An excellent article by Katie Thomas in today's New York Times caught my attention. In the past, I've written about Medicare's 5-star rating system and how it can be a tool to help you select a nursing home. "Not so fast" says Ms. Thomas.
Ms. Thomas writes: "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 the conditions at the homes." Ms. Thomas goes on to report: "The Medicare ratings, which have become the gold standard across the industry, are based in large part on self-reported data by the nursing homes that the government does not verify." In fact: "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 -- are reported by the nursing homes and accepted by Medicare, with limited exceptions, at face value."
Based on the NYT's analysis of data, Ms. Thomas states: "The Times analysis shows that even nursing homes with a history of poor care rate highly in the areas that rely on self-reported data. Of more than 50 nursing homes on a federal watch list for quality, nearly two-thirds hold four- or five-star ratings for their staff levels and quality statistics. The same homes do not fare as well on the sole criterion that is based on an independent review. More than 95 percent of the homes on the watch list received one or two stars for the health inspection, which is conducted by state workers."
A system weighted so heavily in favor of unverified information provided by the facilities being graded is the textbook definition of "the wolf guarding the hen house." At the end of the day, as a person looking for a proper placement in a nursing home, you have do your research and not blindly rely on the Medicare ratings. Caveat Emptor.