Last Friday, the Centers for Medicare and Medicaid Services (CMS) announced in the Federal Register that it is participating in a two-year campaign called "Advancing Excellence in America's Nursing Homes." The campaign was founded and will be implemented by an unprecedented coalition of consumers, providers, foundations, government agencies and other professional leaders. I am privileged to be the initial chair of the steering committee of the groups involved to see that this campaign is successfully implemented.
As stated in the Federal Register notice, "the ultimate objective of this new nursing home quality campaign is to make a real difference in the quality of life and efficiency of care delivery in nursing homes, by accelerating progress in identifying and treating pain and pressure ulcers, by virtually eliminating the use of physical restraints, and by transforming the nursing home work environment to attract and retain nursing and other staff."

But this campaign is so much more than that. The "Advancing Excellence" campaign is designed to make a great leap in Quality and Trust and is a major enhancement to Quality First for nursing homes. For the first time, numerous ongoing quality initiatives including Quality First and the CMS Nursing Home Quality Initiative (NHQI) are coming together and incorporating the culture change activities of organizations including the Pioneer Network, Eden Alternative and The Wellspring Institute.

The campaign is significant in ways that may not initially be apparent. First, the coalition brings to the table many groups, some of which traditionally have not worked together. Key stakeholders involved in the planning of the "Advancing Excellence in America's Nursing Homes" campaign include: Alliance for Quality Nursing Home Care; American Association of Homes and Services for the Aging (AAHSA); American Association of Nurse Assessment Coordinators (AANAC); American College of Health Care Administrators (ACHCA); American Health Care Association (AHCA); American Medical Directors Association (AMDA); Centers for Medicare & Medicaid Services (CMS) and its contractors, the Quality Improvement Organizations (QIOs); The Commonwealth Fund; The Evangelical Lutheran Good Samaritan Society; National Association of Health Care Assistants (NAHCA); National Citizens' Coalition for Nursing Home Reform (NCCNHR) and the National Commission for Quality Long-Term Care.

Second, consistent with Quality First, this campaign gives nursing homes the opportunity to commit openly to specific quality measures so that we can all "stand for" quality and not be defensive about it. The goals that the coalition has identified seek to improve clinical care; incorporate nursing home resident and family satisfaction surveys into continuing quality improvements; and increase staff retention to allow for better, more consistent care for nursing home residents. Nursing homes can volunteer to be measured on these indicators, showing the public we are confident about our commitment to quality.

Third, for the first time, a quality improvement initiative includes in its process measures indicators related to consumer and staff satisfaction. This allows these most important voices of consumers and staff members to speak for themselves. Every serious study of long-term care improvement – including our studies around Wellspring, Pioneer and Better Jobs Better Care point to the health of our workforce as the single biggest key to quality improvement. Caregivers will finally receive the attention they deserve.

Lastly, the campaign will have important synergy with the National Commission for Quality Long-Term Care, the so-called "Quality First Commission." Chaired by former Sen. Bob Kerrey and former Speaker of the House Newt Gingrich, the commission is one of the founders of this new quality campaign. The Commission is another platform to focus the quality campaign's results on solutions for our field and for our policies. As it enters a new phase, the Commission will also focus our country's attention on how long-term care should be financed. It is difficult to talk about quality without addressing the underlying question of how we will pay for the quality we expect and deserve.

Through this campaign, we have a new visible way to tell the story of the quality you've provided for decades and our shared commitment to the transformation of our field. For those of you who do not offer nursing care, the campaign's focus on customer and employee satisfaction can help you focus your own quality first efforts, consistent with Quality First's 10 Elements of Quality. Some of our most innovative applications of Quality First have come from our housing and home and community-based services members. That's why I urge you to sign the AAHSA Quality First Covenant and to develop a plan that focuses on these areas of your work.

This campaign will launch at a Quality Summit on Sept. 29 in Washington, D.C. We expect about 400 people to attend to assess quality in today's nursing homes; the need for public confidence in long-term care; the role of the caregiver workforce in quality improvement and how the campaign will be implemented at the national and local levels. Invited participants include leaders from the consumer, provider, government and philanthropic sectors. Shortly after that, nursing homes will be asked to volunteer to participate.

This campaign is an opportunity for nursing homes to earn their rightful trust in the public's eye as a care sector that is known for excellence and worthy of the public's trust. Our mantra is that quality should be an automatic public expectation. We — and you — are helping to fulfill that promise.

Larry

William L. Minnix, Jr., D.Min.
President and CEO

AAHSA
2519 Connecticut Ave NW
Washington DC 20008