Just this month, the federal government announced it would be restructuring its scoring system used for nursing homes in the U.S. It’s likely going to tighten the compliance guidelines, which could prove problematic for some facilities. The details associated with these new nursing home algorithms will be released to the public later this month.
Thomas Hamilton, the director of the survey and certification group at the Centers for Medicare & Medicaid Services explains that the changes raise the standards for nursing homes and in turn, will require very specific goals to be met before earning a 4 or 5 star rating.
Current Nursing Home Scoring Algorithms
Nursing homes are scored on a scale of one to five stars on Nursing Home Compare, the well-known and widely used 
federal website that is considered the “gold standard” for evaluating the more than 15,000 nursing homes in the U.S.
Many had said in the past that the current way of determining the quality of a facility was faulty since the data is self-reported. In some instances, 5 star nursing homes and with the CMS seal of approval, a host of serious problems are leaving some families feeling misled. During the summer of 2014, The New York Times published a story about the rating system and said that it “relied so heavily on unverified information that even homes with a documented history of quality problems were earning top ratings,”. No one was conducting audits, either.
This led to the government announcing in late 2014 its new requirements for nursing homes. They are now required to report staffing levels on a quarterly basis and they must use an electronic system that can be verified with payroll data. Further, it announced it would begin a nationwide auditing program aimed at checking whether a home’s quality statistic was accurate.
This latest announcement is part of its overall plan to provide better accuracy in both the ratings and reporting for quality of patient care. Nursing homes can increase their overall rating if they earn five stars in this area. The number of nursing homes with five stars in quality measures has increased significantly since the beginning of the program, to 29 percent in 2013 from 11 percent in 2009. This changes everything.
Nursing Home Concerns
There are many representatives of nursing homes who say they’re worried that the changes will send a wrong message to consumers and patients. Mark Parkinson, the president and chief executive of the American Health Care Association, said, “We are concerned the public won’t know what to make of these new rankings. If centers across the country start losing their star ratings overnight, it sends a signal to families and residents that quality is on the decline when in fact it has improved in a meaningful way.”
Anything that improves the quality of care for those in nursing homes is always a welcomed change. To learn more about qualifying for Medicaid or if you’d like to learn more about estate planning, contact our offices today.
Ellen LaPlante
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