About 35,000 fewer nursing-home residents are kept in restraints on a daily basis — down 23 percent from two years ago — according to a federal report released yesterday...
WASHINGTON — About 35,000 fewer nursing-home residents are kept in restraints on a daily basis — down 23 percent from two years ago — according to a federal report released yesterday that also found fewer patients in pain.
The Bush administration, the nursing-home industry and patient advocates said the declines show the value of the administration’s 2-year-old program to tackle serious quality problems in many of the nation’s 16,400 nursing homes by requiring them to disclose data on care.
The information is posted to help consumers make better choices and to prompt the homes to improve their performance. It is available on the Medicare Web site, www.medicare.gov, or by calling 800-633-4227.
“When we made these measurements public, then people paid attention,” said John Rother, policy director for the 35 million-member seniors’ group AARP.
All the information is based on data the nursing homes must routinely collect from residents as part of their participation in the federal Medicare program.
About 1.6 million people live in nursing homes. During a year, an additional 3 million people have a temporary nursing-home stay, according to the report from the federal Centers for Medicare and Medicaid Services.
In the middle of 2002, 9.7 percent of nursing-home residents were restrained on any day. Two years later, the number was 7.5 percent.
Patients kept in restraints can become weak, lose their ability to go to the bathroom on their own and develop bed sores. Restraints should be used only when ordered by a doctor as part of a patient’s medical treatment, according to federal law.
Measurements of pain among long-term and short-term nursing-home patients also improved, dropping 38 percent and 11 percent, respectively.
The report showed a slight increase, 2 percent, in the percentage of patients with bed sores. But among a select group of homes that focused on the problem, there was an 8 percent decline in the percentage of residents with the painful sores, which can lead to serious infection and can indicate neglect.
Dr. Mark McClellan, the Medicare and Medicaid administrator, cited examples of homes in which residents are not restrained and few have bed sores. The 150-bed Eliza Jennings Home in Cleveland, which does not restrain patients as a matter of policy, showed an 84 percent drop in sores, he said.
“It matters which nursing home you choose,” McClellan said.
The program started with 10 measures and has increased to 15. New entries include staffing levels and weight loss among long-term residents.
The government also is starting a trial program in seven states to conduct background checks on all prospective employees of long-term-care facilities who will have direct contact with patients. The states are: Alabama, Idaho, Michigan, Nevada, New Mexico, South Carolina and Wisconsin
Despite recent industry improvements, congressional investigators in 2003 found that many nursing homes have serious quality problems. The General Accounting Office, since renamed the Government Accountability Office, also said state inspectors are failing to catch a large number of the problems.
About 3,500 nursing homes were cited for harming patients or placing them at risk of serious injury, the GAO said. The investigation covered mid-2000 through 2002.
Examples of negligent care include improperly stored medical equipment and patients with untreated bed sores.
Patient advocates have praised the availability of the information but have warned that consumers should not choose a home without visiting it, talking to residents and getting information from state offices that monitor long-term-care facilities.