Study Highlights Consumers Should Use Multiple Research Tactics When Choosing a Nursing Home
A recent article by the New York Times reports that U.S. nursing homes have been manipulating the Nursing Home Compare star-rating system to conceal profound problems.
The star rating system was developed 12 years ago to help consumers determine which nursing home or long-term care facility is best for their loved one. The Nursing Home Compare system rates facilities on a scale from one to five stars, with one-star nursing homes considered “much below average,” and five-star nursing homes considered “much above average.”
The Centers for Medicare & Medicaid Services (CMS) rates Medicare- and Medicaid-certified nursing homes based on health inspection status, quality of resident care measures, and staffing.
According to a recent New York Times investigation that analyzed the data that controls the star-rating outcomes, “the system is broken.”
BBGA posts the Georgia nursing home star ratings annually as a service to the public. While star ratings can be used as a tool to research a nursing home or long-term care facility for a loved one, the New York Times investigation highlights the importance of using more than one research tool when making such a significant decision.
One of the flaws in the star-rating system may be the way in which the data is received. CMS may be relying too heavily on self-reported data, especially from 2020, when routine, in-person inspections were suspended. The star-rating system relies on a mixture of self-reported data from nursing homes across the country and on-site examinations by state health inspectors.
With the advent of COVID-19, CMS had previously suspended certain routine inspections as part of its response to the COVID-19 pandemic to “prioritize infection control and immediate jeopardy situations, and to give health care providers and suppliers time needed to respond to the spread of COVID-19.,” a press release by CMS reads.
The New York Times investigation relied on a database that analyzed millions of payroll records to determine whether facilities are providing residents with the hands-on care they are claiming to provide, reports by state inspectors about the facilities, and operational financial statements.
The results of the investigation revealed:
- A lot of the information submitted to the CMS by nursing homes is incorrect.
- Some nursing homes are inflating their staff levels.
- Resident accidents are often unreported.
- Many facilities that are currently rated five stars would likely fail an in-person evaluation.
- The government rarely audits nursing home data.
- Many facilities are aware in advance of an upcoming inspection and have time to prepare and cover up problems.
- Health inspectors routinely discovered issues with abuse and neglect in five-star facilities, but rarely deemed the issues serious enough to lower the facilities’ ratings.
In combination with reviewing the star rating system, other important research tactics might include talking to friends, family, doctors, social workers, and other trusted sources for recommendations; checking online reviews on multiple platforms such as Google, Facebook, and Yelp; Googling news articles about the facility; making multiple in-person visits to the nursing home or long-term care facility you are considering; and researching and visiting several different facilities for comparison prior to making a decision.