Medicare Changes Raise the Bar for Nursing Home Ratings

In February 2015, the Centers for Medicare & Medicaid Services (CMS) implemented changes to the nursing home rating system. The five star rating system sets the bar for nearly 16,000 nursing homes across the country. Families rely on the system as they choose the best facility for the care of their loved ones. Criteria include the processing and analysis of standards of care regarding performance on quality measures, staffing levels and health inspection results.

Recent reforms to the system were made in light of a growing number of five-star ratings that didn’t match up to patient outcomes. The old ratings were often self-reported by the nursing homes and easily skewed. According to a New York Times article, about “80 percent of the nation’s nursing homes received a four- or five-star rating on their quality measures score (before the changes); afterward, nearly half did.” As a result, staffing scores decreased significantly with the new changes to the system.

Per CMS, a few of the main changes to nursing home star ratings involved:

Improved calculation and verification of staffing levels. We find that staffing is a strong indicator of quality levels in nursing homes and certainly tied to a family’s peace of mind.

Raised standards for achieving higher ratings on the quality measure dimension on the Nursing Home Compare website.

The administration of antipsychotic medications in relation to diagnoses that do not warrant use. Two quality measures regarding antipsychotics for short-stay and long-stay patients will now be configured into the quality measures star rating.

If you, a family member, or a friend is considering a nursing home placement, these changes are good news. But, of course, the rating system is not the only measure that should be taken when selecting a facility. For more on choosing a nursing home, check out one of my previous articles right here.

Putting the health of someone you love into another’s hands is never an easy decision but an easier one to make when you’re informed. If you have questions or concerns about your loved one’s nursing home, please do not hesitate to give us a call.