Home Health Services

Quality Measures

The information below shows how often Mary Greeley Medical Center Home Health Services used best practices when caring for its patients and whether patients improved in certain important areas of care. These indicators of home health care quality are compared to the Iowa and national averages.

The quality measures are divided into the following sections (click the + on the right side to view data):

Managing Daily Activities

(Benchmark data collected from 10/1/2012 to 9/31/2013) 

How often patients got better at walking or moving around.

Mary Greeley
65%

Iowa Average
61%

U.S. Average
61%

What It Is and Why It Is Important

  • This shows how often the home health team helped patients improve their ability to walk or move around.
  • Some patients may need help from a person or equipment (like a cane) to walk safely. If they use a wheelchair, they may have difficulty moving around safely. Getting better at walking or moving around in a wheelchair may be a sign that they are making progress and meeting the goals of the plan of care.
  • In order to be as independent as possible, patients should be encouraged to walk, move around, and do as much as they can themselves, even if it takes more time. Both the home health team and family caregivers should encourage patients to be as active as they can safely.
  • The home health team will evaluate patients’ needs for, and teach patients how to use, any special devices or equipment that will help increase their ability to perform some activities without help.

Higher percentages are better.


How often patients got better at getting in and out of bed.

Mary Greeley
73%

Iowa Average
58%

U.S. Average
56%

What It Is and Why It Is Important

  • This shows how often the home health team helped patients improve their ability to get in and out of bed.
  • A patient’s ability to get in and out of bed by himself/herself is a first step toward doing many other things like getting dressed or getting to the toilet. This is especially important if family caregivers aren’t available to help when home health care ends.
  • The home health team and informal caregivers should encourage patients to do as much as they can for themselves. Patients who can get in and out of bed with little help may be more independent, feel better about themselves, and stay more active.
  • The home health team evaluates patients’ needs for, and teaches patients how to use, any special devices or equipment that may increase their ability to perform some activities without the assistance of another person.

Higher percentages are better.


How often patients got better at bathing.

Mary Greeley
75%

Iowa Average
68%

U.S. Average
67%

What It Is and Why It Is Important

  • This shows how often the home health team helped patients improve their ability to bathe.
  • Being able to bathe is an important element in patients’ ability to be more independent, stay clean, stay healthy, and feel good about themselves. However, there are certain physical abilities (motor skills) required to take a bath (or shower).
  • Patients may need help from a person or special equipment in order to bathe. A patient’s physical abilities can be developed or maintained by managing medical symptoms or through physical or occupational therapy. Getting better at bathing may mean that less assistance is needed to bathe or that assistive equipment is needed to bathe independently. Both can be signs that the patient is making progress and meeting the goals of the plan of care.
  • The home health team and family caregivers should encourage patients to do as much for themselves as they can, even if this takes more time. The home health team evaluates patients’ needs for, and teaches patients how to use, any special devices or equipment that may needed.
  • Being able to perform activities like bathing independently is especially important if there are no informal caregivers who can help when home health care ends. If a patient stops taking care of himself/herself, this may mean that the patient’s health has gotten worse. Some patients will lose function in their basic daily activities even though the home health team provides good care.

Higher percentages are better.

Managing Pain and Treating Symptoms

(Benchmark data collected from 10/1/2012 to 9/31/2013) 

How often the home health team checked patients for pain.

Mary Greeley
100%

Iowa Average
98%

U.S. Average
99%

What It Is and Why It Is Important

  • This shows how often the home health team checked to see how much pain their patients were feeling.
  • Treating a patient’s pain is an important part of the home health plan of care. When home health care starts, the home health team should always ask patients about their pain, so that the team can plan the best ways to treat the pain and keep the patients as comfortable as possible.

Higher percentages are better.


How often the home health team treated their patients’ pain.

Mary Greeley
100%

Iowa Average
99%

U.S. Average
98%

What It Is and Why It Is Important

  • This shows how often doctor’s orders included treatment to monitor and treat a patient’s pain and how often the home health team gave that treatment.At each visit, the home health team should ask whether a patient is having pain. If the patient is having pain, the home health team can work with the doctor help find and treat the cause of the pain and make the patient more comfortable.
  • Pain keeps patients from being active and hurts their overall health. Treating pain helps keep patients comfortable and helps their recovery.

Higher percentages are better.


How often patients had less pain when moving around.

