Long-term Care Ombudsman Blasts State Program That Gives Money to Substandard Nursing Homes

A nursing home ombudsman for a mid-west state told legislators that the state’s program to evaluate nursing homes is flawed. Further, flaws in the ranking system mislead state residents who search for quality care and rewarding facilities that barely meet minimal standards.

The state’s long-term care ombudsman called the Focus on Excellence 5 Star Ratings Bonus program "an unreliable tool.”

"I’m hoping they can improve it,” she said after a lawmaker held a forum at the state Capitol. "You cannot shop online. You have to go out in person.”

The lawmaker said he and several House members from both parties who attended the three-hour session plan to develop legislation to improve the program.

"We have this Focus on Excellence program that’s supposed to be paying people for performance that’s above and beyond the average, and yet what we’re hearing here is that there are some facilities that are being paid for excellence when in fact they’re not even meeting minimum standards,” he said.

"We have agreed as a group that we are going to jump in a van, and we are going to visit some nursing homes unannounced,” he said.

The Focus on Excellence Program, in its second year, is intended to provide a way for state residents to evaluate the state’s approximately 300 nursing homes and to give nursing homes a financial incentive to provide quality care. About $12 million annually is paid for the incentives.

About 95 percent of the nursing homes in the state take part in the pay-for-performance voluntary program. The Focus on Excellence program should not be confused with mandatory inspections by the state Health Department, whose findings are turned over the federal government and compiles them in a five-star rating system of its own: They can be found at medicare.gov.

One woman said she used the Focus on Excellence program to place her 102-year-old mother-in-law in a nursing home which received a top score of five stars. She said her mother received substandard care. The facility denies her allegations.

The founder of A Perfect Cause which looks into nursing home conditions, questioned why bonuses should be paid to nursing home operators to do their job.

He also asked whether any restrictions were placed on how the bonus money was spent.

"Nursing homes are providing woefully substandard services and they’re getting bonuses,” he said.

The Focus on Excellence Web site also is misleading to consumers, he said.

"This site does not offer a place where you can go and get other information,” he said. For more, read the story.


Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

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