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Wednesday, June 18, 2008

Nursing home star rating system unveiled

Just like deciding between a one-star and five-star hotel or restaurant, the Centers for Medicare and Medicaid Services plan to launch a star rating system for nursing homes. The idea is to make it easier for prospective residents and their families to select a quality home.

The rating system will be posted on Medicare’s Web site — www.medicare.gov — by the end of the year.

“More than 3 million Americans rely on services provided by a nursing home at some point during the year. The new ‘five-star’ rating system will provide a composite view of the quality and safety information currently on Nursing Home Compare to help beneficiaries, their families, and caregivers compare nursing homes more easily,” said Kerry Weems, CMS’ acting administrator.

The proposal drew jeers and cheers from the nursing home industry and patient advocates.

Bruce Yarwood, president and CEO of the American Health Care Association praised the idea of the rating system but said he was concerned about using survey data to assess quality in individual facilities.

“Every one of our nation’s nursing home residents deserves the highest quality nursing home care, and although we applaud the longstanding work of CMS, we do not believe that an index which relies upon a broken survey system is an accurate way to measure quality, Yarwood said. “Quality improvement is a dynamic ongoing process - and its quantification must reflect the many variants that go into the delivery of care.”

Yarwood also urged the agency to, “incorporate consumer and staff satisfaction, which are two critical components of quality care,” in its rating system.

Larry Minnix, president of the American Association of Homes and Services for the Aging also hailed the idea of a quality rating system, but questioned whether there is adequate public oversight.

“Numerous expert opinions and reports speak to its inconsistency, subjectivity, lack of timeliness and unintelligibility to the public,” Minnix said in a statement.

Meanwhile, AARP issued a statement applauding the rating system.

“The star rating system proposed today could make it easier for families to identify facilities that consistently provide quality service and safety for their residents,” said AARP Executive Vice President John Rother.

“AARP is also hopeful that added transparency will spur the industry to improve the performance of every nursing home. We look forward to working with CMS to refine the rating system announced today as we work toward making ‘Nursing Home Compare’ an even more valuable tool for families in need of long-term care.”

The Center for Medicare Advocacy said it supported CMS’ intent but questioned the reliability of data that are based on industry reports.

“Two of the three criteria that CMS plans to use — quality measures and staffing data — are self-reported by nursing facilities and are inaccurate,” said Toby S. Edelman, senior policy attorney with the Center for Medicare Advocacy.

“Too often, nursing facilities report that residents are doing much better than they really are and that they have more staff than they really have. Relying on nursing homes to describe accurately how well they are doing - and reporting that information as fact - just doesn’t make sense.”

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