Medicare to Use Five-Star System to Rate Nursing Homes

The Centers for Medicare and Medicaid Services (CMS) announced it will soon rate nursing homes using a five-star rating system.  CMS will likely use staffing levels and the results of federal and state inspections to rate nursing homes.  The American Health Care Association -- the trade group that represents the interests of nursing homes across the country -- said the ranking system should also rely on consumer and staff satisfaction reports.  The number of stars earned by each facility will be posted on CMS' Nursing Home Compare web site.  

According to CMS' acting administrator, the fewer the stars, the more work required by the nursing home to improve its performance.  “I don't think we're going to see many people who are very anxious to put a loved one in a one-star home,” the CMS acting administrator said.  True enough! 

A word of caution, though.  A rating system that assigns stars to nursing homes can be just as dangerous as it can be helpful.  Consumers might conclude that a facility with a five-star rating is better than a facility with three stars, when the three-star facility might provide better care more consistently, but just have been unlucky enough to have been "caught" more often.  Consumers might also interpret a five star rating as a sign that a facility provides better care in all areas than a facility with fewer stars, when the facility with fewer stars provides much better care in one or more specific areas, like pressure ulcer (bed sore, pressure sore, decubitus ulcer) prevention and treatment and prevention of falls. 

The star rating system is well-intentioned.  As long as consumers and CMS do not allow the star rating system to become a short cut to a full-blown investigation of the facility's full track record of care, we all stand to benefit.
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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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