CMS adds rating system to nursing home data

The Centers for Medicare and Medicaid Services is expected to launch a “5 Star Quality Rating System” addition to its Nursing Home Compare Web site on Thursday. The ratings system is intended to be easier for consumers to use, as well as incorporating more data that has not been used in the past.

According to The Bakersfield Californian, “The new rating tool will use federal data to score each facility’s performance in three areas: health inspections, staffing and quality measures.”

While the link on the CMS Web site to the press release is not currently working, more information was available in an e-mail from CMS:

“The five-star information has been added to the site to condense the large amount of rich quality information already available on Nursing Home Compare.  The more detailed information on quality measures, inspections, and staffing will remain available even after the five-star information is added.

The five-star system uses 10 of the 19 key quality measures currently posted on the Nursing Home Compare Web site, including the percent of residents who had pressure ulcers, the number of residents whose mobility deteriorated after admission, and whether residents received the proper medical care, as well as staffing levels in long-term care facilities.”

3 thoughts on “CMS adds rating system to nursing home data

  1. Pingback: Disruptive Women in Health Care » Blog Archive » ‘Tis The Season

  2. Avatar photoGregory D. Pawelski

    State Surveys are independent evaluations of nursing facility performance. Annual surveys are conducted by state survey agencies, usually the state’s department of health, using protocols, procedures, and forms developed by the Centers for Medicare & Medicaid Services (CMS).

    A consumer concern about surveys is the repeated finding by the Governement Accountability Office (GAO), in a series of reports issued since 1998, that surveys understate deficiencies and cite deficiencies as less serious than they actually are.

    The survey component of CMS’s proposed ranking system provides a more positive statement about quality than justified. States are increasingly using their state enforcement systems, instead of the federal system, to sanction facilities for noncompliance with standards of care. State enforcement actions do not appear on Nursing Home Compare.

    The National Senior Citizens Law Center recommends that consumers use the new rating system with caution, and only as an aid while also pursuing other information and strategies. Consumers need to understand that the five-star system is a beginning, not an end.

    A nursing home’s quality can shift from month to month, so you have to be savvy in asking the right questions. Existing residents and their family members should be asked for their opinions.

    Inspection data is mostly based on a once-a-year survey and may not accurately reflect the nursing home’s performance today. Staffing information and quality measures are “self-reported” data by the nursing homes themselves. Self-reported data makes nursing home quality “appear” to be better than it actually is. It cannot easily be reduced to a star rating.

    A recent GAO study found that nursing homes over-report staffing levels compared with staffing reported on audited Medicaid cost reports. Over-reporting of nursing coverage is associated with for-profit ownership of nursing homes.

    Researchers recommend more careful scrutiny of staffing levels in for-profit facilties during the survey process and that improvements be made to the process of public reporting of staffing levels.

    CMS should provide more and better information on Nursing Home Compare, including links to the actual survey forms and information about staff turnover. Also, CMS should use payroll data to report staffing information.

    Anything to do with “quality indicators” is bogus. When de-regulation failed under the present adminitration, they wanted, among other things, the “quality indicator” process to eventually replace traditional annual surverys because it relies upon self-reported, unaudited data supplied by the facilities themselves and is without consequences for failures.

    It leaves you with that warm-n-fuzzy “we’ll-help-them-fix-their-problems,” even though 99% of their failures are failures of practices they should already be experienced in before they are granted a license. It is part of the “kid-gloves,” don’t be-so-hard-on-the-poor-poor-nursing-homes” from the Bush administration.

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