Maryland also established one of the first state public reporting tools. In 1999, the Maryland General Assembly established the Maryland Health Care Commission (MHCC) to carry out several health care reforms in the state, including development of information on nursing home quality. The MHCC worked with the Department of Health and Mental Hygiene and the Department of Aging, experts in long-term care, representatives of the nursing home industry in Maryland, as well as nursing home advocates and long-term care ombudsmen to produce the Nursing Home Performance Evaluation Guide.
There are several ways to search for information about nursing homes in the Guide, including by name, by location, and by characteristics such as size, ownership and specialty care offered. Once a facility is selected, the user can view facility characteristics (e.g., profit status, number of beds, specialty units); resident characteristics (e.g.; gender, age and functional status); and quality ratings based on the CHSRA MDS-based Quality Indicators (QIs).
The QIs are grouped into the four sub-categories of clinical, functional, psychosocial and medication-prescribing care with ratings given for 21 measures. The quality ratings are represented by filled, empty, and half-filled circles. A full circle is utilized for a facility's QI that is at or below the 20th percentile (fewer adverse events), an empty circle for QIs that are at or above the 90th percentile (more adverse events), and a half-filled circle for the middle 70%. Drilling down in each facility's sub-category score allows the user to view the state-wide range of ratings among all facilities for each of the QIs. The Guide also contains information on inspection survey history including the type, scope and severity of deficiencies noted. Information on interpreting and using the data is also presented, as well as a Consumer's Nursing Home Checklist and advice on how to pay for nursing home care.
The Performance Evaluation Guide is available on-line at www.mhcc.state.md.us/nhguide. A sample performance report is included in Appendix C.