The use of physical restraints on nursing home patients has dropped by nearly a quarter in two years and fewer residents report suffering from pain, according to a report released Tuesday by the Bush administration.
Roughly 35,000 fewer patients are in restraints in the nation’s 16,400 nursing homes on any given day, the report says.
The report is an assessment of the administration’s program, begun in 2002, to tackle serious quality problems in many homes by making public information about patient care in every facility. The public release of the quality measures was designed to allow consumers to make better choices and prompt homes to improve their performance.
The information is available on the government’s Web site, www.medicare.gov, or by calling 1-800-633-4227.
'A great first step'
“The improved outcomes are a great first step, but we know much more can be done,” Health and Human Services Secretary Tommy Thompson said. “In fact, we are developing an aggressive nursing home quality plan that will further strengthen our enforcement actions when a nursing home fails to measure up.”
All the information is based on data that nursing homes must routinely collect from residents as part of their participation in the federal Medicare program.
About 1.6 million people reside in nursing homes daily. During a year, more than 3 million Americans have a nursing home stay, the report from the federal Centers for Medicare and Medicaid Services said.
In the middle of 2002, 9.7 percent of nursing home residents were restrained on any day. Two years later, the number was 7.5 percent.
Patients kept in restraints can become weak, lose their ability to go to the bathroom on their own and develop bed sores. Restraints should only be used when ordered by a doctor as part of treatment of a patient’s medical condition, according to federal law.
Pain management also improving
Measurements of pain among long-term and short-term nursing home patients also improved, dropping 38 percent and 11 percent, respectively.
The report showed a slight increase, 2 percent, in the percentage of patients with bed sores. But among a select group of homes that focused on the problem, there was an 8 percent decline in the percentage of residents with painful sores that can indicate neglect.
The program started with 10 measures and has increased to 15. New entries include staffing levels and weight loss among long-term residents.
Despite recent industry improvements, congressional investigators in 2003 found that many nursing homes have serious quality problems. The General Accounting Office, since renamed the Government Accountability Office, also said state inspectors are failing to catch a large number of the problems.
Twenty percent, or about 3,500, of the nation’s nursing homes were cited for harming patients or placing them at risk of serious injury, the GAO said. The investigation covered mid-2000 through 2002.
Examples of negligent care include improperly stored medical equipment and patients with untreated bed sores.
Patient advocates have praised the availability of the information but have warned that consumers should not choose a home without visiting it, talking to residents and getting information from state offices that monitor long-term care facilities.