According to a GAO (Government Accountability Office) Report CMS Has taken Limited Steps to Expand Access to Cost and Quality Information, but Has Not Established Procedures to Ensure This Information Meets Consumer Needs. Government websites are not especially good tools for helping consumers choose healthcare providers, but Nursing Home Compare is in some ways the best model so far, according to a report released Tuesday by the Government Accountability Office. Among the problems identified by the GAO, “transparency tools” such as Nursing Home Compare and Hospital Compare do not contain information on how much services cost, are hard for consumers to comprehend, and they do not allow consumers to easily sort different providers based on selected criteria. In terms of understandable information about quality, Nursing Home Compare does better than similar tools for hospitals, doctors, dialysis facilities and home healthcare. It is the only tool that summarizes providers' performance using easily understood symbols, through the five-star rating system. However, Nursing Home Compare is not “written in plain language with clear graphics” and offers very limited ability for consumers to customize the information they see, the report states. All the other transparency tools have similar problems, although the GAO authors determined that the home healthcare tool does use more consumer-friendly language and graphics. Centers for Medicare & Medicaid Services officials told the GAO that cost information would be difficult to include because beneficiaries are enrolled in a variety of plans beyond traditional fee-for-service Medicare. However, CMS could estimate out-of-pocket payments for services and procedures based...

The positive relationship between nurse staffing levels and the quality of nursing home care has been demonstrated widely. The more staffing you have on the front lines of nursing homes, the safer the residents. As a result, nurse staffing receives a great deal of attention as a solution to improving nursing home quality. To control cost and improve efficiency, nursing homes want to know the plausible minimum staffing level for providing nursing home quality care. However, one of the difficulties has been establishing evidence-based minimum staffing ratios. Assuming that increasing nurse staffing levels facilitates enhancement of the outcomes of nursing home care, identification of recommended nurse staffing levels becomes important. Congress passed the Nursing Home Reform Act of 1987, which gave us a very vague definition of what constitutes adequate nursing home staffing levels. The act required in part, that nursing homes that wish to be certified for participation in Medicare or Medicaid, provide sufficient staff and services to attain or maintain the highest possible level of physical, mental, and psychosocial well-being of each resident" However, the Nursing Home Reform Act and resultant regulations do not mandate a specific staff-to-resident ratio or a minimum number of hours per resident day for resident care, and concerns about the quality of care in nursing homes have continued. Federal Minimum Nurse Staffing Ratios for Nursing Homes I was hoping that Mr. Obama and CMS (The Center For Medicare and Medicaid Services) would finally mandate Federal minimum nurse staffing ratios for our 1.5 million residents in nursing homes....