Care note

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With nursing notes the benefits under the rate in Germany nursing facilities, SGB XI (care insurance) provide. The grades are awarded by the regional associations of the long-term care insurance funds . They are based on the results of the quality tests by the Medical Service of the Health Insurance (MDK). The political goal is to make the services provided by the outpatient and inpatient care facilities and their quality understandable, clear and comparable for those in need of care and their relatives. The care notes are published on the Internet and must be posted in a clearly visible place by the care facilities.

The criteria for publication and the evaluation system are set out in the care transparency agreements - separately for inpatient and outpatient areas .

The care grades are controversial because there are currently no scientifically proven findings on valid indicators of the quality of results and quality of life of nursing care in Germany. The Federal Social Court considers the publication of the nursing notes to be lawful and constitutionally unobjectionable.

Procedure for determining grades according to the transparency agreements

The evaluation criteria are defined in the transparency agreements and assigned to different quality areas.

There are five quality areas for the inpatient area:

  1. Nursing and medical care with 35 assessment criteria
  2. Dealing with residents with dementia with 10 evaluation criteria
  3. Social care and everyday life with 10 evaluation criteria
  4. Housing, meals, housekeeping and hygiene with 9 evaluation criteria
  5. Survey of residents with 18 evaluation criteria

There are four quality areas for the outpatient sector:

  1. Nursing services with 17 evaluation criteria
  2. Medical prescribed nursing services with 10 evaluation criteria
  3. Service and organization with 10 evaluation criteria
  4. Survey of customers with 12 evaluation criteria

To find the care grades, each individual criterion is rated on a scale from 0 to 10. The arithmetic mean of the individual evaluations initially results in an overall grade from very good to poor for each quality area. If criteria do not apply and are therefore not assessed, they are not included in the calculation of the overall assessment.

From the respective overall grades for quality areas 1 to 4 (inpatient) or 1 to 3 (outpatient), the overall result of the examination is determined at the end. The total result is compared with the comparison value in the respective federal state (state comparison value).

The results of the resident survey (quality range 5 or 4 in the inpatient or outpatient area) are shown separately with the number of respondents and are not included in the overall rating.

discussion

  • All parties agree that the care grades should only be one criterion for the decision on the selection of the care facility.
  • The grade determination is also based on the documented performance of the institutions. Services provided but not documented cannot be taken into account. If achievements are documented but not performed, there can be unjustifiably better grades.
  • Despite the maintenance transparency agreements, different review teams in different regions assess comparable services differently.
  • Problems with the responses from those in need of care and their relatives become clear in the results of the residents' survey (October 2009). The respondents did not give grades 4 or 5. 98.8 percent of the facilities received a grade of 2 or better. This can hardly offer those in need of care and their relatives a decision-making aid when choosing a facility. The results of these surveys are not included in the overall grade.

Web links

Individual evidence

  1. § § 115 Abs. 1a SGB XI.
  2. Agreements in accordance with Section 115, Paragraph 1a, Clause 6 of Book XI of the Social Code on the criteria of publication as well as the assessment system of the quality tests of the medical services of the health insurance as well as equivalent test results in inpatient care and outpatient care services - inpatient care transparency agreement (PTVS) of December 17th 2008 as well as care transparency agreement outpatient (PTVA) - from January 29, 2009.
  3. see prefaces of the maintenance transparency agreements.
  4. Federal Social Court, judgment of May 16, 2013 - B 3 P 5/12 R.
  5. Reports from Steinfurt about two old people's homes under joint management that differ greatly ( memento of the original from June 7, 2015 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. were graded. @1@ 2Template: Webachiv / IABot / www.caritas-muenster.de
  6. Press release ( memento of October 16, 2009 in the Internet Archive ) of the MDS of October 8, 2009.