MEDICARE RATINGS FOR NURSING HOMES MAY BE MISLEADING

A recent article pointed out that California has the highest amount of “Five-Star” nursing homes in the United States based upon rankings released by U.S. News & World Report. The magazine used data from Medicare’s Nursing Home Compare Website to arrive at its rankings. Overall, 388 California nursing homes received 5 star ratings.

However, as recently pointed out by the New York Times, these ratings can be misleading in that they are based on incomplete information. The Medicare ratings are based largely upon self-reported data by the nursing homes. This is often information which the government does not verify. Only one of three criteria used to evaluate nursing homes and determine their rating is performed by independent parties. Specifically, annual health inspections are determined by independent individuals. The other criteria, staff levels and quality statistics are self-reported by the nursing homes.

The ratings also do not take into account negative actions taken by the state including state enforcement actions. Thus, even nursing homes with a poor history of care can achieve good ratings based upon their self-reported statistics. This can mislead families and residents about the quality of care being provided at a particular nursing home.

Fortunately the federal government is revising how it evaluates nursing homes in a way that makes it hard for facilities to receive top scores. Pursuant to the new system, indicators such as staffing and the appropriate use of antipsychotic medications. Moreover, information obtain through on-site visits will be given more weight.

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