QI Reports: Caution

Quality Indicator Reports:  Use when you can get them and be Cautious

Hopefully, family members, ombudsmen and others will soon have access to a facility’s Quality Indicator Profile (QI) report. Consumers already have access to HCFA’s Facility and Resident Characteristics report and the survey results on HCFA’s heavily used website www.medicare.gov/nursing or from the facility itself. HCFA indicates that decisions about public availability of the QIs are still being made.  In the meantime, Eric Carlson, Director of the Nursing Home Advocacy Project of Bet Tzedek Legal Services in Los Angeles, recently shared with NCCNHR a copy of a QI report he obtained in March 2000 through the Freedom of Information Act (FOIA) - minus resident-specific MDS information.  It didn’t come cheaply – HCFA charges per page for copying a document, as the FOIA allows - but it arrived within a month, Carlson reported

          Below you will find an authentic copy of a QI report from the Gwynedd Square Center for Nursing shared by Morris Kaplan, the owner and administrator.  A review of this report should be useful in understanding how the QI reports can be helpful, as indicated in the articles by Kaplan and David Zimmerman, the key developer of the QI system.

Be cautious in using QI reports. No one piece of information should ever be relied upon to select a nursing home. Some other important sources are: personal accounts by current residents, or their family members and others who visit regularly, such as ministers or volunteers. Ombudsmen who visit the facility may have good historical information about the quality and consistency of care and any ongoing problems. The last 2-3 survey reports should give you information, keeping in mind that the survey information may be only as good as the agency’s survey process. Additionally, not all surveys are posted in a timely manner, and a facility can change significantly in a short period of time, for better or worse.

Until HCFA finalizes decisions about public disclosure of the QI reports, NCCNHR hopes that providers will voluntarily supply the reports when family members or potential residents request them. The reports, based on the assessment information in the required Minimum Data Set (MDS), do provide indicators that can help the reader ask important questions. In fact, the reports provide flag symbols beside indicators that are unusual or “flag” a problem area. Examples: If a QI percentile rank (number) looks high, it could mean that the facility specializes in care for that type of condition (i.e. pressure sores). You’ll want to know what kind of caregiving program they offer for that condition. It could also mean that there are serious problems. Be inquisitive. It is the consumer’s right and obligation to ask questions. A good provider will do everything possible to provide honest and thorough answers.

NCCNHR’s book, Nursing Homes: Getting Good Care There, provides useful information and questions, which should be asked of a facility.  Information is available on the NCCNHR website, www.nursinghomeaction.org, or NCCNHR’s publication list. National Citizens’ Coalition for Nursing Home Reform, 1424 16^th Street, N.W., Suite 202, Washington, D.C. 20036. 202-332-2275. Fax: 202-332-2949. E-mail: NCCNHR@NCCNHR.org.