Medicare will Change how it Rates Nursing Homes

Posted on: March 3rd, 2015 by Mark R. Friedman

The federal government is changing how it rates nursing homes.

Medicare publishes ratings on every nursing home in the country in a database called Nursing Home Compare.  It makes available a variety of information, and assigns a “star rating” similar to a restaurant or hotel, from one to five stars.

In August 2014, the New York Times reported that many nursing homes had received a five-star rating despite serious complaints about inadequate care at those facilities.  The thrust of the report was that Medicare did not examine nursing homes rigorously enough, and the star ratings could therefore be misleading.

Now, Medicare has released a new version of its database that it calls “Nursing Home Compare 3.0.”  The Centers for Medicare and Medicaid Services (CMS) says that the nursing home ratings will now consider standards on prescribing anti-psychotics, set higher standards for assigning a five-star rating, adjust how it considers staffing levels, and expand the use of targeted surveys to verify information that facilities self-report to CMS.

I applaud these measures, and hope they will make Nursing Home Compare more useful for seniors and their families grappling with the difficult decision on whether and where to enter into a long term care facility.  In particular I applaud the expanded use of surveys.  If CMS follows through on that point, it would go a ways towards addressing the heart of the problem with the nursing home ratings, which is that they rely too heavily on unverified data reported by the facilities themselves.

These developments are particularly welcome since Medicare has announced that it will begin assigning star ratings to hospitals.  Hopefully the standards for hospitals will be more rigorous.

Folks who are researching facilities may find it useful to examine ProPublica’s nursing homes violation database as well (although this is based on CMS data), including its New Jersey chart.

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