Mary Greeley
76%

Iowa Average
69%

U.S. Average
68%

What It Is and Why It Is Important

  • This shows how often the home health team helped decrease the patients’ pain so they could perform daily activities, like getting up, walking, dressing, or bathing.
  • Pain can be caused by a variety of medical conditions and may be a sign of a new or worsening health problem. Pain also leads to depression, anxiety, and a lower quality of life. If pain isn’t treated, performing daily activities such as getting out of bed can become more difficult. Some patients’ pain may not improve, or may get worse, even though the home health team provides good care.

Higher percentages are better.


How often the home health team treated heart failure (weakening of the heart) patients’ symptoms.

Mary Greeley
100%

Iowa Average
98%

U.S. Average
98%

What It Is and Why It Is Important

  • For heart failure patients with symptoms of worsening heart failure, this shows how often home health team took action to relieve those symptoms.
  • Heart failure is a weakening of the heart’s pumping power. Heart failure patients who are receiving home health care may have symptoms of worsening heart failure like trouble breathing; swelling of the legs, ankles, or abdomen; dizziness; fatigue; weakness; cold or clammy skin and/or a fast heart beat. If the patient has these symptoms, the home health care team should contact the patient’s doctor and carry out doctor’s orders to treat the symptoms. The team should also teach the patient and his/her caregivers about heart failure, ways to prevent these symptoms, and when to call the home health team. Some patients may not improve, or may get worse, even though the home health team provides good care.

Higher percentages are better.


How often patients’ breathing improved.

Mary Greeley
72%

Iowa Average
65%

U.S. Average
64%

What It Is and Why It Is Important

  • This shows how often the home health team helped improve patients’ breathing, meaning patients had less shortness of breath. Shortness of breath, or difficulty breathing, is uncomfortable. Many patients with heart or lung problems have shortness of breath because they can’t get enough oxygen to their lungs.
  • Shortness of breath is associated with breathing faster than normal and feeling like there is not enough air. This can make patients uncomfortable and anxious. Shortness of breath can also make a patient tire easily and unable to do normal activities. The home health team, in consultation with the doctor, should check the patients’ breathing and teach them ways to make breathing easier and more efficient; including:
    • Quitting smoking and avoiding secondary smoke
    • Performing breathing exercises
    • Positioning to breathe easier and encourage relaxation
    • Using several pillows to sleep
    • Planning for rest periods between activities
    • Limiting talking, if talking causes shortness of breath
    • Opening a window or using a fan to get air moving
    • Using a humidifier in the winter
    • Using oxygen or medicine correctly, as ordered by the doctorSome patients who have a chronic breathing problem like emphysema may not get better even though the home health team gives good care.

Higher percentages are better.

Treating Wounds and Preventing Pressure Sores (Bed Sores)

(Benchmark data collected from 10/1/2012 to 9/31/2013) 

How often patients’ wounds improved or healed after an operation.

Mary Greeley
87%

Iowa Average
87%

U.S. Average
89%

What It Is and Why It Is Important

  • This shows how often the home health team helped patients’ wounds improve or heal after an operation. Normal wound healing after an operation is an important marker of good care.
  • One way to measure the quality of care that home health agencies give is to look at how well their patients' wounds heal after an operation. Patients whose wounds heal normally generally feel better and can get back to their daily activities sooner than those whose wounds don't heal normally. The home health team can assist with wound healing in several ways:
    • Change the wound dressing, depending on the doctor's orders, or teach the patient or caregiver to change the dressing
    • Teach the patient or caregiver about the following:
      • Signs of wound healing
      • The types of foods that promote healing and restore normal functioning
      • Any drugs the doctor has ordered, such as drugs used to relieve pain Any signs of infection or other problems If any signs of infection or other problems are present, the nurse should contact the doctor and ask if there are additional orders.
      • If the patient sees signs of infection or has concerns about the wound on a day when the nurse is not scheduled to visit, the patient should be instructed to call the home health team to schedule a visit as soon as possible to look at the wound, or call the doctor. Some patients may not improve, or may get worse, even though the home health team provides good care.

Higher percentages are better.


How often the home health team checked patients for the risk of developing pressure sores (bed sores).

