Medicare to Improve Nursing Home Ratings System

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The Obama administration says it’s launching a makeover for Nursing Home Compare, the government website consumers can turn to when a loved one needs long-term care.  Officials said a key improvement will involve a new electronic reporting system to gather details on nurse and aide staffing directly from payroll records.  Staff-to-patient ratios are one of the most important predictors of quality, and currently the government relies on data reported by the facilities themselves.  Required by legislation, the payroll reporting system will take at least a year to implement.  Meanwhile, more focused inspections and new quality measures will be incorporated into the nursing home ratings.  Separately, the administration proposed an update to regulations for home health agencies, the first major rules change since 1989.
Improved quality is the goal.  This commitment to improved ratings information comes after an examination of the Medicare Star rating system by the New York Times found that many top-ranked nursing homes have been given a seal of approval that is based on incomplete information and that can seriously mislead consumers, investors, and others about conditions at the homes.  The Medicare ratings, which have become the gold standard across the industry, have been based in large part on self-reported data by the nursing homes that the government does not verify.  Only one of the three criteria used to determine the star ratings — the results of annual health inspections — relies on assessments from independent reviewers.  The other measures — staff levels and quality statistics — have been reported by the nursing homes and accepted by Medicare, with limited exceptions, at face value.  The ratings also did not take into account entire sets of potentially negative information, including fines and other enforcement actions by state, rather than federal, authorities, as well as complaints filed by consumers with state agencies.
While published ratings are one way to evaluate the quality of a possible nursing home for your loved one, it should not be the only way.  One of the best methods for determining the best facility for care is to visit the facility with a knowledgeable professional.  Our Certified Care Manager is able to accompany a client to nursing homes and point out the good and not so good qualities, as well as educate the client about how to get access to the plan of care and other information necessary to ensure the proper care is given.
If you have a concern about your legal rights, remedies and obligations, contact the experienced lawyers of Courtney Elder Law Associates.