Isle nursing care ranks
above national average

Residents can see how Hawaii
stacks up on an Internet site

8 measures of care

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By Helen Altonn
haltonn@starbulletin.com

Hawaii's nursing homes are above the national average on an overall basis, said Walter Long, quality projects manager, Mountain-Pacific Quality Health Foundation.

"We can't say how much," he said. "We don't have all the states' data, just a national number and Hawaii number."

The Centers for Medicare and Medicaid Services launched the national Nursing Home Quality Initiative yesterday to guide consumers and spur nursing facilities to remedy deficiencies.

Data for Medicare- and Medicaid-certified nursing facilities, not residential care homes, on three of eight measures were published today in 70 newspaper ads across the country under the heading: "We care about the quality of care in nursing homes."

The Mountain-Pacific Quality Health Foundation, based in Helena, Mont., with offices in Hawaii, Wyoming, and Guam, is a nonprofit, physician-sponsored organization funded by the Centers for Medicare & Medicaid Services.

Foundation director Dee Dee Nelson, announcing the initiative here yesterday, said the quality improvement organization is one of 52 nationally that will share $120 million over three years to work with the facilities on improvements.

Dr. Nathaniel Ching, foundation medical director said: "The goal of the initiative is simple: The best care for all nursing home residents in Hawaii."

Terri Byers, vice president of the Healthcare Association of Hawaii, which represents hospital-based nursing homes, and Bob Ogawa, president, Hawaii Long Term Care Association, representing private nursing homes, joined in support of the effort.

Residents can see how Hawaii's 45 nursing facilities stack up against eight quality measures on a Web site: www.medicare.gov/NHCompare/Home.asp or they can call at 1-800-MEDICARE. The Web site will be updated quarterly.

The facilities, running near capacity with 3,752 residents, are listed separately so consumers can compare their conditions.

A pilot project was conducted for six months on the eight quality care measures at nursing facilities in Colorado, Florida, Ohio, Maryland, Rhode Island and Washington state.

Mary Rydell, Pacific Area Representative, Centers for Medicare and Medicaid Services, emphasized that the data are just one tool to help evaluate nursing homes.

In some cases, the information may be skewed because of circumstances at the facility or the nature of the residents, she said.

For instance, the percentage of residents with pain -- one of the conditions measured -- will be higher for homes with rehab patients who may not be able to take pain medicine, she said. "It doesn't mean the care is poor."

People shopping for a nursing home should visit different facilities and talk to administrators, caregivers, residents and others who can answer their questions, she said.

They can also obtain information from state Long Term Care Ombudsman John McDermott at 586-0100, and Medicare Certification Officer Gerald Chung in the state Department of Health, 692-7420.

Chung said he believes Hawaii's nursing homes generally "are pretty good. We're going to get our share of complaints in all types of facilities ... but all facilities are willing to improve."

McDermott said the facilities "are doing a much better job than when I started 13 years ago in long term care. I think the surveyors have gotten much better in knowing what to look for, and that has helped as well."

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Nursing homes measured
against 8 conditions of care

Hawaii's average quality of care in nursing homes for eight conditions compared with the average across the United States:

>> Percentage of residents with loss of ability in basic daily tasks: Hawaii, 16 percent; U.S., 15 percent.

>> Percentage of residents with pressure sores: Hawaii, 7 percent; U.S., 8 percent. Percentage of residents with pressure sores with an additional level risk adjustment based on the facility's admitting pattern, Hawaii 7 percent; U.S., 9 percent.

>> Percentage of long-term residents with pain: Hawaii, 9 percent; U.S., 11 percent.

>> Percentage of short-stay residents with pain: Hawaii 22 percent; U.S. 25 percent.

>> Percentage of residents in physical restraints: Hawaii, 7 percent; U.S. 10 percent.

>> Percentage of residents with infections: Hawaii, 15 percent; U.S. average not available.

>> Percentage of short-stay residents with delirium: Hawaii and U.S. average, both 4 percent. Percentage of short-term residents with delirium with an additional level of risk adjustment: Hawaii, 3 percent; U.S. 4 percent.

>> Percentage of short-stay residents who walk as well or better than when they were admitted: Hawaii, 29 percent; U.S. 30 percent.