Perhaps the most significant criticism of the rating system involves its reliance on self-reporting. That’s important, but so are other means of keeping patients safe, such as “improving or maintaining functional status, treating pain, maintaining weight, avoiding incontinence and catheter use, avoiding depression, avoiding physical restraints and the inappropriate use of antipsychotic medications, and improving vaccination rates.” For example, patient safety focuses on the prevention of harm by evaluating the number of patients that fall and the steps that nursing homes take to prevent falls. Some critics focus on the criteria that the ratings measure. The star ratings have been criticized almost from their inception. Ideally, they do so by striving to provide a high quality of care. Since consumers base choices on star ratings, nursing homes have an incentive to achieve high ratings. Nursing homes with the lowest ratings tend to be unprofitable. Nursing homes with the highest ratings therefore tend to have the highest profits. Clinical quality ratings are based on 15 criteria, including health outcomes, patient safety, and adherence to clinical guidelines.The rating considers whether more hours of care are devoted to residents who need them. Staffing ratings are based on the number of hours of care provided to each resident.Health inspection ratings are based on the three most recent health inspections, with greater weight assigned to the most recent.In addition to an overall rating, CMS awards stars in each of three categories: If the system works, family members should feel comfortable choosing a four-star or five-star nursing home and should be wary of choosing one that earned only a single star.Īccording to CMS, nursing homes with five stars are considered to deliver care that is well above average quality while nursing homes with one star are well below average. The CMS awards one to five stars to nursing homes (and certain other healthcare providers) that are certified to accept Medicare. A “care compare” website allows consumers to search for ratings by zip code or by a facility’s name. Centers for Medicare & Medicaid Services (CMS). With the best of intentions, the federal government instituted a rating system to help consumers make informed decisions. How do consumers evaluate the promises that nursing homes make to provide excellent care to their loved ones? Still, some deliver care more capably than others. Many of the nation’s nursing homes deliver quality care to people who desperately need it.
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