Medicare strengthens rating system for nursing homes
You can now be more confident when looking for a nursing home for yourself or a loved one. Medicare has just improved its Nursing Home Compare website so that the public can get a more precise and meaningful picture of the quality of care at 15,800 nursing homes nationwide.
Families must often search for a nursing home for a spouse or parent at a moment’s notice, after some crisis or emergency. When no time to spare, many turn to Nursing Home Compare to begin their research. The website – at medicare.gov/nursinghomecompare — receives 1.4 million visits annually.
Nursing Home Compare provides details on recent health and safety inspections, nursing homes’ staffing levels and such quality measures as whether residents are in pain or losing weight.
The website uses a five-star rating system to help families understand the differences between nursing homes. Each facility receives a star rating for its overall performance and separate ratings for its recent inspections, staffing levels and quality measures. One star means “poor.” Five stars mean “excellent.”
Nursing Home Compare already enjoys a solid reputation among consumers – 85 percent find what they’re looking for. The latest revisions will make it even more trustworthy and user-friendly:
First, Medicare will rate nursing homes according to two new quality measures, both involving the use of antipsychotic medication. This is an outgrowth of an ongoing campaign to discourage nursing homes from using such powerful drugs simply to calm dementia patients who become unruly.
Next, Medicare will do more to verify the quality data and the staffing levels that nursing homes now report themselves. The government will inspect a sampling of nursing facilities and rely on payroll data to make sure operators aren’t overstating the quality of their care and the number of their caregivers.
Finally, Medicare will raise the standards for nursing homes to achieve a high star rating. This will encourage nursing home operators to step up their quality improvement efforts, as well as make it easier for consumers to distinguish the best performing facilities from the lesser ones.
Just three years ago, only 16 percent of nursing homes had scored five stars on quality measures. By this past January, 46 percent had reached that coveted rating. In fact, as many as 80 percent of nursing homes had scored four or five stars. One-star homes accounted for just 8 percent.
Though the higher scores may be partially the result of the nursing homes’ self-reporting, they’re also an indication of real improvements in patient care. As just one example, more attentive care of bed-ridden nursing home patients has reduced the prevalence of pressure ulcers in recent years.
As welcome as those caregiving reforms are, Medicare thinks more progress can and should be made. Quality improvement needs to be a continuous process. The new, more demanding thresholds for star ratings on the quality of care will challenge nursing homes to redouble their efforts.
A higher bar will lead to even better patient care.
The improved Nursing Home Compare website and the increased public scrutiny will help nursing home leaders pinpoint problems in their facilities and promptly correct them. Owners who don’t will be left to explain to a prospective resident why their nursing home compares so poorly against other facilities.
Still, the star ratings aren’t meant to be the final word on a nursing home’s quality of care. They’re simply a screening tool that lets families focus on a few facilities that interest them. The families can then have an informed conversation with a nursing home’s staff when they visit.
Even under the best circumstances, choosing a nursing home can be trying. There are always many emotions at work. But if you do both your homework and your legwork and take it one step at a time, you’ll be able to make an informed decision.