State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Quality Reporting System (QRS)


QRS is an evolving web-based consumer information system that provides detailed comparative data about all Texas nursing homes. Its primary purpose is to provide information to assist consumers in making choices about long-term care services. The system was originated by former DHS Commissioner Eric Bost and was first launched in 1999. Initially, the site was used to list, rate and compare Texas nursing homes to assist consumers in selecting nursing home care. In December 2000 a new version of QRS was introduced. The new version included information on hospital-based nursing facilities and new search features to help consumers find specific information more easily. In 2000, QRS also became a fully bilingual (English/Spanish) web site.

Design of the system was under the direction of Dr. Cortes' division of Medical Quality Assurance; work was overseen by an advisory group consisting of representatives from key stakeholder groups (providers, consumers, and the medical community); and a contractor was hired to assist with some of the technical work. The system is funded with Title 19 (Medicaid) monies in the amount of approximately $475,000 per year.

QRS provides quality information from three sources: MDS-based quality indicators (i.e., those developed by CHSRA), survey deficiencies, and the complaint system.12 From these sources, four separate scales are created; results for each home are presented using a system similar to that used in Consumer Reports--a circle that ranges from fully-darkened to fully open, indicating one of five levels of "quality." In addition, a summary score is presented for each home. This score is the simple average of each of the four separate scores. Finally, the system allows users to drill down to increasingly detailed data about each home, including a complete list of all deficiencies on the most recent survey and a summary of the facility's regulatory compliance history over the past few years.

12. See Appendix C for an overview of how the QRS evaluates the state's nursing facilities.

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