Some nursing homes in Greater Cincinnati make frequent use of restraints. Others don't use them at all.

        Some nursing homes have three times the percentage of patients with bedsores as the state average. Some come in three times lower than state average.

        These are just some of the wide variations in nursing home care that can be found in a vast amount of fresh data released this week by the Centers for Medicare and Medicaid Services, the agency that runs the federal Medicare program.

INFOGRAPHIC

• Comparing nursing homes

        The “Nursing Home Compare” information can be viewed in detail at www.medicare.gov.

        Ohio is one of six states selected in a pilot project to expand the amount of quality-of-care information on nursing homes.

        While some consumer groups praise the effort as an improved tool for comparing facilities, the nursing home industry contends that the data can be misleading and hard to understand.

        “Our view is that more information is better than less information, and easily accessible information is better yet,” said Steve Proctor, a spokesman for the Ohio Department of Aging.

        Some quality information, such as the number and types of violations found during nursing home inspections, has been public record for years, but such information has rarely been easy to find or widely disseminated.

        The power of the Internet is that nearly limitless information can be posted and updated, Mr. Proctor said.

        In addition to the new information from Medicare, the Ohio Department of Aging in March started posting more nursing home information on its Web site, www.ltcohio.org. Later this year, the results of up to 25,000 resident interviews will be posted on that site, Mr. Proctor said.

        People using the site can examine up to three years of “deficiencies” cited by nursing home inspectors, including many details about the violations and a 1-to-4 scale that depicts the severity of the violation. Anything above 3 can involve serious harm to a patient.

        New this year, and just for the six states in the pilot study, are nine quality measures, including percentages of patients with bedsores, placed in restraints, or suffering pain or dementia.

        In many cases, nursing homes either did not submit information on all nine quality measures or the numbers involved were considered too small to present a meaningful snapshot.

USING WEB SITE

It takes several steps to reach the information, but tapping into www.medicare.gov will lead people to vast amounts of data about nursing homes.     • Starting at www.medicare.gov, click on “Nursing Home Compare” to see an overview of the Web site's features.     • Click “Begin Nursing Home Search” to start a step-by-step process to view nursing home data. Use the “Next step” button to see lists of nursing homes by state, county, city or ZIP code.     • Placing a check next to a particular nursing home then hitting “next step” will open a page of summary information about the home. Users also can “Select all” of the nursing homes on a list.     • Clicking on “View all information for this nursing home” reveals details about bed capacity, quality measures and inspection reports.     • Pages can be printed out. However, caution is advised to avoid wasting paper. Listing just addresses and phone numbers of the 81 nursing homes in Hamilton County takes up 13 pages. Printing out lists of quality measures or inspection report details for several nursing homes will absorb dozens of pages.

        For example, of the 125 nursing homes in Hamilton, Butler, Clermont and Warren counties:

        • 19 did not report information about bedsores.

        • 32 reported nothing about patients who lost too much weight.

        • 62 offered no data on pain reported by short-stay patients.

        Nursing home administrators are skeptical about the expanded Web site.

        “The ratings that CMS is publishing ... are difficult for consumers to understand, and do not address the areas that residents and families care most about,” said Peter Van Runkle, president of the 820-member Ohio Health Care Association.

        For example, the Medicare Web site indicates that 23 percent of the patients at East Galbraith Health Care Center, 3889 E. Galbraith Road, suffer bedsores. That's among the highest in the region and far above the 9 percent state average.

        But the site says nothing about how many patients came into the East Galbraith facility for treatment after developing those sores while cooped up in beds at home, and sometimes at hospitals or other nursing homes. Nor does it show how many were treated successfully and sent back home.

        “One of our specialties is wound care,” said Ashley Butler, executive director at East Galbraith.

        The types of quality comparisons included on the Web site are legitimate. Understanding what they mean is tricky, Ms. Butler said.

        “I think it's going to be hard for the general public to understand what they're looking at,” Ms. Butler said. “Facilities that take very ill patients will end up looking worse than those that don't.”

        It may be possible for nursing homes to make themselves look better on the report card simply by refusing to take tough-to-serve patients.

        “This is self-reported data. There are ways to play games with the numbers,” Ms. Butler said.
       

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