The NY Times had an article recently discussing how the nursing home industry is concerned about the new rating system for nursing home facilities. The industry is concerned because 22 percent of the nation’s nearly 16,000 nursing homes received the federal government’s lowest rating in a new five-star system, while only 12 percent received the highest ranking possible.
Under the new rating system, a facility could obtain up to five stars based on criteria such as staffing and how well they fared in state inspections. The lowest ranking possible was one star. Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services, said the agency was merely taking existing data already on the agency’s Web site and making it easier for patients and families to evaluate a nursing home. ”This should help consumers in narrowing their choices, but nothing should substitute for visiting a nursing home when making a decision,” Weems said.
Under the new system, five stars means a nursing home ranks ”much above average,” four star indicates ”above average,” three means ”about average,” two is ”below average” with a one indicating ”much below average.” The rankings will be updated quarterly. Of course, these ratings are based on how well the State investigates complaints and conducts surprise inspections. In South Carolina, DHEC is so poorly funded, and investigators are so poorly trained, that many violations are not recognized or complaints investigated. DHEC hardly ever finds any nursing home complaint substaniated.
The ratings are based on three major criteria: state inspections, staffing levels and quality measures, such as the percentage of residents with bed sores. The nursing homes will receive stars for each of those categories as well as for their overall quality.
Consumer groups note potential problems with the data. For example, the staffing data is self-reported just before state surveys and is widely recognized as unreliable.
”From a consumer viewpoint, it’s not stringent enough,” said Alice H. Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform. Hedt said consumers should consider the star ratings, but not solely rely on them when comparing facilities. Her organization also warned that nursing homes may appear in the ratings to give better care than they actually do.
CMS used three year’s worth of inspections to rate nursing homes based on an annual survey designed to measure how well homes protect the health and safety of their residents. The measurement for staffing reports the number of hours of nursing and other staff dedicated per patient each day. The measurement for quality looks at 10 areas, including the percent of patients with bed sores after their first 90 days in the nursing home and the number of residents whose mobility worsened after admission.
Industry officials said surveys conducted in some states are stricter than others, so they cautioned against using the new ratings to conclude that one state’s nursing homes were better than another’s.