Mary Greeley
100%

Iowa Average
98%

U.S. Average
98%

What It Is and Why It Is Important

  • This shows how often the home health team checked to see if patients might be in danger of getting pressure sores (bed sores). This means the team may have checked the patient’s skin, asked about nutrition, and asked whether patients have problems controlling their bowel or bladder.
  • Some patients who get home health care are at greater risk of developing pressure sores (bed sores) because they are confined to bed, have problems moving around, don’t eat a healthy diet, or have trouble controlling their bladder or bowels. By finding out if the patient is at risk for pressure sores (bed sores) as soon as care begins, the home health team can teach the patient or caregiver ways to avoid pressure sores, such as:
    • Turning the patient often or encouraging them to move around
    • Eating and drinking healthy foods
    • Improving bladder or bowel control
    • Keeping the skin clean

Higher percentages are better.


How often the home health team included treatments to prevent pressure sores (bed sores) in the plan of care.

Mary Greeley
99%

Iowa Average
98%

U.S. Average
97%

What It Is and Why It Is Important

  • This tells you how often the home health team, included in the plan of care , ways to prevent pressure sores (bed sores) for patients at risk for developing them.
  • Patients who receive home health care can avoid getting pressure sores (bed sores) when the home health team takes steps to prevent them. The home health team can teach the patient or caregiver ways to avoid pressure sores, such as:
    • Turning the patient often or encouraging them to move around
    • Eating and drinking healthy foods
    • Improving bladder or bowel control
    • Keeping the skin clean

Higher percentages are better.


How often the home health team took doctor-ordered action to prevent pressure sores (bed sores).

Mary Greeley
100%

Iowa Average
98%

U.S. Average
96%

What It Is and Why It Is Important

  • This shows how often the home health team got doctor’s orders that included treatments to prevent pressure sores (bed sores) and provided those treatments to the patient.
  • Patients who receive home health care can avoid getting pressure sores (bed sores) when the home health team takes steps to prevent them. The home health team can teach the patient or caregiver ways to avoid pressure sores, such as:
    • Turning the patient often or encouraging them to move around
    • Eating and drinking healthy foods
    • Improving bladder or bowel control
    • Keeping the skin clean

Higher percentages are better.

Preventing Harm

(Benchmark data collected from 10/1/2012 to 9/31/2013) 

How often the home health team began their patients’ care in a timely manner.

Mary Greeley
96%

Iowa Average
94%

U.S. Average
92%

What It Is and Why It Is Important

  • This shows how often the home health team began a patient’s care:
    • On the date the doctor ordered
    • Within two days after the agency was notified of the order
    • Within two days of the patient coming home from the hospital or other facility The doctor’s order may or may not specify a start date. If the order doesn’t include a specific start date, home care should start either within two days after the agency was notified of the order or the date the patient was discharged.
  • It is important for patients to get the home health care they need, when they need it. If home health care is delayed, the patient’s condition could worsen.

Higher percentages are better.


How often the home health team taught patients (or their family caregivers) about their drugs

Mary Greeley
99%

Iowa Average
93%

U.S. Average
92%

What It Is and Why It Is Important

  • This shows how often the home health team taught patients or their family caregivers about their drugs (including prescription drugs, over-the-counter drugs, vitamins, and herbal supplements). This teaching includes the following:
    • When and how to take each drug
    • How to tell whether each drug is working
    • What side effects to watch for
    • What to do if side effects happen
  • When patients understand how their drugs work, they’re more likely to take them correctly, and less likely to make a mistake that may cause harm.

Higher percentages are better.


How often patients got better at taking their drugs correctly by mouth.

Mary Greeley
62%

Iowa Average
51%

U.S. Average
51%

What It Is and Why It Is Important

  • This shows how often the home health team helped patients get better at taking their prescription and other drugs correctly (including prescription drugs, over-the-counter drugs, vitamins, and herbal supplements). The measure includes only drugs the patient takes by mouth.
  • For drugs to work properly, they need to be taken correctly. Taking too much or too little can keep the drugs from working properly and could cause unintended harm including death.The home health team can help teach ways to organize drugs and to take them properly. Getting better at taking drugs correctly means the home health team is doing a good job teaching patients how to take their drugs and about the harm that can occur if they don’t follow these instructions. Communication among the patient, doctor, and the home health team is important. Specific items that should be discussed include:
    • All the prescription and other drugs the patient takes.
    • Allergic reactions or bad reactions (like rashes or dizziness) to any drugs in the past.
    • If a drug isn’t working (for example, if the patient still hurts after taking pain medication). Some patients may not get better at taking their drugs even though the home health team provides good care.

