New Ratings Put Spotlight On Nursing Homes

22 Percent Of Nursing Homes Get Minimum, One-Star Rating; 12 Percent Get Top Score

(CBS/AP)  Sister Alphonse Marie never thought she'd ever get rated like a restaurant, but the nursing home she runs just earned a top 5-star rating in the government's first ever ranking of nursing homes, reports CBS News correspondent Wyatt Andrews.

To some of the residents, those five stars aren't enough.

"They deserve six stars," said one.

The explanation: " I think it is a daily striving to give the very best care possible to our residents," said Marie, administrator of the Jeanne Jugan Residence in Washington, DC.

But other nursing homes did not fare so well in the ratings, which are based on a variety of measures, including state health inspections and the number of staff, Andrews reports.

About 22 percent of the nation's nearly 16,000 nursing homes received the government's lowest rating in a 5-star system unveiled Thursday. Only 12 percent received the highest ranking.

Such a simple rating for so complex a task as caring for the elderly has led to much anxiety in the nursing home industry.

Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services, said the agency was merely taking existing data already on the agency's Web site and making it easier for patients and families to choose a nursing home. He said it can be difficult for people to understand all the aspects of an inspection.

"This should help consumers in narrowing their choices, but nothing should substitute for visiting a nursing home when making a decision," Weems said.

Officials also see the new rating system as a way to challenge nursing homes to improve the care they provide to nearly 1.5 million patients nationwide.

"Transparency is key when it comes to nursing home quality," said Sen. Herb Kohl, D-Wis.

Under the new system, five stars means a nursing home ranks "much above average," four star indicates "above average," three means "about average," two is "below average" with a one indicating "much below average." The rankings will be updated quarterly. The industry is already questioning the validity of the rankings.

To nursing home operators, the five-star system is a great idea whose time has not yet come.

The system "is poorly planned, prematurely implemented and hamhandedly rolled out," said Larry Minnix, president and chief executive officer of the American Association of Homes and Services for the Aging, an industry trade group.

The ratings are based on three major criteria: state inspections, staffing levels and quality measures, such as the percentage of residents with pressure sores. The nursing homes will receive stars for each of those categories as well as for their overall quality.

Consumer groups like the concept, but they agreed there are some potential problems with the data. For example, the staffing data is self-reported just before state surveys and is widely recognized as unreliable.

"From a consumer viewpoint, it's not stringent enough," said Alice H. Hedt, executive director of the National Citizens' Coalition for Nursing Home Reform. "It's basically taking information already available on Medicare's Nursing Home Compare Web site and pulling it into an easier system for consumers to use, and that is a good thing."

Hedt said consumers should consider the star ratings, but not solely rely on them when comparing facilities. Her organization also issued a press release warning that nursing homes may appear in the ratings to give better care than they actually do.

"Our initial reaction is that consumers should probably avoid any facility with a one- or two-star rating and even a three-star rating unless people they trust convince them that the rating is inaccurate or unfair," she said.

But, in Indiana, eight nonprofit nursing homes have reported they got one star for staffing even though they have some of the highest staffing levels in the state, said Jim Leich, president and chief executive officer of the Indiana Association of Homes for the Aging. He believes the one-star rating is the result of a records glitch particular to any nursing home that is part of a campus that includes housing for residents with less intensive care needs.

"It's really going to be an injustice for some of our best facilities," he said.

The Jennings Center for Older Adults in Garfield Heights, Ohio, got four stars for its nursing home, said Martha Kutik, the center's president and CEO. Still, she's worried that the rating system relies on surveys that measure cracks in the ceiling but don't measure patient and family satisfaction.

"Any system that's going to measure quality for consumers should keep satisfaction high on the list," Kutik said.

CMS used three year's worth of inspections to rate nursing homes based on an annual survey designed to measure how well homes protect the health and safety of their residents. The measurement for staffing reports the number of hours of nursing and other staff dedicated per patient each day. The measurement for quality looks at 10 areas, including the percent of patients with bed sores after their first 90 days in the nursing home and the number of residents whose mobility worsened after admission.

Weems said he expected criticism from individual nursing homes and their representatives in Washington.

"Criticisms are the path to improvement, so we hope to hear from them," Weems said.

As he told Andrews, "If there is competition for the residents, especially among the high quality nursing homes, I think we're all going to benefit from that."

[drivelphobe]

As with all goods and services, the best are the most expensive. Quality care for the aging is restricted, as it should be, to those with the ability to pay and with the connections to get it. We are capitalists and to the victor goes the spoils. I am sickened at the whining from those who demand and expect that which they don''t deserve.

[wl7bzh]

Be careful how you treat your children as you raise them and when they are adults. For they will be deciding in which one of these homes you will be placed.

Posted by eggy1620 at 11:30 AM : Dec 19, 2008

What goes around.....?

[eggy1620]

Be careful how you treat your children as you raise them and when they are adults. For they will be deciding in which one of these homes you will be placed.

[godseyesore-2009]

HHS download site is stupidly and narrowly focused on a single operating system. Nice going with taxpayer funds. The site should provide access to all citizens.

[pirmin3]

These ratings will be for sale just like congress is. Waste of time.

[vcofreason]

Nursing homes that neglect or abuse ANYONE should be closed, have any funding ripped out from under them and the owners AND the scum that did it thrown in jail and held criminally responsible. I think they should start a registry of all the trash that works in those homes that steals and abuses these defenseless people.

This article was poorly written with confusing writing and inadequate anything. CBS needs to step up the pace and get some proper writers in. That was sad.

[wardoglrs]

The American society and the intention of Freedom has been hijacked by there elected officers