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Medicare Ratings of Nursing Homes Biased

By: Cohen, Placitella & Roth @ Jan 30, 2017

When you are searching for a nursing home for either yourself or your loved one, one of the most seemingly helpful tools is that of the Medicare nursing home compare tool. The nursing home compare tool allows a user to search for Medicare nursing homes in their area, and then provides a list of nursing homes and their rankings. Nursing homes are ranked on a star-based system, with a nursing home receiving between one (being the worst) and five (being the best) stars for criteria such as health inspections, staffing, and quality measures. Each nursing home also receives an overall rating.

But new evidence suggests that these rating are biased, and allow nursing homes to “game the system,” as highlighted in an article in The New York Times. As such, the General Accountability Office (GAO) is calling for improvements to the system.

Why the Medicare Nursing Home Compare Tool Isn’t as Spot on as it Would Like You to Believe

According to the New York Times article cited above, many of the Medicare nursing homes that have the highest ratings have been given four or five stars based on information that is incomplete; in fact, the ratings are based largely on self-reported data from the nursing homes themselves. What’s more, the government does not verify this self-reported data, which means that nursing homes can report whatever they want, and the Medicare compare tool accepts the information without scrutiny.

Remember the criteria listed above – health inspections, staffing, and quality measures? The problem with using only these criteria is that the ratings fail to take into account any complaints that have been filed by patients or consumers, as well as any legal actions taken against the nursing homes.

Reform Is Needed

An article in Philly.com concludes that the Medicare nursing home compare tool not only needs to be more accurate, but more consumer friendly. Strengthening quality control measures and the sources from which data is collected to determine ratings is a start, but not the only solution. The GAO would also like to see improvements to the compare tool that make the site easier to use and easier to understand, and would like to make it possible for patients to compare nursing homes in different states, which could be very important for those living near states’ borders. Currently, you can only compare nursing homes in a single area.

Nursing Home Malpractice Attorneys Who Care About You

At the law office of Cohen, Placitella & Roth, P.C., we find it unfortunate that the Medicare nursing home compare tool – which has the potential to be very useful to consumers – is not meeting expectations. We are also abhorred to learn of situations where a patient seeks a facility based on its high rating only to learn that care is less than acceptable.

If you are a victim of nursing home malpractice, or suspect the neglect or abuse of a loved one, please contact us today. You can reach us online or by phone.

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