Frequently Asked Questions
How does Rochester Regional Health assure quality care at its skilled nursing homes?
- We select qualified care delivery staff
- Although not yet required by the Centers for Medicare and Medicaid Services (CMS), we perform criminal background checks
- We provide orientation and ongoing education to our staff
- We take an integrative approach to skilled nursing care, and follow a comprehensive care plan that's developed to meet every resident's unique, individual needs
- We monitor quality indicators on a weekly and monthly basis to look for trends in either direction
- We act on our results by changing methods of how care is delivered
- We proactively seek ways to improve care
- We use best practices where established
- We have consistent medical direction and input
- We learn from our State and Federal surveys
- We listen to what our residents and their families are telling us
- We assign each resident his/her own aide to build a special bond between residents and staff
What is the Nursing Home Quality Initiative?
It's an endeavor by the federal Centers for Medicare and Medicaid Services (CMS) to improve the quality of health care for all Americans and provide information to consumers that will allow them to compare nursing homes locally and across the country. Unity Health supports this endeavor, and continuously strives to provide the best possible health care.
How is CMS comparing nursing homes to one another?
Nursing home are being compared to state and national percentages of patients reported with the following:
- Physical restraints used daily
- Unexpected loss of function in some basic daily activities
- Pressure sores
- Short-stay residents with delirium
- Short-stay residents with pain
- Short-stay residents with improvement in walking
How and when did CMS gather this information about your nursing home?
CMS gathers information about nursing homes from a nationally standardized assessment form called the Minimum Data Set (MDS). We fill out and submit this form to CMS for each of our residents on a regular basis.
How often do you submit the MDS forms to CMS?
For long-term residents, regulations require that a form is completed:
- on the 14th day after admission
- on a quarterly basis
- whenever the resident experiences a significant change in his/her condition
For short-term residents covered by Medicare, the MDS is completed:
- on the 5th, 14th, 30th, 60th and 90th days of stay
When consumers look at the CMS web site and ads, they'll find that Unity Health's three nursing homes look pretty good in some areas compared to the national and state averages, while other areas look pretty bad. If someone is looking for a nursing home for a loved one, shouldn't they select a facility with all "good" ratings?
Research shows that a facility's rating on the various indicators is not consistently "good" or "bad," but is typically mixed. Therefore, it is difficult to draw a conclusion about overall facility quality based on the numbers shown for each of the individual indicators.
What does the information tell us about Rochester Regional Health's nursing homes and why is this information important?
You will find that Rochester Regional Health's nursing homes are consistent with, or better than other nursing homes on some quality indicators and not as good as the state average on others. Disparities occur based on the frailness of the population we serve. The CMS data is best evaluated over time.
Are the CMS measures "risk-adjusted" and does that assure they are valid indicators of your facility's quality?
Some homes may have higher percentages of residents with certain conditions because of the types of medical conditions they specialize in caring for. Some adjustments are made to take into account risk factors for certain conditions of individual residents, but consumers should ask facilities to explain these differences.
Our nursing homes each have their own specialty.
It looks like there are some quality problems in your nursing home. What are you doing to remedy them? What does the federal government require you to do?
Rochester Regional Health's nursing homes are committed to doing everything possible to ensure the highest quality of care for residents. To try to predict who is at-risk, for injuries and medical complications before they happen, we are participating in a three-year research study with the New York Association of Homes and Services for the Aging (NYAHSA) to try to address potential problems before they occur.
Also, nursing homes that receive federal and state funds must meet standards developed by CMS and pass annual inspections. If an inspection finds that a nursing home is not in compliance, it must be corrected.
It looks like some nursing homes have some very serious quality problems. Shouldn't these facilities be shut down?
If an inspection identifies problems that are serious and threatening to the health and safety of residents, and the nursing home fails to correct the problems, the home may be banned from participating in Medicare and Medicaid. Or, other enforcement methods may be used to bring about compliance, such as monetary fines, bans on new admissions, or transfer of residents.
Based on what we see in this report, should people be afraid to place their loved ones in a nursing home?
The data should be viewed as one tool to use in making decisions about nursing homes. Numbers alone cannot convey all there is to know about the quality of a nursing home. Consumers should use the reported quality measures as a springboard for asking questions. There may be a legitimate reason why a facility appears to have a higher or lower than average rate of a particular measure that does not signal poor or excellent quality. Facilities that specialize in treating and healing pressure sores, for example, may appear to have a "worse" score than other facilities. Consumers should ask nursing home staff about any numbers that concern them.
It's also important to understand that even the best homes may have isolated problems from time to time due to the frailty of residents. What counts most? The nature, degree and duration of the problem and how the facility responds to correct it to ensure they do not recur. If family members have questions and concerns they should ask nursing home administrative staff for an explanation.
What should consumers look for to assess the overall quality of nursing home care?
- Services and specialties that match the needs of your loved one
- Recommendations from doctors, social workers and family members of residents
- Warm, friendly, and respectful interactions among staff, residents, and family members
- Respected and knowledgeable facility leadership, medical direction, and board members
- An inviting and homelike environment
- Visit frequently after placement, drop by at various times
- Express your concerns and needs to the staff
- Ask questions