Report praises
isle nursing homes

Improving isle facilities score
better than the national average

Hawaii is one of few states that scored better than the national average in most areas of care measured at nursing homes last year, the Mountain-Pacific Quality Health Foundation reports.

The state's 45 nursing homes showed big improvements in several categories from 2002 to 2004, according to the foundation, Medicare's Quality Improvement Organization in Hawaii.

Dee Dee Nelson, the foundation's Hawaii director, said the nursing homes have been working hard to improve their quality of care under the national Nursing Home Quality Initiative.

"And the recent data collected by the Centers for Medicare & Medicaid Services show that their efforts are paying off, benefiting Hawaii's taxpayers and nursing home residents," she said.

The nursing homes statewide have about 3,800 beds.

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Major improvements appeared in measurements of Hawaii nursing home residents with pain, dropping to 3 percent last year from 9 percent in 2002, and residents in physical restraints, down to 3 percent from 7.4 percent.

Nationally, percentages of nursing home residents with pain fell to 6.6 percent from 10.7 percent and those in physical restraints dropped to 7.5 percent from 9.7 percent.

Little change showed across the country in the percentage of residents with pressure sores. In Hawaii, the percentage dropped slightly, to 6 percent from 6.7 percent. Nationally, a slight increase occurred to 8.7 percent from 8.5 percent.

An area requiring more attention is the percentage of residents who lose control of their bowels or bladder -- 64 percent in Hawaii compared with the national average of 47 percent.

Other weak areas in Hawaii's nursing homes: The percentage of those who spend most of their time in bed or in a chair (5 percent in Hawaii, 4 percent nationally), and the percentage of those able to move around in their room (14 percent here and 12 percent nationally).

Bob Ogawa, Hawaii Long Term Care Association president, said he is "extremely pleased. ... We've always sincerely thought we provided outstanding care in Hawaii but certainly it's always nice to be able to have simple, understandable measures that verify that."

He said the collaborative effort is "very satisfying ... We have always tried to approach it and develop relationships with state and federal agencies from a perspective that, hey, 'Aren't we all trying to achieve the same thing, which is quality care.'"

The team includes the Long Term Care Association, the Mountain-Pacific Quality Health Foundation, Centers for Medicare & Medicaid Services and the state Office of Health Care Assurance. Ogawa said the areas in which Hawaii's nursing homes fell below national levels may be tied to a "significantly higher acuity" of nursing home residents here.

He said the Long Term Care Association's "Pono Project: Quality of Care, Quality of Life," which started last year, will study the data and look at ways to make greater improvements.

Terri Byers, Healthcare Association of Hawaii vice president, said the association is pleased that nursing home residents are receiving better care because of the partnerships between nursing homes, quality improvement organizations and others. "This promising quality improvement collaboration has only just begun."

The national Nursing Home Quality Initiative was launched in 2002 to improve quality of care in nursing homes, home health agencies and hospitals. Mountain-Pacific Quality Health Foundation has worked with the nursing homes on improvements.

More information about nursing homes and suggestions to help make health care decisions are available on www.medicare.gov. Click on "Compare Nursing Homes in Your Area." Those without Internet access may call 1-800-MEDICARE (1-800-633-4227).