Revamped Rating System Downgrades Nearly One-Third of Homes

How do the Feds rate nursing homes?

In a follow-up to a recent post, reports have come out indicating that the federal government’s rating of nursing homes saw an overall reduction in scores for almost one-third of the more than 15,000 nursing homes and long-term care facilities across the nation. These ratings are compiled and reported by the federal government through the Centers for Medicare and Medicaid Services (CMS) on a website called “Nursing Home Compare” in what is called its “five-star” quality rating system.

According to USA Today, about 1.5 million people use the website to look up ratings for nursing homes. Given the unfortunate history of many facilities when it comes to resident abuse and neglect, and the absolute importance of finding a place where an individual or a loved one needs proper treatment and attentive care, this is obviously a very important resource for those consumers. The website has been in need of a massive overhaul, however, because much of the quality data and staffing levels, which are two key criteria, were self-reported by facilities which of course could lead to bias or disingenuous reporting.

What were the problems?

The new CMS rating system published on Nursing Home Compare utilizes data that better verifies staffing levels by examining payroll records, calls for states to look into quality assessments, and even takes into account the use of antipsychotic drugs to control patients which has become increasingly frowned upon and discouraged in the industry as a method of chemical restraint where there are less chemical-based and more humane ways of calming patients.

What do the new results show?

With new criteria and better measurements, CMS came out with different data that downgraded the ratings of thousands of facilities, thus implying they were quite overinflated under the old ratings paradigm. According to reports, approximately 61% of facilities had their scores lowered in metrics related to quality of care, though overall their ratings did not drop as substantially. This shows, however, the obvious disparity and inaccuracy in the prior quality of care self-reported data. On a five-star scale, around 28% of nursing homes lost a star off their rating, and 3% lost a whole two stars with the new metrics. 1,200 of the homes that saw a decline in ratings actually fell from the top perch of having five stars (again on a previously inflated scale).

Is this good or bad?

Both. This may be seen negatively at first by consumers who may feel panicked at the lower rankings of some homes, or who may feel they do not know where to go. At the same time, however, there are still many homes that retained their overall status or at least stayed close to it. And more positively, we now know that CMS will employ more rigorous metrics and standards when assessing homes, which means over the long term that homes will be properly scrutinized so consumers can pick the right ones, and homes will also take note themselves so they can avoid the types of issues of abuse, neglect, mismanagement and otherwise that caused their lower rankings in the first place. The new system should hopefully spur facilities to improve quality of care, staffing levels, and methods of assisting patients. In the long run, it should truly be a win for everyone.

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