Higher percentages are better.


How often the home health team checked patients’ risk of falling.

Mary Greeley
99%

Iowa Average
98%

U.S. Average
97%

What It Is and Why It Is Important

  • This shows how often home health team checked patients who are 65 and older to see if these patients might be in danger of falling down and hurting themselves. When home health care starts, the home health nurse will check for anything that could make a patient more likely to fall and hurt themselves, including:
    • A history of falling
    • A mental health condition
    • A drug regimen that includes many different drugs
    • Conditions in the home that may cause falls
    • Difficulty moving around
    • Difficulty getting to and from the toilet
  • Falls can seriously affect the health of an older person. By checking older people and their homes for things that could increase the chances of falling, the home health team can suggest ways to prevent falls and help keep patients safe.

Higher percentages are better.


How often the home health team checked patients for depression.

Mary Greeley
100%

Iowa Average
98%

U.S. Average
98%

What It Is and Why It Is Important

  • This shows how often the home health team checked to see if patients were feeling especially sad or depressed. The home health team cares for their patients’ mental and physical health. Some patients who need home health care may feel depressed, which may affect their recovery and their overall health. Some questions the home health team may ask to find out if patients are depressed are: “Over the last two weeks, how often have you had little or no interest in doing things?” or “How often have you felt down, depressed, or hopeless?”
  • When patients who may be depressed get the help they need, it helps their recovery and may improve their overall health.

Higher percentages are better.


How often the home health team determined whether patients received a flu shot for the current flu season.

Mary Greeley
89%

Iowa Average
80%

U.S. Average
71%

What It Is and Why It Is Important

  • The home health team should always consider whether each patient needs a flu shot for the current flu season. This shows how often the home health team found out if a patient needed or already received a flu shot.
  • Home health patients may be in danger of getting very sick from the flu because they already have a medical condition that may affect their ability to fight the flu. A yearly flu shot is an important way to keep from getting the flu.

Higher percentages are better.


How often the home health team determined whether their patients received a pneumococcal vaccine (pneumonia shot).

Mary Greeley
95%

Iowa Average
82%

U.S. Average
70%

What It Is and Why It Is Important

  • The home health team should always ask if their patients have ever had a pneumonia shot. This shows how often the home health team found out if the patient needed or already received a pneumonia shot.
  • Home health patients may be in danger of getting very sick from pneumonia, a serious lung infection, because they already have a medical condition that may affect their ability to fight pneumonia. A pneumonia vaccine may help prevent some types of pneumonia.

Higher percentages are better.


For patients with diabetes, how often the home health team got doctor’s orders, gave foot care, and taught patients about foot care.

Mary Greeley
99%

Iowa Average
95%

U.S. Average
94%

What It Is and Why It Is Important

  • This shows how often the doctor’s orders included diabetic foot care and how often the home health team checked the feet of patients with diabetes for problems and taught patients (or their family caregivers) special foot care.
  • Patients with diabetes are at greater risk of having problems with the blood circulation in their feet and therefore need regular foot care. Even a small problem like a cut or a blister can lead to serious health problems, including having to remove a toe or the foot (amputation). Regular foot care helps prevent these problems and keeps patients with diabetes healthy.

Higher percentages are better.

Preventing Unplanned Hospital Care

(Benchmark data collected from 10/1/2012 to 9/31/2013) 

How often patients receiving home health care needed any urgent, unplanned care in the hospital emergency room – without being admitted to the hospital.

Mary Greeley
10%

Iowa Average
14%

U.S. Average
12%

What It Is and Why It Is Important

  • This shows how often home health patients had to go to the emergency department (without being admitted to the hospital) while they were receiving home health care. When a patient who is receiving home health care has to go to the emergency room, it may be a sign that they did not receive the right kind of care or teaching from the home health team.
  • The home health team develops and carries out a plan of care for each patient. The plan of care is designed to help prevent medical emergencies. In many cases, a call to the home health team or a visit from them can prevent a visit to the emergency room. Some patients may need to go to the emergency room even though the home health team provides good care. Lower numbers are better for this measure.

Lower percentages are better.


