weight,
• percentage of residents with very bad pain at any time or moderate pain every day over the last seven days,
• percentage of residents in the nursing home who are reported to have one or more bed sores, and
• percentage of residents in the nursing home who are in physical restraints daily.

The measures for post-acute care patients are:

• percentage of short-stay residents who have symptoms of delirium,
• percentage of short stay residents with very bad pain at any time or moderate pain every day over the last seven days, and
• percentage of short stay residents whose walking has improved

As part of the initiative, Medicare's Quality Improvement Organizations (QIOs) will work with local nursing homes to improve quality of care. The QIOs are CMS contractors that perform these types of quality improvement initiatives. In the past, they have worked successfully with hospitals, physician offices, and, in some cases, nursing homes to improve quality. The QIOs will work closely with individual nursing homes to understand their environment and processes to develop effective systemic changes that will improve quality of care.

In addition, state and local long-term care ombudsmen will use the new data, along with other information and personal visits, to assist families in making informed decisions about placement in nursing homes. The ombudsmen are primarily volunteers who help nursing-home residents and their families on a daily basis and are trained and funded through HHS' Administration on Aging.

"Over the next few months of the pilot we'll be testing and tweaking the information to make sure that it is truly useful to consumers and helpful to the nursing homes in their efforts to improve the care they are providing to their residents," Scully said. "This is one of many tools, including visiting the nursing home and the other data on CMS' Web site, that consumers should use to help pick a home for a family member."

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