Medical, house, quality
Kate Goodrich, M.D.

The federal government is eyeing possible changes to Nursing Home Compare to better capture patient safety concerns, a top official said Thursday.

Currently, the comparison tool captures only a “subset of harm” that is inflicted on residents in nursing facilities. That’s why the Centers for Medicare & Medicaid Services is considering developing a composite measure of healthcare-acquired infections, which would be incorporated into the rankings, said Kate Goodrich, M.D., the agency’s chief medical officer.

“While we view patient safety and quality improvement as a continuum, we agree that specifically ‘calling out’ facility performance on patient safety can resonate with and be beneficial to consumers,” Goodrich, who is also director of the Center for Clinical Standards and Quality, wrote in a Health Affairs blog.

Her comments come in response to a November Health Affairs study, which contended that the standard measure for capturing quality at nursing homes does not paint an accurate picture of patient safety. Authors compared nursing homes’ performance in standard quality measures with six noted patient safety standards — including pressure sores, infections, falls and medication errors — and concluded that the relationship was weak between the two measures, “leaving consumers who care about patient safety with little guidance.”

In her Thursday response, Goodrich emphasized that SNF patient safety is a “crucial strategic priority” for the federal government. She countered the study’s conclusions by writing that Nursing Home Compare does contain measures that either directly capture harm or are highly correlated with it, such as inappropriate antipsychotic use, which is linked to falls and other events.

Along with the infection-related composite measure, she said CMS will “continue to explore additional facets of and measures associated with safety in nursing homes going forward.” In addition, the agency recently developed measures to gauge the transfer of health information between providers and the patient. Those were designed to meet the requirements of the IMPACT Act, and CMS is intending to propose adopting them for the SNF Quality Reporting Program, Goodrich wrote: “We believe these measures will address the important safety issue of improving the hand-off of medication information during critical care transitions.”