The rating game.

The California HealthCare Foundation (CHF), a not-for-profit organization based in Oakland, is funding a $2.4 million program to evaluate the quality of the state's nursing homes and distribute the findings to the public.

The program, called the California Nursing Home Consumer Information System, will be carried out by a coalition consisting of the University of California-San Francisco (UCSF), the University of Wisconsin-Madison, RAND, the UCLA/Boran Center for Gerontological Research, and the California Advocates for Nursing Home Reform (CANHR).

"There's really no good way for consumers to evaluate and choose between nursing homes based on quality," said Ann Monroe, director of CHF's Quality Initiative, which funded the program. "When this project is completed, consumers will be able to access objective, unbiased, easy-to-understand ratings of the quality of care provided by each nursing home in the state."

AARP State President Jacki Antee said there's a real need for a rating system. "I know from personal experience how difficult [choosing a nursing home] is for family members," she said in a prepared statement. "We need to have a second opinion from someone we can trust."

Using a combination of existing state and federal nursing home patient data, facility inspection reports, and individual nursing home characteristics, researchers will develop two sets of indicators for evaluating nursing home performance. The first set of measures will be based on characteristics of the facilities themselves, including:

* Facility appearance and programs;

* State and federal inspection results, including identified deficiencies and enforcement actions;

* Consumer complaints filed with the state;

* Staffing indicators, including wages and benefits, staffing levels, and turnover rates; and

* Financial indicators, including facility solvency.

The second set of indicators will measure quality of care, including:

* Nutrition and eating;

* Physical and cognitive functioning;

* Behavioral and emotional patterns;

* Skin care;

* Psychotropic drug use;

* Accidents;

* Elimination and incontinence; and

* Quality of life.

CANHR, a not-for-profit outreach and education organization, will then disseminate the information to the state's nursing home residents and consumers by displaying and maintaining facility-specific quality performance data on its web site. It will also develop print guides and operate a toll-free help line.