For several years families looking for nursing home care for a loved one have relied on Medicare’s Nursing Home Compare website. This site provides quality ratings for more than 15,000 facilities nationwide, awarding grades of one to five stars in three evaluation categories – health inspections, staffing levels, and clinical data – plus an “Overall” rating. The system isn’t perfect, but it does help people make side by side comparison of multiple nursing homes quickly and easily. The system is also not without controversy: last week here on the AgingOptions blog we told readers that a chronic shortage of nurses has caused the Centers for Medicare and Medicaid Services to downgrade the rating of more than 1,600 homes. (You can read that story by clicking here.) But it’s the best system around, for now.
Short-Stay Rehab Facilities are Finally Being Rated
There’s one big drawback to Nursing Home Compare: there’s no data available for people in need of short-term rehabilitative care. At least, that used to be the case – until recently. We discovered this just-published article on the Kaiser Health News website revealing some good news for short-stay patients and their families: “For the first time,” says Kaiser’s Judith Graham, “the federal government is shining a spotlight on the quality of rehabilitation care at nursing homes — services used by nearly 2 million older adults each year. Medicare’s Nursing Home Compare website now includes a ‘star rating’ (a composite measure of quality) for rehab services.” These services, typically paid for by Medicare for stays of no longer than 100 days, can include skilled nursing care, physical therapy, and occupational or speech rehabilitation for people recovering from hospitalization. Some 13,800 short-stay rehab facilities are now included in the ratings.
According to Kaiser, the addition of ratings data for short-stay rehab patients has been welcomed by health care experts and by the nursing home industry as a tool to help seniors make better decisions about where to seek post-hospitalization care. “This matters,” says Judith Graham, “because high-quality care can help older adults regain the ability to live independently, while low-quality care can compromise seniors’ recovery.” One Harvard University health care expert noted that previous ratings haven’t distinguished between these two groups of nursing home residents – short-term rehab patients and long-term residents – even though their needs are quite different. “Temporary residents are trying to regain the ability to care for themselves and return home as soon as possible, he noted. By contrast, permanent residents aren’t expecting improvements: their goal is to maintain the best quality of life.”
Short-Stay Rehab Ratings are Valuable – but They Can Be Hard to Find
We tried locating the new ratings for rehab facilities, and after a few tries we found them – but at first it wasn’t easy. The process starts with a visit to the Nursing Home Compare website. Once you enter your zip code or city, you’ll see a list of all the rated facilities in your area. The system allows you to compare three facilities at a time, so once you’ve made your selection, hit the “compare now” button at the top. When you do, you’ll see a new page with six tabs: General Information, Health inspections, Fire safety inspections, Staffing, Quality of resident care, and Penalties. The one you want to select is the Quality of resident care tab. On the left, below the overall quality rating for each facility, you’ll see a short-stay quality rating and a long-stay quality rating.
But the new system offers far more than an overall rating of one to five stars, even though – once again – you have to search a bit to locate the rest of the story. If you click on the words “Short-stay residents” you’ll see 13 specific measures of the quality of rehab care. This allows patients to drill down into details of each facilities’ performance: for example, how many short-term residents were subsequently re-hospitalized, how many developed pressure ulcers, how many experienced falls during their stay, how many were prescribed antipsychotic drugs, and so on. This new addition to Nursing Home Compare provides a treasure trove of data to help families make an otherwise difficult decision – which short-term rehab facility will offer the best care – significantly easier.
Short-Stay Rehab Should Lead to Long-Term Recovery
Published ratings are helpful, but we caution you that they don’t tell the whole story. Many times loved ones have to make a quick decision, selecting a rehab facility with too little time and insufficient information ((we wrote about the problem on the AgingOptions blog last month.) If you can, visit a few facilities and ask these questions:
- What are my needs going to be during the post-hospital period?
- What kind of help will be needed, and for approximately how long?
- What is my anticipated recovery, and what do you think the most difficult parts of it might be?
- How will the facility meet my needs, specifically?
- What kind of medical care and therapy will I get there? From whom and how often?
A big key is to get information early. One doctor told Kaiser that patients and families should insist on seeing a discharge planner soon after entering the hospital and start the planning process long before discharge date. His advice: tell the discharge planner, “I don’t care about choices: Tell me, what do you think will be best for me.” Be insistent.
When it Comes to Retirement, Think Long Term
Planning for your future as you age involves preparing for decisions like this, and that means good, honest communication with your loved ones and careful preparation to ensure you receive the type of medical care you need. These two elements – family and medical – combined with a solid financial plan, a carefully-crafted legal strategy, and a well thought out approach to your housing needs, make up the key components of an AgingOptions LifePlan, the most comprehensive type of retirement plan we know of. We hope you’ll accept our invitation to spend a few hours and join Rajiv Nagaich soon at a free LifePlanning Seminar near you. It could be the most important and most eye-opening experience you’ll have as you prepare for the retirement you’ve always dreamed about.
You’ll find a calendar of presently scheduled seminars here on our Live Events page, where you can register for the date and time of your choice. Don’t face the future unprepared! You can look ahead with confidence, thanks to the power of an AgingOptions LifePlan. Age on!
(originally reported at www.khn.org)