Five Star Quality Rating System for Nursing Homes
Baltimore's Inner Harbor and the site of the 2009 Institute of Medicare and Medicaid Payment Issues.
The 2009 Institute on Medicare and Medicaid Issues was, as in years past, a well-run and highly informative event. The Institute provides the latest developments in law, and the opportunity to discuss those developments with employees of the Centers for Medicare and Medicaid Services ("CMS").
One hot topic addressed at the conference was the most recent evolution of the Nursing Home Compare Website. Similar in look to a hotel rating system, the site will now include the new five-star quality rating program in which CMS assigns each nursing facility a star rating. A one star rating is classified as "much below average," while a five star rating gets the "much above average" rating. While the Five-Star program is intended to provide consumers with an easy way to compare nursing homes, it has garnered quite a bit of controversy. After all -- your nursing facility is not a hotel.
Even CMS concedes that those facilities with one star ratings still meet the federal conditions of participation. The star ratings are based exclusively on the subjective review of federal surveyors and may cause the average consumer to avoid all but the highest rated facilities. While that might seem like a logical (and desired) progression, a one star facility might still be the perfect fit for a loved one. The only way to tell is to make the visit and interview the facility.
So what does it take to get a higher rating? Survey, Staffing & Quality Measures. The scoring system starts with a review of the most recent on site inspections by surveyors (including standard annual surveys and complaint surveys), and then adds and compares that information to annual surveys conducted in the last three years along with complaint surveys from the same time period which resulted in a deficiency. The more frequent citations with higher severity the lower the ultimate rating. Once the initial score has been determined, they can add or subtract a star based on the staffing levels CMS finds optimal. Next, a star is added or subtracted based on a quality measure rating (e.g, the frequency of pressure sores, or changes to a resident's mobility).
Published Ratings
On December 18, 2008, CMS published its rating system. 23% of nursing homes were rated as one star, 21% as a two-star, 23% as a 4-star and 12% were rated as five star. Take a look at the site http://www.medcare.gov/NHCompare/ . Let me know what you think.
