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Assemblyman Proposes New Way To Evaluate Nursing Homes

Assemblyman Ron Kim thinks it’s time to come up with a new way to define if a nursing home is creating a quality environment for its residents.

Kim, a Flushing Democrat, has introduced A.8168 in the Assembly creating a nursing home resident quality and safety study focused on a measure known as the frailty index. The program would be paid for with money from the Federal Civil Money Penalty Reinvestment Program.

A frailty index encompasses several elements, Kim wrote, including a global standard of clinical risk, a measure of vulnerability and risk, the accumulation of chronic illnesses and the loss of function and/or cognition and is characterized by sudden declines and diminished recovery from illness or trauma. He said frailty risk score reliably predicts adverse outcomes including risk of hospitalization, length of stay, pharmacy/lab costs, mortality, and clinical outcomes: wounds, falls, delirium, mortality, weight loss, etc., which can help prioritize the use of resources and supports for the resident.

Frailty risk assessment and scoring is used by national health systems in Canada, Australia, China and the United Kingdom as well as in California and a growing number of states.

“The legislature finds the need to conduct a demonstration to evaluate the impact of using a globally recognized frailty score-based methodology on resident outcomes and provider quality in nursing homes in New York state,” Kim wrote in his legislative justification.

Kim’s proposal would include an intervention group comprised of residential care facilities that volunteer and will receive training and use the frailty risk assessment platform as well as a control group that continue to operate under the status quo to allow for comparison. The study will also be designed to assure geographical balance in the residential health care facilities as well as accounting for bed size, affiliation with hospital/health system, ownership type, occupancy and star rating.

Final reports will be submitted to the governor, Assembly, Senate and chairs of the Senate and Assembly Health and Aging committees.

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