The New York Times reported changes to the Nursing Home Compare website on CMS.gov.  The federal government announced that it was changing the way it measures nursing homes, essentially adjusting the curve that it uses to rate homes to make it more difficult for them to earn coveted four- and five-star government ratings.  Under the changes, scores are likely to fall for many homes, federal officials said, although they did not provide specific numbers.

“In effect, this raises the standard for nursing homes to achieve a high rating,” said Thomas Hamilton, the director of the survey and certification group at the Centers for Medicare & Medicaid Services, which oversees the ratings system.  Nursing homes are scored on a scale of one to five stars on Nursing Home Compare, the widely used federal website that has become the gold standard for evaluating the nation’s more than 15,000 nursing homes even as it has been criticized for relying on self-reported, unverified data.

In August, The New York Times reported that the rating system relied so heavily on unverified information that even homes with a documented history of quality problems were earning top ratings. Two of the three major criteria used to rate facilities — staffing levels and quality measures statistics — were reported by the homes and not audited or verified by the federal government.

In October, the federal government announced that it would start requiring nursing homes to report their staffing levels quarterly — using an electronic system that can be verified with payroll data — and that it would begin a nationwide auditing program aimed at checking whether a home’s quality statistic was accurate. 

The changes were part of a further effort to rebalance the ratings by raising the bar for nursing homes to achieve a high score in the quality measures area, which is based on information collected about every patient. Nursing homes can increase their overall rating if they earn five stars in this area. The number of nursing homes with five stars in quality measures has increased significantly since the beginning of the program, to 29 percent in 2013 from 11 percent in 2009.

The updated ratings will also take into account, for the first time, a nursing home’s use of antipsychotic drugs, which are often given inappropriately to elderly patients with dementia.

 

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