Icon: enlarge
Nursing home (symbol image)
Photo: Oliver Berg / DPA
In the past six months, many employees in the Medical Services of Health Insurance (MDK) had to reinvent themselves.
They had no other choice.
In mid-March, Federal Health Minister Jens Spahn announced that the MDK would suspend quality control in the homes until the end of September.
"People in need of care need our special protection," said Spahn.
The test stop should prevent seniors from contracting the coronavirus and the nursing staff in the homes from having to fill out too many report sheets.
The MDK tried to make the most of the forced break.
Many of his examiners are registered nurses or doctorate doctors; they have been given temporary leave to help fight the crisis.
They assisted in homes, clinics and health authorities or advised unsettled nursing staff on a telephone hotline.
Their compulsory break is supposed to end in October, the examiners are allowed to go back to the homes to lift the duvets of some residents and see whether the seniors may have been sore.
This also ends the worry that quality defects could go unnoticed because of the corona protective measures.
But shortly before the restart of the controls, consumer advocates expressed fundamental concerns.
It's about the new care TÜV, the specifications for the controls by the MDK.
"The new quality check procedure, which is replacing the previous care marks, remains difficult to understand in terms of its content and presentation," writes the Federation of German Consumer Organizations (vzbv) in a fact sheet.
The old system was "a farce"
The assessment is heavy, after all, the completely overhauled test procedure in inpatient care was only restarted last November.
Previously, the quality of care in homes was assessed by an overall grade.
The old care TÜV was criticized, however, because houses with serious defects also achieved top marks.
Clever home managers could easily cover up deficits.
The national grade average was 1.2.
Unfortunately, Health Minister Spahn had also stated that it was a "farce".
Everything should get better with the new system that scientists invented.
The medical services advertise in a brochure that the new procedure should provide "impulses for improving the quality of care for the benefit of people in need of care".
The new test procedure was "successful".
But will the reformed ratings really help the average consumer who wants to find a good nursing home for grandma or grandpa?
"However, there are still serious criticisms of the new system," writes the vzbv.
For the most part, the quality of care would only be ascertained internally, i.e. through information from the homes themselves;
the collected data would be "checked exclusively for statistical plausibility".
An external control by the MDK only takes place "on the basis of a small sample".
In each house, the inspectors visit exactly nine people in need of care at their bedside - regardless of how many residents live in the entire facility.
The vzbv is now demanding a "comparable summary of the test results and a quick overview of quality defects".
Since those in need of care pay a large part of the nursing home costs themselves and the national average is 2015 euros per month, and the trend is rising, they have "a right to understandable and comparable information," writes the vzbv.
The complex presentation of the results is currently "opaque for consumers".
However, this is precisely where a dilemma lies: the simplicity of the old notation system was criticized by experts.
The new differentiation should help.
20 pages long reviews
But the vzbv is not alone with its criticism, the BIVA-Pflegeschutzbund also expresses concerns.
"Unfortunately, the reform of the assessment missed the opportunity to establish more transparency in terms of quality," the association wrote in a statement.
For consumers one sees "no significant improvements".
While the old care TÜV with its summary of school grades did not allow a differentiated view of the homes, the new system is now far too complicated.
Those affected would have to work through reviews, some of which are 20 pages long.
The BIVA-Pflegeschutzbund also complains that the information on the quality of results came from self-reported information from the homes.
However, false information would not be penalized.
In addition, some criteria missed the interests of the residents.
The quality assessment focuses primarily on body-related categories such as wound care or the risk of falling.
From surveys, however, one knows that the quality of life is also important for residents, the main concern is maintaining self-determination and treating them with dignity.
There are great doubts about whether the quality will be maintained in all homes in view of the pandemic.
Despite all the criticism, the BIVA-Pflegeschutzbund therefore considers it "overdue" for the exams to be resumed.
Originally, all homes should be checked at least once by the end of 2020.
This schedule is likely to be delayed due to the corona break.
During the pandemic, nursing staff fell ill in many homes, and care services were canceled at the same time.
So it was "widespread deterioration in quality of care".
Because of the visiting bans, relatives could not have bridged these bottlenecks.
"In the past few months, we were often told in the BIVA advisory service that relatives had suffered severe physical, cognitive or psychological losses during the Corona period," it says.
That must now be worked through - by the auditors of the medical service.
Icon: The mirror
