A study of insured and uninsured Americans showed that those without health insurance get sicker as they age until they turn 65 and qualify for Medicare, Friday, Dec. 28, 2007. But they're not likely to become as healthy as someone who had health insurance all along. (AP / CBS)
How do you know what kind of care your loved one will get in a nursing home? A new rating system introduced a couple of weeks ago by the Centers for Medicare and Medicaid Services (CMS) attempts to rate nursing homes, but the new system is already drawing criticism locally and nationally.
The new system rates nursing homes on three criteria; health inspections, staffing levels, and quality measures. Those are put together and the nursing home is given a “star” rating from one which is very below average to five which is well above average.
The ratings from this study show that more than half of the nursing homes in the grand valley that receive Medicare funding are below average. If stars are any sign of quality of care Grand Junction’s Medicare funded nursing homes aren’t shining. Five of the eight nursing homes in the grand valley rated by CMS were rated below average; three were given the lowest rating one star out of five La Villa Grande, Mesa Manor and Mantey Heights Rehabilitation Center. Two others received two stars, Palisade Living Center and Eagle Ridge at Grand Valley. Paul Crook, La Villa Grande’s administrator says “the ratings don’t necessarily reflect what the survey’s showed.” Crook says he’s proud of the facilities latest health inspection survey from March he says the inspection showed no violations that immediately threatened harm to residents.
CMS shows that La Villa Grande had 29 health deficiencies, well above the state average of 12 and the national average of nine. Crook says the new ratings are misleading and don’t account for some staffing issues and extra quality measures the facility is taking. Crook says, “we feel like the information they gathered was used inappropriately used in generating a ratings system.”
Melissa Wood the administrator of Larchwood Inns says that the new rating system is premature and problematic. Larchwood Inns received a rating of four of five stars. Still, she says that the information gathered based on surveys is not timely. After a facility is inspected it is given ten days to dispute any findings, Wood says if the facility wins it could take up to six months for the information to update online and with rating information gathered every three months the initial complaints will show up in the new rating system. Wood says, "the consumer that is going to be using it needs to know that it's not timely, it’s not necessarily an accurate picture of what it’s trying to rate.”
Thomas Hamilton with CMS helped design the new star rating system and he says that the information they’re compiling has always been available on its website but now three years of surveys are put together and broken down in the star rating system, making it easier to sort through. Hamilton says, “so in total what were doing is taking about 200,000 records of an on-site survey and making them more understandable and useful to the consumers and families.
Another concern is that the staffing rating is taken by a two week snap shot of an entire year, nursing facilities say that this number can be deceptive. Hamilton says CMS is already looking at changes to how they look at and rate staffing at homes; for example using a facilities payroll. Facilities say they also have concerns with the quality measures. Wood says that the ratings don’t account for facility specialties and that can make a, for example a post-op facility look like patients are in more pain.
Hamilton says he understands there may be concerns with any new system and that he is willing to consider any suggestions. Both Wood and Crook say they are working with parent companies to file complaints. One thing is agreed upon by all parties is that there is no substitute for visiting a nursing home and asking questions for yourself.
Every facility mentioned in this report was given the opportunity to comment; Other than La Villa Grande, Mesa Manor was the only other below average performer to issue a media statement.
Use the link below to navigate through the Center for Medicare and Medicaid Services new rating system.