Nursing Home Compare not good enough, Harvard experts say

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Nursing Home Compare is “often complicated, incomplete," Grabowski says.
Nursing Home Compare is “often complicated, incomplete," Grabowski says.

The Centers for Medicare & Medicaid Services' Nursing Home Compare is suffering from “considerable” knowledge gaps that may make it harder for consumers to make informed decisions about their post-acute care, according to some experts.

In a blog posted Tuesday in the Health Affairs Blog, Harvard researchers Brian E. McGarry, Ph.D., and David Grabowski, Ph.D, argued that the tools currently at hospital patients' disposal for choosing a post-acute provider are “often complicated, incomplete, and potentially misleading.”

Nursing Home Compare, the website meant to inform consumers about local long-term care providers, is lacking in information regarding short vs. long nursing home stays, facility features or amenities, care coordination or the “culture and care philosophy” of the provider. The tool also suffers from dissemination issues, McGarry and Grabowski wrote, with some patients and hospital staff unaware that it's available.

“Patients and providers alike need to know that help is available, and barriers to accessing these websites during the potentially stressful and hectic time of discharge planning need to be minimized,” the blog reads.

To improve Nursing Home Compare the authors recommend first separating the measures regarding short- and long-stay residents so patients can “identify the quality metrics most pertinent to their situation.”

They also recommend adding new information to the comparison website, like building age, availability of private rooms, photos of the facility, and reviews from residents or their family members to offer data more in line with consumers' concerns.

“Although some of this information is subjective, consider that even individuals researching hotels have easy access to useful data of this sort,” McGarry and Grabowski wrote. “Certainly patients considering where to spend weeks or months of important recovery time are entitled to similar resources, and recent evidence suggests that consumers are already turning to social media platforms such as Facebook to post facility feedback and obtain first-hand perspectives.”

Bringing such information Nursing Home Compare would allow CMS to oversee its exchange in “a controlled and transparent manner.”

The last recommendation detailed in the blog post would be connecting long-term care consumers to both Nursing Home Compare and the Home Health Compare tool. Advertising alone wouldn't be enough, the researchers wrote. Instead, CMS may have to consider making it mandatory for Medicare patients to be informed of the tools during their discharge planning process, and that they have web-enabled technology to access the sites from their hospital rooms.

Those Nursing Home Compare changes will be crucial as acute and post-acute care providers become more integrated, McGarry and Grabowski said.

“If consumers are to play an active role in the evolving postacute care choice environment, it is essential that they be well-positioned to make good decisions,” the post reads.