The Washington Post and Kaiser Health News reported in mid-July that the CMS rating system for nursing-homes, introduced in December as a makeover for its Nursing Home Compare web resource, has drawn a mixed response from industry and consumer groups who question its effectiveness at meeting the public’s needs (“Nursing-Home Ratings Draw Mixed Reviews,” July 14).
15,600 nursing homes were rated through the new system in December, and although some observers, such as Sen. Herb Kohl (D-WI), spoke favorably of the result, last month’s Post article said industry groups have complained that the ratings mislead families and patients by failing to give “an accurate picture of the amount and kind of care in each facility,” while nursing homes and consumer groups alike, including AAHSA and NCCNHR, were dissatisfied with the new system’s method for rating staffing, which “all sides agree is the best indicator of quality of care.”
PHI spoke with Janet Wells, Director of Public Policy at the National Citizen’s Coalition for Nursing Home Reform (NCCNHR), to ask about the organization’s stance on the rating system and its surrounding controversy.
She said NCCNHR believes “the nursing data is the most important single component of the 5-Star Rating System” since it “not only allows consumers to compare nursing homes according to the hours of registered nursing and nursing assistant care they provide, but CMS also for the first time acknowledges the appropriateness of the standards identified in the huge HHS study of staffing ratios in 2001. Nursing homes have to staff at levels approaching those identified minimums to get five stars.”
As for the many criticisms of the system, she said, “The problem with the staffing ratings is that they’re based on not very reliable data reported by nursing homes. CMS has been developing a system to collect staffing information electronically from payroll records for at least a decade, and this summer it announced for the first time that its lawyers have given it the legal go-ahead to implement it. NCCNHR is frustrated by how long this process is taking because the data would be so valuable. Consumers would not only know the hours of nursing care residents receive but also facilities’ turnover and retention rates.”
She pointed to The Nursing Home Transparency and Improvement Act, which is part of both the Senate and House health care reform bills, as a piece of legislation that “would give CMS a deadline to implement this system.”
The House Energy and Commerce Committee added an amendment to its bill last week that would require a GAO study of the Five Star system. The study, she said, includes looking at “whether CMS’s staffing levels are really necessary for good care and, if so, how much it would cost to bring nursing homes up to those levels. If health care reform passes with this amendment, it should be an interesting study.”
