Ohio KePRO Motion December 2004

Despite all the recurring tidings of good cheer, the holiday season can be a lonely time for some. It can be par ticularly
lonely for residents of nursing homes and seniors who are homebound, especially if they don't hear from specific family
member s or friends.

hanks to the Centers for Medicare &
Medicaid Ser vices (CMS), an agency of
the U.S. Depar tment of Health & Human
Ser vices, families with loved ones in nursing
homes or who are receiving home health
care can use a valuable resource to check
on their quality of care.

CMS publishes quality measures for nursing
homes and home health agencies as par t of
its national Nursing Home Quality Improvement
(NHQI) and Home Health Quality Improvement
(HHQI) programs. Consumers can use these
publicly repor ted measures to compare
nursing home and home health care quality.
Family members and friends with Internet
access can log on to www.medicare.gov and
click on "Nursing Home Compare" or "Home
Health Compare" to access and compare
the quality measures.

Those who do not have Internet access
can use a toll-free telephone help line,
1-800-MEDICARE (1-800-633-4227),
to get the information.

The CMS programs also fund Medicare's
Quality Improvement Organizations (QIOs) to
provide no-cost assistance to nursing homes
that wish to improve their quality measures.
QIOs also help consumers obtain specific
information on nursing homes and home
health agencies in their state.

"Nursing Home Compare and Home Health
Compare give individuals a valuable quality
tool to ensure that their loved ones are
getting the best possible care," said Alice
Stollenwerk Petrulis, MD, FACP Dr. Petrulis .
is medical director at Ohio KePRO, the
Medicare QIO for Ohio.

"Right now, family members can search the
Web site by state, county, city or zip code
to view several specific quality measures on
individual nursing homes or home health
care agencies," said Dr. Petrulis. "Early next
year, CMS will expand this ser vice to
consumers to include hospital quality
information as well."

Interacting with family and
friends is important for everyone
during the holidays, but it is even
more critical for nursing home
residents and the homebound.

The quality measures are updated regularly
and are calculated from data repor ted to
CMS on nursing homes and home health
care agencies.

in Ohio can use the quality measures to
pinpoint areas to improve care.

The data from the quality measures should
be used with other community resources
and suggestions from family, friends, and
healthcare providers to make decisions
about a loved one's care needs.

"Consumers who have questions about the
measures should also contact individual
nursing homes or home health agencies,"
said Dr. Petrulis. "The quality measures are
just one tool families can use to ensure
their loved ones are getting the care that is
right for them."

Interacting with family and friends is impor-
tant for ever yone during the holidays, but
it is even more critical for nursing home
residents and the homebound. Dr. Petrulis
noted that contact with loved ones is
critically impor tant, not only during the
holidays but year-round.

"So this year, the term `quality time' with
family has an added meaning," said Dr.
Petrulis. "Families and friends with loved
ones in nursing homes or who are receiving
home health care have a valuable tool for
checking on the quality of care for their loved
one, whether they live far from home or in
the same community."

Resources
If you do not have a computer or Internet
access, information about Nursing Home
Compare and Home Health Compare is
available by calling the Medicare toll-free
help line at 1-800-MEDICARE
(1-800-633-4227).

The goal of the programs is to improve the
quality of care for nursing home residents
and those receiving home health care.
Nursing homes and home health agencies

Staff at Ohio KePRO can be reached through
the Medicare Beneficiar y Help Line at
1-800-589-7337 to answer questions
about quality of care issues.

Letter to the Editor

Who to Call in Home Care for Medical Emergencies

By Alice Stollenwerk Petrulis, MD, FACP, Medical
Director

Thanks to Medicaid waiver programs
and the increased availability of in-
home care ser vices, more Ohioans are
choosing to receive health care and
suppor t in their own homes, rather
than moving into a nursing home or
assisted living facility.

In such institutions, it is usually ver y
clear whom to tur n to when one needs
medical assistance. But when receiv-
ing home health care, the answer is
not always so clear. Do you call the
on-call nurse, the case manager, the
doctor, 9-1-1, or do you have someone
take you to the emergency room?

Ohio KePRO, the state's Medicare
Quality Improvement Organization,
offer s these tips to handle medical
emergencies in home care settings
and avoid unnecessar y visits to the
emergency room:

you should contact the home health
agency office or on-call nurse. If the
situation is serious enough, the
nurse or case manager may instruct
you to call 9-1-1 or go directly to the
emergency room.

Repor t symptoms or complications
when they first appear, to allow
time to involve your physician, who
may be able to adjust your treatment
and keep you out of the hospital or
his or her office.

Holiday gatherings with lots of food can be challenging
for those with diabetes. Cur rent research shows that
following a meal plan, getting regular physical activity,
taking prescribed medicines, and keeping blood sugar
levels in a normal range can delay or prevent the
death and disability associated with diabetes.

In the spirit of the holiday season, persons with
diabetes should consider the following tips when
attending holiday gatherings:

Have a plan for what, when, and how much you
will eat. Select healthy foods that fit your meal plan.
Bring your favorite healthy dish to the occasion.
Eat slowly. This will reduce your chance of eating
too much.
Don't come to the par ty hungr y.
Choose water for your beverage. Water is a
healthy, no-calorie beverage.

Don't be shy to discuss your diabetes control plan.
Family and friends are your suppor t system and can
help by offering a variety of low fat, high fiber foods
and ser ving low fat versions of favorite dishes.

Learn to recognize changes that
mean your disease or condition is
getting worse. Your healthcare
provider may be able to make
changes to your treatment and
prevent an emergency. Home care
nurses can also teach you and your
family on the best ways to treat
your disease or condition.

Repor t any symptoms or complica-
tions related to your illness to your
home care nurse or case manager.
A case manager will advise whether

When to call 9-1-1
Despite your best effor ts to stay out
of the hospital, emergencies some-
times occur. In these cases, call 9-1-1
to get professional care as quickly as
possible.

Ohio KePRO is the Medicare Quality
Improvement Organization (QIO) for
Ohio. Beneficiaries or anyone acting on
their behalf can call its Help Line
toll-free at 1-800-589-7337 for more
information.

More infor mation about diabetes management is
available by calling the National Diabetes Education
Program at 1-800-438-5383 or by visiting the following
Web sites: http://ndep.nih.gov and
http://www.cdc.gov/diabetes/.

Alice Stollenwerk Petrulis

Ohio KePRO, the quality improvement organization for
Medicare in Ohio, conducts diabetes projects for the
Medicare population at-large, beneficiaries enrolled in
Medicare Advantage plans, and for the African-
American beneficiar y population in Ohio.

Executive Editor : Suzana C. Iveljic, MBA

Editor : Daniel B. Moss, BSBA

e-mail: dmoss@ohqio.sdps.org

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Publication No. 4123-OH-009-12/2004. This material was prepared by Ohio KePRO, the Medicare Quality Improvement Organization for Ohio, under contract with
the Centers for Medicare & Medicaid Ser vices (CMS), an agency of the U. S. Depar tment of Health and Human Ser vices. The contents presented do not
necessarily reflect CMS policy. For more information, please call 1-800-MEDICARE (1-800-633-4227), or visit the CMS Web site at www.medicare.gov.