August 9, 2010
As many of you know, skilled nursing facilities across the country have been grappling with the Centers for Medicare and Medicaid Services’ (CMS’) Five Star Quality Nursing Home Ratings System for nearly two years now. AHCA/NCAL has long advocated that the Five Star System fails to provide the tools necessary to evaluate quality care and may do more to confuse and even mislead consumers than to enlighten them. A recent study by Holleran Consulting, a national research firm, echoes many of the concerns AHCA has raised since the system was hastily launched in December 2008.
Released in June, the Holleran study found little to no connection between a nursing facility’s rating under the Five-Star System and resident and family satisfaction. In fact, according to the data, a nursing facility’s Five Star rating is not predictive of how a resident or family member will rate their satisfaction with the facility. The study highlights one such example of a nursing facility rated as a 1-star facility (the lowest according to CMS’ standards) had a higher willingness, on average, to select the facility again than all other facilities.
Reliably and accurately measuring quality, and publicly disclosing the results, will help all consumers make informed health care choices—especially in identifying care facilities which best meet individual needs. The Five Star Rating System, based on a broken survey system designed to measure compliance with federal and state regulations rather than quality, contains incomplete, inaccurate, and even out-of-date data.
Once again, the rating system’s flawed methodology is being legitimately called into question through this new study. Previously, thirty-one state attorneys general sent a letter to Health & Human Services Secretary Kathleen Sebelius to temporarily suspend and revise the current Five Star system “using a more appropriate criterion-reference evaluation methodology.”
We hope CMS will re-evaluate its scoring and ratings criteria. AHCA will continue working with CMS to improve the Five-Star system, and we are pleased that our concerns are being corroborated independently.