One state tackles nursing home quality issue
Responding to needs of citizens, business
The Colorado Hospice Organization (CHO), galvanized by news from the Arlington, VA-based National Hospice Organization (NHO) that the Clinton Administration was considering abolishing the nursing home benefit, met for an April 15 brainstorming session and passed a resolution proposing to address concerns about quality in the nursing home benefit.
CHO plans to provide technical assistance for providers, data collection and dissemination, closer collaboration with state regulators, and the nursing home industry, as well as a commitment to promoting collegial working relations between hospices.
"We were responding to the fact that a sizeable percentage of Colorado’s potentially hospice- eligible, terminally ill population could be denied access to hospice care, as well as the traumatic implications for some of our larger hospice providers, with as much as 30% of their patient base living in the nursing home," says Alan Canner, JD, CHO’s executive director.
"Plus we are keenly aware in our state that when any hospice is awry in the nursing home, all hospices suffer."
Colorado hospices had already established a close working relationship with the state Department of Public Health and the Environment and its licensing staff for hospice by meeting regularly with state surveyors, providing inservice training for the Health Facilities Division, and participating on the department’s long-term care advisory committee, Canner says.
Eight-page self-assessment in development
"We are very excited about having the opportunity to increase surveyors’ understanding so that they know what should be happening to identify real problems," he adds. Canner is now finalizing an eight-page self-assessment instrument reflecting what should be happening in the hospice/nursing home relationship, "which we will share with hospices and nursing homes. If people have wrong answers, they can come to CHO’s Technical Assistance Committee for assistance from peers who are more sophisticated with the benefit," he says.
"One of the other things we are trying to do is to create a culture among Colorado hospices that when they hear rumors, they should immediately call the affected colleague and report what they heard. Maybe that director doesn’t know what’s happening, or needs to be put on notice that it needs to be cleaned up, or else this will squelch rumors that are not based on fact."
[Editor’s note: The Hospice Organization of Wisconsin (HOW), along with the Wisconsin Health Care Association and Association of Homes and Services for the Aging, has produced a 23-page guide for how contract relationships between hospices and nursing homes ought to work.
Hospice/ Nursing Home Interface: Guidelines for Care Coordination for Hospice Patients Who Reside in Nursing Homes can be ordered for $30 from HOW at P.O. Box 259808, Madison, WI 53725. Telephone: (608) 835-8184. Fax: (608) 835-9719.]
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