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"Medicare launches rating system for nursing homes"

Original source:

Contra Costa Times

By Sandy Kleffman
Updated: 12/19/2008 05:32:20 AM PST

Consumers now have a new tool to compare the quality of Bay Area nursing homes thanks to a five-star rating system Medicare unveiled Thursday.

For the first time, each of the nation's 15,800 nursing homes with Medicare or Medicaid contracts has been awarded one to five stars based on inspections, staffing levels and other quality measurements.

The ratings can be viewed at

"This should help consumers in narrowing their choices, but nothing should substitute for visiting a home when making a decision," said Kerry Weems, acting administrator of the Centers for Medicare and Medicaid Services.

The rankings are part of a national movement to provide more transparency in health care and to help consumers make wiser decisions.

Some consumer advocates, however, lauded federal officials for these goals but said the rankings have limited usefulness.

"We think this particular rating system leaves out important information and people should be aware of that," said Mike Connors of California Advocates for Nursing Home Reform.

Medicare officials say they hope the nursing homes that receive one star, the worst ranking, will attempt to discover the reasons for their poor showing and improve their facilities, Weems said.

Nationwide, 22 percent of the facilities received one star, and 12 percent had the highest ranking of five stars.

In the East Bay, 12 nursing homes in Contra Costa County and 10 in Alameda County received a one-star rating, defined as well below average.

"If a nursing home has a very poor rating, that should raise a red flag and questions," Connors said.

The only nursing home in Contra Costa County to receive five stars was Vintage Estates of Richmond. Alameda County had 15 facilities in the top-performing category.

The ratings were based on inspection surveys that determine whether facilities are in compliance with federal rules.

They also take into consideration staffing and how the nursing homes perform on 10 quality measures, including how many residents have bed sores, whether their mobility worsened after they were admitted to the facility and whether they received proper medical care.

Much of this information had previously been on Medicare's Web site, but consumers complained that it was difficult to wade through, Weems said. The five-star ranking was designed to make comparisons easier.

Connors said his group is particularly concerned that the rankings often don't consider compliance with state standards. For example, if the state fines a home for negligence that leads to a patient's death, that will not necessarily show up on the Medicare Web site, he said.

"In California, we're in a unique situation in that we have many standards that go above and beyond what the federal law requires," he said.

The data on staffing levels, he added, "is notoriously unreliable. It's self-reported, not audited and it's collected from nursing homes two weeks immediately preceding an inspection."

California Advocates for Nursing Home Reform has its own Web site to help consumers make comparisons at

A nursing home industry group also criticized the program. The rating system is "premature and problematic due to the fact that it is premised upon a flawed survey system," said the American Health Care Association. It noted that the rankings do not include the viewpoint of residents.

Medicare plans to update the information at least quarterly. This is only the first step, Weems said. Upgrades and modifications of the data will be considered, he said.

Consumer advocates urged people to view the rating system as a beginning, not an end in judging nursing homes.

"The availability of these ratings is good for consumers, but the ratings need to be kept in perspective," said Eric Carlson of the National Senior Citizens Law Center.

Family members should remain vigilant in monitoring care, he said, no matter how many stars a facility receives.