In May, the Kaiser Family Foundation released findings about nursing home ratings across the country, focusing on all homes certified by Medicare and/or Medicaid. The news for some is great, while news for others may be cause for concern. The report cited a general improvement in conditions over the three decades since the 1987 Nursing Home Reform Act, but that there are still deficiencies and consequently citations that plague the industry.
As was reported toward the end of 2014 and early 2015, the federal government’s Nursing Home Compare website, which is used by the Centers for Medicare and Medicaid Services (CMS) to rate nursing homes for consumers, was largely deficient. Nursing Home Compare rates nursing homes on a five-star scale. The system was overhauled to rely more on frequent and unplanned inspections, measuring staff through payroll data, calculating quality of care by considering residents’ health status (such as noting particular conditions like pressure sores or certain injuries or illnesses), (through inspections, for example), and additional criteria. Consequently, many homes saw their ratings decline as a result of the adjusted metrics.
According to published data and findings by the Kaiser Foundation, over a third (about 36%) of the 15,505 nursing homes across the country (which receive Medicare and/or Medicaid funding) had dismal ratings of two stars or fewer on the government’s five-star scale. A whopping 39% of nursing home residents nationally lived in these one and two-star facilities. Approximately 19% of homes (20% of residents nationally) were rated three stars, while 23% were at four stars (accounting for 23% of residents nationwide) and 22% were at five stars (comprised of 18% of residents across the country).
Profit vs. Non-profit
A particularly interesting factoid is that for-profit nursing homes tend to have lower overall ratings than non-profit or government-run nursing homes (about 7 in 10 facilities are for-profit). According to the data, about 42% of for-profit nursing homes received only one or two stars. A common goal of nursing homes in general is to cut overhead and costs as much as possible so that they can yield greater revenue and profit, yet that can leave them woefully understaffed such that residents suffer from negligence and abuse as a result of a sometimes non-present staff or an overworked staff. Thus by inference this statistic is not surprising, but still nevertheless disturbing.
The report reflects findings that smaller facilities (i.e. fewer beds and thus fewer residents) tend to boast better ratings. For example, 39% of homes with fewer than 60 beds received five stars, while 20% of facilities with between 60 and 120 beds received five, and only 14% of facilities with more than 120 beds received five. Conversely, only 20% of facilities with fewer than 60 beds received one or two stars, while the rate was 37% at facilities with between 60 and 120 beds, and a disturbing 45% at nursing homes with more than 120 beds received one or two stars. Notably, a similar trend related to size was found when breaking down by profit and for-profit nursing homes. For example, a third of for-profit facilities with fewer than 60 beds received five stars, while nearly half of non-profit homes with fewer than 60 beds received five stars.
These statistics, and the others presented in the report, should be considered by prospective nursing home residents and their families. Knowledge is power, and a facility’s ratings and history should be well known before making a decision.
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