When asked to develop quality and performance improvement programs to help nursing homes, quality improvement organizations, or QIOs, typically targeted their higher-performing facilitiesand in at least eight casesexplicitly excluded nursing homes with a high number of deficiencies, a new report from the Government Accountability Organization has found. The move to choose only the better facilities has drawn criticism from nursing home associations, state officials and at least one federal lawmaker who said he will seek legislative reforms for the QIO program.
Millions of older and disabled Americans have to rely on nursing home care, Sen. Chuck Grassley (R-Iowa), ranking member on the Senate Finance Committee, said in a written statement. Grassley added that QIOs are the groups who are chartered to monitor and improve quality at such facilities. Its a waste of that resource to have QIOs stay away from poor-performing nursing homes and fail to help the nursing home residents who are the most vulnerable to inadequate care.
The GAO, however, did find that nursing home staff felt that their work with QIOs had led to some improvement in resident care, but gauging how effective those interventions were has proven difficult.
In its report, the GAO said that the QIOs should increase the number of low-performing facilities they assist. Additionally, the GAO said that the CMS, which contracts with the quality organizations, should require that QIOs give up the identities of the facilities they are working with and to collect more complete and detailed information on the programs QIOs use to assist homes. A third recommendation would have the CMS expand the quality measures used to evaluate the homes.
David Schulke, executive vice president of the American Health Quality Association, which represents QIOs, said that the member organizations would welcome an expansion of the program, but the dollars arent there yet. The problem is not a lack of willingness or skill; we have that, he said. The key to scaling up is funding. -- by Matthew DoBias