At issue | May 9 Herald-Leader listing of nursing home ratings
The Herald-Leader may have marked a first for daily U.S. newspapers when it announced that it will publish the federal quality ratings of nursing homes on a regular basis. The paper is to complimented for this public service.
The ratings are based on the new federal Five-Star Rating System, and the newspaper said it would publish them every three months for all facilities in Fayette and five surrounding counties.
That's good news for advocates of nursing home reform who have been fighting to keep the new system since it was started in December 2008. No sooner had the rating system been announced than the nursing home industry — not wanting to air its dirty laundry — began attacking it.
For example, when the new system was announced, it showed that 23 percent of the nursing homes in Kentucky had the lowest ratings possible — one or two stars. The list of nursing homes published May 9 showed that 39 percent of them had the lowest ratings.
The nursing home industry has looked for every way possible to attack the new system. In fact, it was able to get 31 state attorneys general, including Kentucky Attorney General Jack Conway, to sign a letter asking federal Health and Human Services Secretary Kathleen Sebelius to suspend the rating system.
The secretary refused but said that she would take a look at the system and make changes, if needed.
Supporters of the system also have changes they want made. One change needed is to base the staffing part of the ratings on actual hours worked by front-line caregivers obtained from payroll records. Right now, the nursing homes report the data themselves and it is not audited.
Then there is criticism about the ratings being based on a "curve" which means, say the critics, that certain percentages of nursing homes in each state are automatically given good ratings and a certain number given failing grades
That's true, but an official at the Centers for Medicare and Medicaid Services told us that this was done at the request of the nursing-home industry, because nursing home owners were concerned that there could be some states where publishing actual scores would show most of the nursing homes with failing grades.
Nursing-home reform advocates in Kentucky want to take the system a step further. Legislation was introduced in the last two sessions of the Kentucky General Assembly that would have forced nursing homes to display their ratings in a prominent place in the facility, just like restaurants.
The legislation was defeated under nursing-home industry pressure, but advocates say they will keep trying.
As the new system evolves, however, is it useful? The answer is yes. and many supporters of reform say it is one of the most significant developments in improving long-term care in a long time.
In addition to using the rating system, consumers should also monitor facilities diligently, even those with five stars. Don't choose a nursing home based only on the star rating. Things have a way of changing, even ratings. Make sure you visit the facility, talk to the nurses and administrators and to residents. Pay no attention to the excuses of the people who run low-rated facilities — but use the rating and other factors to judge for yourself.
Ratings are available for any nursing home in Kentucky, or the United States, that has Medicare and/or Medicaid residents just by logging on to http://www.Medicare.gov/NHCompare.
In the end, the best thing about the new ratings is that they provide an incentive for nursing-home owners to do better, because who wants dirty laundry out there for everyone to see?