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The Flawed Five-Star Rating System for Nursing Homes

For the past five years, nursing homes have been using the government’s flawed five-star rating system. Many consider it flawed for its reliance on self-reported, unverified data. Two major criterion used to rate the facilities are staffing levels and quality statistics. The data for both of these recordings are submitted by the nursing homes themselves and generally are not reported by the federal government. Through faulty reporting procedures, even homes with documented history of qualityrating system problems were earning top ratings.

Starting in January, nursing homes will have to begin reporting their staffing levels quarterly, using an electronic system that can be verified with payroll data. Officials will also initiate a nationwide auditing program geared at checking quality measure ratings. The improved rating system will also take into account the percentage of its residents being given antipsychotic drugs. Such medications are often inappropriately given to help sedate residents with dementia, even though doing so can have dangerous effects. Other reporting measures to follow include: the percentage of residents who are readmitted to the hospital and the percentage discharged to the community.

To help implement these measures, last month President Obama signed into law a bipartisan bill passed in September that provides $11 million in funding to set up an electronic collection system. The Improving Medicare Post-Acute Care Transition Act also requires hospice to be inspected at least once every three years. Previously, many facilities went years without any inspections.

Choosing the right nursing home to best care for your loved ones is often a daunting task. Although this rating system is maintained and published through the Centers for Medicare and Medicaid Services and programs such as Medicare and Medicaid can help cover some of the costs of the nursing home, it does not mean much if your loved ones are not receiving proper care. Implementing these measures to ensure quality reporting will hopefully help families choose the nursing home with the best care or reassure patients and their families with their choice of nursing home. In the future, we hope to see that the improved rating system will have a positive correlation with better health outcomes for patients.

Meanwhile, experienced elder law attorneys are also familiar with the local nursing homes and can be helpful in the selection process. It is always helpful to visit the nursing home in advance.

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