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CMS Earns 3 Stars for Updating the Zagat’s of Nursing Homes

  Alan Fuchsberg  |  February 14, 2015  |  

How do you choose a nursing home to take care of a loved one? Where do you start to look for nursing home ratings?

For some of us, just the term “nursing home” has negative connotations. It conjures images of dimly lit corridors with dingy rooms and a Nurse Ratched making her way from room to room with a tray full of prescription medications. Her spotless, blindingly white sneakers squeak on the linoleum floor with every step.

It is as if you were transported to the 1950s the moment you entered the building. You cannot get over the feeling that this is where Elizabeth Taylor is locked up in “Suddenly Last Summer.”

This is New York, though, where we have so many options available to us that we have come to rely almost exclusively on star ratings. Zagat, Michelin, Trip Advisor—we use the star ratings for the first cut, to narrow down the field. Then we read the reviews.

The Centers for Medicare and Medicaid Services offers a similar rating service for the nation’s 15,000 Medicaid-eligible nursing homes. The agency’s ratings are available in a searchable database called Nursing Home Compare, but these sites have not been evaluated by mystery shoppers or professional nursing home reviewers. In fact, until recently, the facilities submitted the data to CMS and CMS accepted it all without question.

Changes to the CMS Nursing Home Ratings

The system rates the facilities on a five-star scale based on three basic criteria: health inspections, staffing, and quality measures. CMS provided the inspection data. The facilities reported the other two. Staffing numbers include staff-to-patient ratios, hours of coverage and so on. Quality measures include the number of residents with pressure ulcers, the number of patients appropriately vaccinated against flu and pneumonia, etc.

There was plenty of room for embellishment, then, in two of the three categories. And as the New York Times pointed out last summer, even the inspection data had its shortcomings: Only Medicare inspections were included; state violations and fines were left to the consumer to discover.

The upshot is that facilities that fell short in important ways still received the highly coveted four- and a five-star rating.

If Zagat makes a mistake, you pay for the meal and never return. If CMS makes a mistake? It’s hard to undo a nursing home admission.

We’ll continue this in our next post. If you have questions about nursing home ratings, we invite you to contact our law firm.

Data Source: The New York Times, “Government Will Change How it Rates Nursing Homes,” Katie Thomas, Feb. 12, 2015

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