Bush Administration Announces Quality Rating System for Nursing Homes
CMS on Wednesday announced plans to implement by the end of the year a five-star rating system to help consumers make more informed decisions when they select nursing homes, the AP/Detroit News reports (Freking, AP/Detroit News, 6/19).CMS will base the ratings, which will appear on the Medicare Web site, on government inspection results, staffing data and 19 quality measures. In addition, the ratings might include information on whether nursing homes treat patients with dementia or those on ventilators (Zhang, Wall Street Journal, 6/19). According to CMS officials, the agency will seek comments from the nursing home industry and consumers to decide the specific criteria for the ratings (AP/Detroit Free Press, 6/19).
Acting CMS Administrator Kerry Weems said, "We know the public is hungry for information," adding, "Transparent information is an effective incentive for quality" (Cooley, CQ HealthBeat, 6/18). Lower ratings "will likely put" nursing homes "on the path to improvement," Weems said. "I don't think we're going to see many people who are very anxious to put a loved one in a one-star home," he added (AP/Detroit News, 6/19).
Comments
John Rother, executive vice president of AARP, said, "The star rating system proposed today could make it easier for families to identify facilities that consistently provide quality service and safety for their residents."
Lauren Shaham, a spokesperson for the American Association of Homes and Services for the Aging, said, "We hope that a rating system would improve the quality of nursing homes' care, but we are concerned that in the time-frame that CMS has outlined they're not going to be able to build a stable, solid house to do that." AAHSA President and CEO Larry Minnix said that CMS should base ratings on "four essential pillars": patient and family satisfaction; staff satisfaction; clinical quality outcomes; and public oversight (CQ HealthBeat, 6/19).
American Health Care Association President Bruce Yarwood said that CMS should not use government inspection results as the only criteria for the ratings and should consider consumer and staff satisfaction. He said, "We do not believe that an index which relies on a broken survey system is an accurate way to measure quality" (AP/Detroit News, 6/19).
Toby Edelman, senior policy attorney with the Center for Medicare Advocacy, said that two of three criteria CMS plans to use for the ratings -- staffing data and quality measures -- are "self-reported by nursing facilities and are inaccurate." He said, "Relying on nursing homes to describe accurately how well they are doing ... just doesn't make sense" (Wall Street Journal, 6/19).
Joint Hearing
The Senate Judiciary Committee Antitrust, Competition Policy and Consumer Rights Subcommittee and the Senate Special Committee on Aging on Wednesday held a joint hearing that focused on a bill (S 2838) under which nursing homes could not require new patients to agree to settle any quality-of-care disputes through arbitration.
During the hearing, Aging Committee Chair Herb Kohl (D-Wis.) said that "we must protect the right of those who receive inadequate care to hold poor-performing facilities publicly accountable." Bill sponsor Mel Martinez (R-Fla.) said that such arbitration requirements are "removing the one incentive the industry has to self-regulate."
A nursing home industry representative said that such arbitration requirements help reduce liability costs for the facilities, as well as the time required to settle quality-of-care disputes. Sen. Orrin Hatch (R-Utah) said that a ban on such arbitration requirements would increase liability costs for nursing homes and force many of the facilities to close (Reichard, CQ HealthBeat, 6/19).
