Nursing Home Rating Confusion - KCBD NewsChannel 11 Lubbock

11/20/02

Nursing Home Rating Confusion

"It's just real frustrating because I don't feel like the whole story's being told," says Rita Mitchell.

She's the head nurse at Lakeridge Rehab, and over the past few weeks, she's been disappointed by the media's coverage of Medicare's Quality Indicators for nursing homes, a new system which compares a facility's percentage of sick and injured patients with a statewide average.

"People are coming in and just asking us questions, and I'm explaining it in detail like I'm explaining it to you, and then on the news, it's just one quick little sentence about 'this is what you're supposed to do,' and that's kind of frustrating because there's so much more to this story and people need to know," says Mitchell.

What they need to know, she says, is how Medicare arrives at their numbers. For example, at Lakeridge, Medicare lists the percentage of residents with pain at 20%, significantly above the state average of 9%. The percentage of short stay residents with Delirium is listed a full 70% above the state average. All accurate figures, but easily misinterpreted.

At Lakeridge Rehab, they treat a higher percentage of seriously injured people, and report those ailments to Medicare in order to get paid, but many people look at those percentages and think that substandard care is being provided.

"We have to show that they need therapy. We have to justify the need for therapy by showing that they have had a decreased range of motion, or they've had a decline in some way in order to get reimbursed for the therapy, but then again, when we put that on there, it shows up on the Quality Indicator that we've allowed then to decrease their range of motion," says Mitchell.

It's a catch-22 that's left nursing homes asking Medicare for a better way to report the facts.

"So, this is a good thing, but yet it's not refined enough to be a really good thing," she says.

To check out nursing homes in your area (click here).

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