Nursing Home Rating System Undergoes Changes
According to a recent article in the New York Times, the federal government stated that it intends to change the way it measures nursing homes to make it more difficult for a facility to earn a four or five star rating. The Centers for Medicare & Medicaid Services (CMS) created the Five-Star Quality Rating system to more easily assist consumers, their families, and caregivers compare nursing homes.
At medicare.gov you can go to the Nursing Home Compare page to look at nursing home ratings in your location. Like a hotel, five star ratings are homes with above average quality and 1 star means the home’s quality is greatly below average. A nursing home is rated overall and then in three separate categories: Health Inspections, Staffing, and Quality Measures.
How the Ratings are Calculated
CMS has a 5 step process to calculate how many stars a nursing home receives as follows:
- Start with the Health Inspection Rating.
- Add 1 star if the Staffing rating is 4 or 5 stars and greater than the Health Inspections Rating. Subtract 1 star if the Staffing rating is 1 star.
- Add 1 star if the Quality Measures rating is 5 stars. Subtract 1 star if the Quality Measures rating is 1 star.
- If the Health Inspections rating is 1 star, then the Overall rating cannot be upgraded by more than 1 star based on the Staffing and Quality Measure ratings.
- If a nursing home is a Special Focus Facility, the maximum Overall rating is 3 stars.
You can read more about the 5-Star Quality Rating System by visiting CMS’s Technical Users’ Guide.
CMS has released its updated system: Nursing Home Compare (NHC) 3.0. CMS has four areas it is revamping including: adding two additional quality measures (QMs), raising performance expectations, adjusting the Staffing algorithm, and expanding targeted surveys. CMS hopes to raise the standards for nursing homes to achieve a high rating. According to the New York Times article, federal officials believe that nursing home scores are likely to fall for many homes.
Do the Ratings Work?
Previously, the New York Times published an article stating that the nursing home rating system relied heavily on unverified and undocumented information. According to the New York Times, two of the three major criteria used to rate the homes were merely reported by the nursing homes and not checked by the federal government. After that article came out the federal government reported that it would require nursing homes to start reporting their staffing levels quarterly using an electronic system to verify the levels and that it would also begin auditing the program that checks the accuracy of the reported statistics on nursing homes.
On an interesting note, the New York Times reports that nursing homes with five stars had increased to 29 percent in 2013 from 11 percent in 2009.
Nursing Home Negligence
As the New York Times articles suggest, not all nursing homes are of the quality you suspect them to be. While the government tries to manage the rating of these homes, unfortunate circumstances can occur. If you have put your loved one in a nursing home and suspect abuse or neglect, please contact an experience attorney at McDivitt Law Firm today. We are here to help hold that nursing home accountable for its neglect or abuse.
Also, don’t forget to check out our blog on mandatory reporting laws for elder abuse.