There is good news from Washington for nursing home residents and their families. The federal government recently announced a new pilot program to assess and make public the quality of nursing home care. From the number of bedsores reported to the frequency of restraint use, the reports will evaluate several quality indicators and make the data available to consumers.

    The pilot program will begin in January 2002 in Maryland and four other states -- Colorado, Ohio, Rhode Island, and Washington -- and the results will be published in April 2002.

    The Center for Medicare & Medicaid Services (CMS) and the National Quality Forum (NQF), a voluntary, standard-setting organization, have developed a set of 11 measurements to assess the quality of care. These include seven measures of chronic care quality (physical restraints, pressure sores, weight loss, infections, pain management, declines in activities of daily living and use of anti-psychotic drugs without a psychiatric diagnosis), and four measures of post-acute quality care (managing delirium, pain management, improvement in walking and re-hospitalizations).

    Following the pilot project, CMS will refine and expand the initiative to include data from nursing homes in every state and the District of Columbia. The nationwide project is scheduled to begin in October 2002.

    Maryland was selected in part because it already conducts one of the most comprehensive and aggressive quality assessment programs in the country. Each year, the state releases a guide that measures the ability of every nursing home in the state to internally monitor falls, malnutrition, dehydration, pressure sores and other care indicators.

    Facilities must be continuously and thoroughly assessed so that the elderly and their families can select the home that best meets their needs. As payers, federal and state governments and insurance companies can also benefit greatly from this information.

    But comprehensive information is no substitute for vigorous monitoring and enforcement of quality standards. To ensure quality nursing home care, the federal government must maintain a strong regulatory role.

    Unfortunately, the Bush Administration has recently suggested weakening existing federal nursing home inspection guidelines. The Bush proposal would make it much more difficult for inspectors to cite widespread violations in areas such as oral hygiene, incontinent care, grooming assistance, and appropriate positioning. Congress must exercise oversight to make certain that nursing home residents are not harmed by an ineffectual inspection system.

    Currently, 1.5 million elderly and disabled Americans reside in nursing homes, and that number will increase significantly as the baby boom generation ages. We owe our frail seniors, one of our most vulnerable populations, the strongest protections possible in the sunset of their lives. To provide less is a disservice to us all.