As health care providers, we all want to provide the highest quality of care possible to our patients. Over the last few years, the member facilities of the Louisiana Nursing Home Association have made a special effort to implement changes and best practices to improve quality of care, including culture change.
LNHA is proud that a substantial number of nursing facilities improved their overall Five Star Quality Rating between 2009 and 2014. The overall rating created by the Centers for Medicare and Medicaid Services is based on scores in three domains: health inspections, staffing and quality measures. The proportion of facilities with a one-star overall rating in Louisiana has decreased by 57 percent, and the proportion with a five-star overall rating increased by 438 percent from January 2009 to May 2014, and the percentage of facilities with a four-star rating increased by 70 percent during the same time period.
The following data regarding quality also show great improvement by Louisiana nursing facilities:
- RN staffing increased 75 percent in Louisiana nursing facilities as compared to 44 percent nationally.
- Total nurse staffing increased 19 percent in Louisiana as compared to 13 percent nationally.
- The use of physical restraints and the development of pressure ulcers decreased faster in Louisiana than in the nation.
- Neuroleptic medication use decreased 11 percent.
According to the 2013 American’s Health Rankings Annual Edition, Louisiana’s seniors rank second worst in the nation in health measures such as diabetes, obesity, physical inactivity and smoking. Those factors contribute to the health outcomes that are experienced in the facilities.
A cost-saving achievement took place when LNHA, working in concert with the Department of Health and Hospitals, succeeded in reducing the number of overall beds and the number of empty beds. Over the past 10 years, Louisiana’s nursing facilities accomplished an intentional reduction of beds from 40,000 beds to approximately 35,000 beds, a 12.5 percent decrease — the equivalent of 35 fewer nursing facilities being taken offline. If your community has a nursing facility, it is comforting to know it will be there when a loved one needs it, whether it’s for long-term care or a short-term rehabilitative stay.
Another achievement is that LNHA, in response to the Hurricane Katrina disaster, became the first association in the country to have a hazard mitigation program approved by the Federal Emergency Management Agency. LNHA’s member facilities take their responsibilities very seriously to ensure the safety of their residents in times of disaster.
It is important for long-term-care service providers to be regulated . Long-term care encompasses a full spectrum of services in a variety of settings, including assisted living facilities, skilled nursing facilities and home- and community-based services. Each provides varying levels of care based on the patients’ needs. Frail, elderly and disabled individuals should be cared for in a setting that meets their clinical needs while taking into consideration their personal desires.
Well-intentioned policy makers are motivated by the desire to provide alternatives to nursing facilities and some may have the false belief that expansion of home-care programs will keep frail, elderly and disabled people from entering nursing facilities. They believe home and community social welfare services will save the state Medicaid system money.
Every lawmaker and taxpayer should research the fraud and abuse that occurs in the home and community-based service programs year after year in Louisiana. With little oversight, home- and community-based service providers are prone to a particular risk of poor service quality, fraud and even physical abuse . In a year with a severe budget deficit, taxpayers’ dollars should be spent in a fiscally responsible manner. Let’s not fund programs fraught with fraud and waste. Louisiana’s seniors deserve quality in a safe environment.
Joe Donchess is executive director of the Louisiana Nursing Home Association.