In recent weeks the Centers for Medicare and Medicaid Services, which oversees and monitors nursing homes, in conjunction with relevant state agencies, announced a significant reform of its “five star” rating system for about 15,000 nursing homes across the United States. These ratings, along with statistics as well as data on citations or sanctions, are available on CMS’s Nursing Home Compare website.
The old version of Nursing Home Compare relied largely on self-reported data by homes about the quality of care they offer to patients, as well as self-reported data on staffing levels. Much of this went unverified and led to certain homes being overrated due to the biased data. In order to remedy this problem, which was reported on at length in the latter months of 2014, CMS (which falls under the Department of Health and Human Services), worked to refine the data collection process by using payroll information to corroborate staffing level statistics and by stepping up investigations to verify the quality of care at facilities. It also adds a vital new piece of criteria that takes into account the use of antipsychotic medications, which is increasingly seen as a means of chemical restraint and an inappropriate way to medicate and sedate patients.
Effect of New Rankings
New ratings based on the revamped and more scrutinizing methods has resulted in the decrease of nursing home ratings across the country. Several nursing homes in Sauk Valley, Illinois, had their federal ratings on the Centers for Medicare and Medicaid Services five-star scale downgraded. As reported by saukvalley.com, seven nursing homes were downgraded by one star – two homes were decreased from four stars to three stars, three homes were decreased from three stars to two stars, and two more facilities were downgraded from two stars to one star.
This news regarding ratings comes on the heels of reports at the end of 2014, also made on saukvalley.com, of very poor performing nursing homes across the Sauk Valley area. From about the middle of 2011 to 2014, 65% of Sauk Valley nursing homes had deficiency citations, as compared to 25% across all of Illinois. Patients at Sauk Valley area facilities suffered various problems, such as not being administered needed insulin, not following code instructions (e.g. “resuscitate” during a hypoglycemic episode), improperly removing a tracheostomy tube, and deaths that result from certain negligence. Homes were hit with deficiency citations and fines – one facility in particular paid tens of thousands of dollars in fines to the federal and state governments.
This is particularly important data because Illinois ranks as one of the worst states for quality nursing homes in the country, and because Sauk Valley area facilities are primary reasons for that low rating, as the statistics demonstrate. Sauk Valley exemplifies how the change in the CMS five star rating system has led to diminished rankings thanks to greater scrutiny and closer verification of data versus the old process of using self-reported nursing home data. Critics point to limitations such as a limit on the number of homes that can receive higher ranks (four or five stars), while proponents would point to these tougher ratings forcing homes to work harder at caring for residents.
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