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EDITORIAL: Nursing homes need attention

Gazette (Cedar Rapids, IA) - 8/27/2014

Aug. 27--A number of developments clearly show the need for better information and accountability regarding the state of Iowa's nursing homes, and raise the question of whether regulatory changes are needed.

Last week, The Gazette's Erin Jordan reported that Iowa nursing homes, on average, lose 41 percent of their staff each year. The attrition rate among nurses is 47 percent. Some homes had loss rates far higher.

It's no surprise that huge turnover is bad for patient outcomes. Residents get better care from experienced staff who know them and their health history. High turnover also leads to high costs for training new staff, paid for by residents and taxpayers.

Far more surprising is that the state collects reams of nursing home data but does very little analysis of those numbers. The state, for example, doesn't crunch turnover numbers to find nursing homes with lower turnover rates. It's possible officials could learn valuable lessons on best practices from those facilities.

State officials also know little about exactly why so much turnover is happening. A survey found that short staffing is a top factor, but it was conducted in 1998. It's likely that low pay is also a variable, among others. This is the kind of analysis that's vital for policymakers and consumers.

Mechanisms for helping consumers judge nursing home quality also are lacking. Last month, The Des Moines Register reported that a Waverly nursing home received a Governor's Award for Quality Care in Health Care Facilities even though it had been cited just weeks earlier for unsanitary conditions and failing to provide residents' meals as outlined in their care plans. The award is supposed to recognize the state's best facilities.

And this week, a New York Times investigation found serious flaws in Medicare's nursing home ratings. The Times found that Medicare's ratings relied largely on self-reported data that was not independently verified, and lacked negative information on problems discovered by state officials.

Nursing home residents and their families deserve far better than this. They deserve a regulatory system that uses data to improve rules, regulations and facility conditions. They deserve state leaders who demand thorough analysis and accountability. And they deserve a meaningful ratings and awards system that truly reflects quality. It's time for our leaders to deliver.

--Comments: (319) 398-8292 or editorial@thegazette.com.

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