The Centers for Medicare and Medicaid Services (CMS), a federal agency that is part of the U. S. Department of Health and Human Services, annually ranks the 15,000-plus nursing homes that participate in Medicare or Medicaid programs. Last December, the agency released its first quality ratings for these facilities.
The Center uses a star rating system, from a low of one star to a high of five. The ratings, based on health inspection surveys, staffing data and quality of care measures, are available at /NHCompare.com. The website provides easy access to essential information for anyone evaluating nursing homes in a particular geographic area. According to the CMS Acting Administrator Kerry Weems, Our goal in developing this unprecedented quality rating system is to provide families a straightforward assessment of nursing home quality, with meaningful distinctions between high and low performing homes. The new information will also help consumers and families identify important questions to ask nursing homes and challenge nursing homes to improve their quality of care.
The rating system is based on a nursing home's performance in the following critical areas:
Health inspection surveys. State and federal surveyors perform annual assessments of each facility's healthcare services and measure its compliance with local and federal rules. The survey is intended to protect residents' health and safety. Quality measures. This category uses 10 key measures to examine the quality of a facility, including percentages of residents who have pressure ulcers (i.e., bedsores) after their first 90 days in the facility; the numbers of residents whose mobility worsened after admissions; and the receipt of proper medical care by the population. Staffing information. This category calculates the number of hours of nursing and other staff care per patient per day, adjusted to account for the particular needs of residents (e.g., illness levels, services required.) This measurement is considered to be particularly important, because the more professional attention is paid to nursing home residents, the more likely it is that the resident is rece iving appropriate care. The product of the system is a quality rating for a nursing home's performance according to these measures, coupled with a composite score. A one-star rating means that the facility is "much below average," while two stars represent "below average" performance. Three stars? "Average." Four stars means "above average," and five, the highest rating, means "much above average."
The new system has gotten high praise from Senator Herb Kohl, Democrat from Wisconsin, who's chairman of the Senate Special Committee on Aging. With this new rating system, CMS is improving the ability of consumers to readily obtain critical information which should be used in conjunction with in-person visits to a facility." He added, Transparency is key when it comes to nursing home quality. I commend Acting Administrator Weems and, as always, appreciate the opportunity to work together to improve our nations nursing homes."
Choosing a nursing home or community-based care is one of the most difficult and sometimes confusing decisions families have to make, noted Thomas Hamilton, director of the CMS group that designed the new system. The new website improvements also include links to information for community-based alternatives to nursing homes that may be of great interest to families. Regardless of the type of support a family chooses, he said, It is vital that families and caregivers use the Web site as just one of many important sources of information they should consult. Families should also consult with their physician, talk to the states nursing home ombudsman or the states survey and certification office and, most importantly, visit the nursing home or community-based program for themselves.
The first round of ratings found about 12 percent of the nation's nursing homes deserved the five-star rating, while a disturbing 22 percent received only one star. Ratings for the other approximately two-thirds of the nursing homes were distributed fairly evenly among the two, three and four star rankings.
U. S. News rolled up the data to produce listings of the best (/sections/health/best-nursing-homes/index.html) and worst (/articles/health/best-nursing-homes/2009/03/11/10-worst-states-for-top-nursing-homes.html) nursing homes, concluding that the 10 states that have the lowest percentage of top-rated homes are Louisiana, which has only nine five-star homes, slightly more than three percent of the 284 facilities in that state. Georgia, with 6.2 percent of its facilities rated tops, was second, followed by Oklahoma (7.1 percent); Tennessee (7.3 percent); West Virginia (7.7 percent); Kentucky (8.7 percent); Indiana (8.9 percent); Missouri (9.1 percent); Texas (9.3 percent); and Ohio and Utah, tied for tenth place, with 9.9 percent of five-star rated facilities.
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