|
|
Speedy Release Sought of Nursing-Home Reports
By Jennifer Levitz, The Providence Journal
August 3, 2005
The state Health Department has a longstanding practice of keeping nursing-home inspections secret until nursing homes review the reports and attach formal responses.
That means it can take a month for an inspection report to become public and longer if the facility disputes the findings.
But the state's new Health Department director said he will speed up the release of nursing-home inspection reports to the public.
"It depends on the problem found, but I think families want to know and they want to know in time for them to make a decision," said Dr. David R. Gifford, who was confirmed as the new health director in May.
Gifford, whose department was under scrutiny in the past year for regulations that favored nursing homes more than residents, said he's called around the country and believes that while Rhode Island is far from alone in delaying reports, the state could do better. Ohio and Michigan, for instance, release inspection reports almost immediately, as soon as the nursing home gets a copy.
"Could Rhode Island do it the way Ohio or Michigan does it?" he said. "That could be very reasonable."
Gifford said he's consulting with his legal counsel: "If the statute allows us to do it, I would be pursuing something along those lines."
The General Assembly passed a package of legislation in June to improve regulation for the state's 10,000 nursing home residents. The new laws require Gifford to establish a process for notifying families about quality-of-care concerns.
The Health Department is paid by the state and federal government to conduct annual inspections of the state's 100 nursing homes. It must inspect poor-performing facilities more often.
The results of these inspections are of great interest to both the public and to the industry. The results are used to rank nursing homes on both the Health Department's Web site and the federal Centers for Medicare & Medicaid's popular "nursing home compare" Web site. In addition, nursing homes that fare poorly on inspections can be hit with penalties and loss of Medicaid or Medicare revenue.
But in Rhode Island, when the state's inspections are done, the state keeps the information secret while the document goes back and forth between the Health Department and the nursing home.
The Health Department has 10 business days to get the inspection report to the nursing home. Then, the nursing home has 15 days to return a "plan of correction" to the Health Department, according to the facilities' regulation department. The plan of correction, which tells how the facility has corrected a problem, is part of the final public report.
There is no federal regulation requiring the state to give nursing-home owners the delay.
The Centers for Medicare & Medicaid guidelines say states can make inspection reports available to the public after the nursing home receives a copy of the inspection.
The guidelines say, however, that states can choose to wait for the "plan of correction" before making the report public.
Gifford said most New England states do choose to wait, though Massachusetts does not wait for a plan of correction.
Janet Wells, director of policy for the National Citizens' Coalition for Nursing Home Reform, an advocacy organization in Washington, D.C., said in an interview earlier this year that nationally, the nursing-home industry has a lot of opportunities during the inspection process to argue the findings before the public gets a look at the report.
The nursing-home industry says that it wants to make sure inspection reports are accurate.
Al Santos, executive director of the Rhode Island Health Care Association, which represents most of the state's for-profit nursing homes, said: "We certainly want the families and patients to know what's happening in a nursing home, but we want it to be fair and accurate."
"Sometimes it takes a while to be fair and accurate," he said. "You can't . . . jump the gun to get something out quickly if it's not accurate."
Santos believes it can take too long for the Health Department to resolve disputes over an inspection. Such appeals involve lawyers and go to Informal Dispute Resolution hearings at the state. The inspection doesn't become public until the dispute is resolved.
Santos said the delay can hurt nursing homes as well as consumers, because nursing homes might have improved and want to get the latest inspection up on the state and federal Web sites.
Gifford said he doesn't know yet when changes will be made. He said he understands the industry's concerns, and that he, too, doesn't want to see inaccurate information reach the public. He notes that new laws require nursing homes to notify families of immediate jeopardy to a resident or widespread problems with care.
He also sees the value of having information presented with the context of a plan of correction. But he said he doesn't want to be "paternalistic."
He believes most families simply want to know if there is a problem, so they can ask the appropriate questions and make decisions. "I think all of us would like to be treated that way," he said.
|
|
