Nursing Home Rating System for Medicare Misleading?

With the growth of the internet and consumer-based reviews, we are constantly looking for the inside opinion on nearly every service we use. Whether it be the latest Hollywood movie to hit the screen or a new restaurant that opened down the street, we will quickly jump on board when we see the five-star rating. While the rating system generally provides accurate feedback, it doesn’t always pane out so well. Many have been disappointed to get to the movie and find out it was a flop or frustrated after eating at the new hot spot only to be treated with poor service and given cold food.

While this may be something to shrug off as a wasted evening in the entertainment or dining world, it is not such a light matter for ratings to be misleading in the health care world, especially when it comes to nursing homes. That is exactly was a recent New York Times investigation revealed about the way Medicare’s rating system was working. The report stated that Medicare was often providing misleading or incomplete information about the nursing homes in their system.

The ratings are on a one to five-star system and consider the following:

  • Quality of care measures
  • Nurse staffing levels
  • Health inspection reports

The reviews can be found on Medicare’s nursing home compare website. This is where the New York Times went to determine whether or not these ratings were truly accurate. They concluded that the incomplete information may give potential consumers a false sense of security, as the staff level and quality statistics were generally based off of self-reported data without any government verification. This makes it easy for any nursing home, quality or not, to claim they offer great service. Furthermore, the ratings did include any information on state fines, enforcement date, or complaints.

Nursing Homes Work Around the System

The New York Times essentially concluded that most nursing homes learned how to work around the system to harness great ratings, regardless of whether or not they actually qualified for a five-star rating. But wasn’t this obvious? Yes. Nearly half of the nations nursing homes had either four or five-star ratings in the system, even though two-thirds of the facilities within that group were on the federal watch list for lack of quality.

The misleading nature of the rating system just goes to show how important it is for individuals to consider a variety of factors when selecting a nursing home. You should make sure you schedule a visit with the nursing home, meet the staff, talk with residents, and discuss the decision with other family members before making a choice. You can also check with your state’s long-term care ombudsmen to determine whether or not they have had any complaints filed against them.

Have an issue with a nursing home? Want legal guidance? Contact our Nassau County elder law attorneys today.