How often home health patients had to be admitted to the hospital

Mary Greeley
15%

Iowa Average
17%

U.S. Average
16%

What It Is and Why It Is Important

  • This shows how often patients were admitted to the hospital while under the care of the home health team.
  • Some home health patients may need to be admitted to the hospital, even if they are getting good care. For example, some chronic medical conditions can’t be cured and, over time, may make a patient’s health worse. For some patients, a readmission to the hospital may be a planned part of continuing treatment for their medical conditions. However, some inpatient hospital care may be avoided if the home health team is doing a good job checking the patient at each visit to find problems early, and communicating regularly with the doctor and other members of the team about the patient’s condition. The home health team should check how the patient is eating, drinking, how well they are taking their prescription and other drugs, and how safe the home environment is. If the patient shows signs of getting worse, the home health team should notify the doctor as soon as possible. In some cases, the doctor will want to see patient or have the patient go to an urgent care facility or a hospital. Lower numbers are better for this measure, because the home health team, in many instances, can prevent the need for hospital care. At the same time, the home health team should ensure that patients who need hospital care are hospitalized as soon as possible. Lower numbers are better for this measure.

Lower percentages are better.

Patient Experience of Care Survey

The purpose of the survey is to gather information from patients (or their family or friends) about experiences with a home health agency. The survey asks patients about their home health care, and if they would recommend that agency to someone else. The survey tells you what other patients thought about a home health agency. The survey results also tell home health agencies where to focus their quality improvement efforts.

Patient Experience

Patients who reported that their home health team gave care in a professional way.

(Survey data collected from patients who got home health services between 7/1/2012 to 6/30/2013)

Mary Greeley
89%

Iowa Average
88%

U.S. Average
88%

What It Is and Why It Is Important

  • Patients who got home health services during the current reporting period reported how often their home health team gave care in a professional way. “Gave care in a professional way” means that:
    • There were no problems with the home health care
    • Providers were always gentle
    • Providers were always respectful
    • Providers were always up-to-date about the patient’s treatment
  • This shows the percent of patients surveyed who said the home health team gave care in a professional way.

Higher percentages are better.


Patients who reported that their home health team communicated well with them.

Mary Greeley
89%

Iowa Average
86%

U.S. Average
85%

What It Is and Why It Is Important

  • Patients who got home health services during the current reporting period reported how well their home health team communicated. “Communicated well” means that the home health agency did all of the following:
    • Explained services before giving them
    • Gave advice promptly
    • Always said when staff would arrive
    • Always explained things clearly
    • Always listened carefully
  • This shows the percent of patients surveyed who said yes the home health team always communicated well.

Higher percentages are better.


Patients who reported that their home health team discussed medicines, pain, and home safety with them.

Mary Greeley
84%

Iowa Average
86%

U.S. Average
84%

What It Is and Why It Is Important

  • Patients who got home health services during the current reporting period reported if their home health team talked with them about:
    • Medicines
    • Pain
    • Getting around their home safely
  • This shows the percent of patients surveyed who said yes the home health team discussed medicines, pain, and home safety with them.

Higher percentages are better.


Patients who gave their home health agency a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest).

Mary Greeley
83%

Iowa Average
85%

U.S. Average
84%

What It Is and Why It Is Important

  • Patients who got home health services during the current reporting period answered a separate question that asked for an overall rating of the home health care services. Ratings were on a scale from 0 to 10:
    • “0” means “worst home health care possible”
    • “10” means “best home health care possible”
  • This shows the percent of patients surveyed who gave their agency a 9 or 10 on a scale of 0 (lowest) to 10 (highest).

Higher percentages are better.


Patients who reported YES, they would definitely recommend the home health agency to friends and family.

Mary Greeley
82%

Iowa Average
81%

U.S. Average
79%

What It Is and Why It Is Important

  • Patients who got home health services during the current reporting period reported whether they would recommend the home health agency to their friends and family.

    This shows the percent of patients surveyed who said yes, they would definitely recommend the home health agency.

Higher percentages are better.

 


Source:

Home Health Compare (www.medicare.gov/homehealthcompare) has information about the quality of care provided by “Medicare-certified” home health agencies throughout the nation. “Medicare-certified” means the home health agency is approved by Medicare and meets certain Federal health and safety requirements.

Home Health Compare can help you or your family or friends choose a quality home health agency that has the skilled home health services you need. The Home Health Compare Web site was created through the efforts of the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (DHHS).

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