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GAO Studies the CMS Nursing Home Rating System

Making the decision to place a loved one in a nursing home is always a difficult and emotional process. The San Diego nursing home neglect lawyer at our firm appreciate that the process is made even more difficult by the fact that most families do not know where to begin when choosing a home. With stories of nursing home mistreatment shared frequently, it is not easy to confidently select a facility where a loved one’s quality of care will be prioritized.

There are no fool-proof ways to chose a long-term care facility without having any risk at all of a senior suffering from neglect or mistreatment. However, one great resource to start with is the “Nursing Home Compare” website supported by the Centers for Medicare and Medicaid (CMS). The website offers various tools which allow those throughout the country to get an idea of how certain nursing home stack up against one another on a wide range of variables. Combining various data sets (mostly based on federal regulatory information), the website also gives virtually all nursing homes in the country a uniform rating of between one and five stars. The rating is perhaps the easiest way to get a split-second estimate of the level of care likely to be provided at any given facility.

This week the Government Accountability Office (GAO) released the results of a study into the CMS rating system. The study was called for by the Patient Protection & Affordable Care Act. The research examined the history of the nursing home rating system and the ways that the system might be altered in the future.

The star rating system has actually only been around for the last five years. In 2008 a CMS contracted company joined with a nine member “expert panel” to put the rating system together. The nine member panel was comprised of various shareholders, all of whom were deemed experts in long-term care research. Together they made various methodological decisions to put the current system into place. Perhaps of most importance, the group determined how measures of various individual factors—like staffing levels and numbers of citations—would combine to create the final star rating value.

The GAO continued by explaining that future changes to the rating system can be instigated in one of three ways. First, a stakeholder can share concerns about the system and ask for possible alterations. Second, routine monitoring by CMS could give rise to modifications. Finally, availability of new data sets might require inclusion into the ratings program. The report recommended that more planning be conducted to assess exactly how any possible change in the system might affect the actual goals of the program. By clearly laying out what is hoped to be achieved by the five star rating system, CMS officials will likely be better positioned to determine whether a suggested modification does or does not help reach those goals.

If you are going through the process of choosing a nursing home for a loved one, our North County nursing home neglect attorneys recommend taking a look at the resources online. However, no matter what location is chosen, it is important to keep eye on the care being provided after move-in. Mistreatment or negligent conduct is never acceptable and should be called to account if it occurs.

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