Nursing Home Abuse

Raising the Bar for Nursing Home Ratings

In late February of this year, federal star ratings of almost one-third of the nursing homes in the U.S. took a big hit. This is the result of a major adjustment of the quality standards that the Centers for Medicare and Medicaid Services references.  The goal is to make these ratings more meaningful to those considering long-term care facilities for themselves or for their elderly parents.

The main changes that went live on February 20, 2015 include adjusting the curve for the quality-measures (QM) rating. This rating is based on information about each patient. Here’s what Medicare states on its Nursing Home Compare website.

We have made 3 significant improvements to the Five Star Nursing Home Quality Rating System:

  1. Incorporated the 2 nursing home quality measures for antipsychotic use into the Quality Measure Rating.
  2. Increased the number of points necessary to earn a Quality Measure Star Rating of 2 or more stars.
  3. Changed the scoring method for the Staffing star rating. Nursing homes must earn a 4-star rating on either the RN or total Staffing rating to achieve an overall Staffing rating of 4-stars.

A large number of nursing homes are impacted by this new rating system and will see lower quality measure rating as a result of these changes.

Last fall, The New York Times published a scathing report about the nursing home rating system. The problem was that it relied too much on unverified information that even homes with a documented history of quality problems were earning top ratings. Nursing homes reported on two of the three major criteria used to rate operations — staffing levels and quality measures statistics — which were not audited by the federal government.

Last October, the federal government announced that it begin its requirement for nursing homes to report their staffing levels quarterly viaan electronic system. The new electronic system can verify the reports with payroll data. Moreover, a nationwide auditing program focused on the accuracy of a home’s quality statistic commenced at the same time.

As the New York Times points out: “Before the [Feb. 20, 2015] change, about 80% of the nation’s nursing homes received a four- or five-star rating out of five on their quality measures score; afterward, nearly half did. The number of homes receiving one star in that area increased to 13 percent, from 8.5 percent, after the recalibration.”

Consumer advocates on behalf of elder care applaud this stricter measure. Consumer Voice public policy director, Robyn Grant, told the NYT: “We think that rescaling the quality measures will result in improved reporting of the quality of care a nursing home may provide.” I can’t help but agree.

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