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Medicare Fights Nursing Home Abuse By Changing Guidance

Armen Hareyan's picture

Medicare is taking serious steps to fight Nursing Home abuse, coming up with new creative ways to improve nursing home guidance. The Centers for Medicare & Medicaid Services (CMS) on June 19 issued new guidance for nursing home surveyors, further defining and clarifying several important dimensions of care to help improve nursing home residents' quality of life and environment. Beginning June12, 2009, nursing home surveys will be conducted with a sharpened focus on resident rights in key areas such as:

* Ensuring they live with dignity;

* Offering choices in care and services;

* Accommodating the environment to each of their needs and preferences; and

* Creating a more homelike environment -including access for visitors.

Currently, nearly 1.5 million individuals live in approximately 15,800 nursing homes on any given day, and about 3 million people will spend some time in a nursing home each year.

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"These groundbreaking revisions matter in the daily lives of people who live in the nation's long-term care facilities," said CMS Acting Administrator Charlene Frizzera. "The improvements in the guidance are intended to support efforts underway to transform nursing homes into environments that are more like their homes through both environmental changes and resident-centered caregiving."

The new guidance also calls on nursing homes to de-institutionalize their physical environments. The guidance highlights institutional practices that facilities should strive to eliminate including meals served on institutional trays and noise from overhead paging systems, alarms and large nursing stations.

A homelike environment is not achieved simply through enhancements to the physical environment, according to the new guidance. It concerns striving for person-centered care that emphasizes individualization, relationships, and a psychological environment that welcomes each resident and offers comfort.

The guidance also makes clear that residents have the right to choices concerning their schedules -consistent with their interests, assessments, and plans of care. Choice over schedules includes, but is not limited to, those matters that are important to the resident, such as daily waking, eating, bathing, and going to bed at night. The facility should gather this information in order to be proactive in assisting residents to fulfill their choices.

CMS inspects nursing homes periodically to ensure they meet the federal regulations requiring that each resident receive good quality care in a home that also provides good quality of life. CMS provides guidance, such as today's release, to help surveyors interpret those regulations.

The new guidance provides a substantial roadmap for environmental and culture change in nursing homes, while noting that some facilities are further along than others. As noted in the guidance: "many facilities cannot immediately make these types of changes, but it should be a goal for all facilities that have not yet made these types of changes to work toward them."

The guidance can be found at http://www.cms.hhs.gov/transmittals/downloads/R48SOMA.pdf