![]() ![]() Ability to move worsened, anti-anxiety or hypnotic medication.In addition to the overall QM rating, he looked at seven QM metrics specific to long-term care: He thought he might find a few trouble spots, but never expected to find 1,127 homes across the country still considered “good” or “very good” overall despite low QM ratings.īeltz used CMS’ May 1 Nursing Home Compare Star Rating and minimum data set (MDS) quality measures databases. Beltz said he couldn’t find anything comparable online so decided to tackle the project himself. The idea to look at quality measures came from ProPublica’s Nursing Home Inspect. Unfortunately, these can be so dense and filled with jargon that even experts like Edelman admit they have difficulty making sense of them. Facilities essentially “work to the test,” focusing on the metrics that CMS more strongly considers in the ratings.ĬMS publishes tech guides to help users navigate and understand the rating system. Since most of the metrics are self-reported, “quality measures are not very reliable to begin with,” Edelman said. The process “is so confusing there is no way the average consumer can figure this all out,” Toby Edelman, senior policy attorney at the Center for Medicare Advocacy, told me by phone. “Unfortunately, many consumers don’t know this and think that if a nursing home gets a high rating, they’re strong on all measures,” Beltz said. High scores in the inspection and staffing categories, for example, can bump up a facility’s rating despite a low QM score. “Because of the way CMS awards and subtracts points for each category, it’s possible to score a one or two on QM and still end up with a four or five overall rating,” Brian Beltz, 1point21’s content manager and research coordinator, said in a phone interview. Other states with high incidence of discrepancies between overall and quality ratings were Texas, Ohio, Illinois, Missouri and Florida. They found that 49 nursing homes in Pennsylvania - nearly 20 percent of long-term or skilled facilities with a four- or five-star overall rating - had QM ratings of only one or two. San Diego content and data visualization company 1point21 Interactive conducted an initial review of star ratings in Pennsylvania for the Philadelphia law firm Rosenbaum and Associates. (CMS recently updated its criteria to include 13 out of 24 measures). These ratings provide information on 11 physical and clinical measures, including use of antipsychotic medications for both long-stay and short-stay residents, according to the CMS website. The QMs offer some insight on how well these facilities are caring for their residents’ physical and clinical needs. Each nursing home receives one overall five-star rating and separate ratings in health inspections and staffing, and for QM. Quality measures (QM) is one of three categories in the star system used by the Centers for Medicare & Medicaid Services. More than a thousand nursing homes nationally with high overall ratings had only one or two stars in quality measures, which could point to some serious health implications for residents. Nursing home star ratings are misleading and disingenuous, according to a recent analysis comparing ratings with quality measures alone. ![]()
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