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Nursing Home Ratings System to be Online By Year's End

Jun 19, 2008 | Parker Waichman Alonso LLP

A new nursing home rating system should be up and running on the Medicare Website by the end of this year.  The new site will employ a 5-star system to rate nursing homes based on government inspection results, staffing data and quality measures.  It is hoped that the new ratings systems will act as an incentive to encourage nursing homes to improve quality, and to stem the high rate of nursing home abuse and neglect that endangers so many residents.

There are 16,400 nursing homes with over 1.5 million residents nationwide.  Unfortunately, the quality of many nursing homes is questionable -  according to a recent report by the General Accounting Office, approximately one-fifth of all nursing homes were cited for serious deficiencies last year.  The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of negligence and or abuse, though it concedes that the number is probably higher. According to the National Center’s study, 57% of nurses’ aides in long-term care facilities admitted to having witnessed, and even participating in, acts of negligence and abuse. Data from the U.S. Centers for Disease Control and Prevention show that nursing home neglect played role in the deaths of nearly 14,000 nursing home patients between 1999 and 2002. Even when the consequences are not fatal, nursing home negligence robs victims of a sense of security and their dignity.

Information on nursing home quality can be tough to come by for families in the process of selecting a facility for a loved one.  The new ratings use information on a facility's staffing level, the number of patients with bed sores, violations and other data that shed light on the quality of care.  It may also include information such as whether a nursing home provides care to patients with dementia or those on ventilators.

Earlier this year, the Centers for Medicaid and Medicare Services added the identities of so-called Special Focus Facilities — nursing homes that rank in the worst 5% to 10% for inspection results in a given state - to the Nursing Home Compare database on its website.   These homes were selected for stepped-up scrutiny by regulators. The list includes about 130 facilities.

Consumer advocates are pleased that Medicare has committed to providing families with a tool they can use to find a quality nursing home, but stress that the site will only be useful if it is easy to use. Ease of use is one of Medicare's major goals for the site, and the agency will be  accepting public comments in July and August on the site and its contents.

One patient advocate also told The Wall Street Journal that the new nursing home ratings will rely too much on information furnished by the facilities themselves, which may make them inaccurate.  " Too often, nursing facilities report that residents are doing much better than they really are and that they have more staff than they really have," Toby S. Edelman, senior policy attorney with the Center for Medicare Advocacy said. "Relying on nursing homes to describe accurately how well they are doing -- and reporting that information as fact -- just doesn't make sense."