Washington's nursing homes reduced their residents' pain and used fewer physical restraints over the last two years. But the percentage of residents suffering from bedsores increased...

Share story

Washington’s nursing homes reduced their residents’ pain and used fewer physical restraints over the last two years. But the percentage of residents suffering from bedsores increased slightly.

This new information was released yesterday by the federal Centers for Medicare & Medicaid Services as part of its Nursing Home Quality Initiative launched in 2002. The aim was to improve the quality of the nation’s 16,400 nursing homes.

The report was based on information on residents’ well-being that all nursing homes are required to report upon admission and at least every three months after that.

The trends are similar for the nation: a decrease in chronic pain and a decline in use of physical restraints, according to the report. But complaints of bedsores, also called pressure ulcers, stayed flat nationwide.

About 1.6 million people nationwide live in nursing homes. During a year, an additional 3 million people have a temporary nursing-home stay, the report says.

“One of the brightest spots to come out of this is the way nursing homes have responded to the challenge,” said Jeff West, project manager with Qualis Health in Seattle.


Medicare provides information on nursing homes at 800-633-4227 or www.medicare.gov.

Go to “Nursing Home Compare.”

As part of the initiative, the federal government contracted with Qualis Health and other nonprofit “quality improvement organizations” in every state. Their job was to help nursing homes learn how to better meet residents’ needs.

Areas targeted for improvement were pain management, the use of restraints and treatment of pressure ulcers. Washington and a few other states also worked to change the culture of nursing homes from hospital-like settings to real homes that are good places to work and live.

That effort was successful enough that it will be adopted nationally, West said.

As for pain management, Washington nursing homes reduced the percentage of long-term residents in chronic pain from 14 percent to 9 percent, the study said.

“Qualis Health has really made a lot of headway in helping facilities find practical ways to relieve the pain that residents feel,” said Kary Hyre, state long-term-care ombudsman.

Nursing homes have learned how to help residents identify how and where they hurt, said Hyre. At Ida Culver House-Broadview in Seattle, staff learned how to use pain medication more wisely.

“A lot of family members and some residents feel they might get addicted” to pain medications, said Judy Tracey, director of nursing. “But if you have true pain you can’t get addicted.”

It’s important to keep pain under control so a resident is more willing to eat and exercise, Tracey said. “Then they actually feel better and can go home sooner,” she said.

The study found that the state’s nursing homes reduced the percentage of residents physically restrained from 9 percent to 4 percent. Restraints include anything that keeps a resident from moving freely, including a bedrail or a lap tray in a wheelchair. Restraints “negatively impact the quality of life for anybody,” West said.

The information on pressure ulcers was disappointing. The percentage of Washington long-term-care residents with bedsores increased from 9 percent to 10 percent, slightly higher than the national rate. Reducing the incidence of such sores will be a top priority in the coming years, West said.

The federal agency also announced plans to increase the information available to families about staffing levels and weight loss in nursing-home residents. It expects to strengthen the investigation of complaints, improve fire safety and implement a pilot project to expand background checks of job applicants to nursing homes and other long-term-care facilities.

Marsha King: 206-464-2232 or mking@seattletimes.com

This report includes information from

The Associated Press.