Nursing homes are gaming CMS star ratings system, New York Times probe finds

Many nursing homes in the U.S. have taken advantage of the CMS star ratings system to achieve higher ratings without addressing quality issues, according to an investigative report from The New York Times.

To assess the accuracy of these ratings, the Times analyzed millions of payroll records, 373,000 state inspection reports and financial statements of more than 10,000 nursing homes submitted to the government. The publication also obtained ratings data that are not publicly available from scholars who had research agreements with CMS. 

Four key findings:

  • Of more than 3,500 nursing homes with five stars from CMS, at least 2,400 were cited for infection control issues or patient abuse, according to January 2020 data from Nursing Home Compare.

  • COVID-19 patients treated at five-star nursing homes were about as likely to die as those treated at facilities with one star. 

  • Nursing home information submitted to CMS was often incorrect and made the facilities appear safer and cleaner than they were.

  • Some nursing homes inflated staffing levels and failed to report accidents or health issues among residents.

The Times said the ratings system left nursing homes ill-prepared for the COVID-19 pandemic, as facilities were able to achieve higher star ratings without improving care quality.

"They were allowed to not have enough staffing, and they were allowed to ignore infection-control deficiencies, so they had poorer quality than the public knew about, and they were in the worst position to manage Covid," Charlene Harrington, RN, PhD, a professor at the University of California, San Francisco's School of Nursing who also sits on a board that advises CMS on its star ratings, told the publication.

In a statement to the Times, a CMS spokesperson said the star-rating system is "intended to serve as one tool" to help people select a nursing home.

"Overall scores should be considered in light of a potential resident’s unique care needs,” the spokesperson said.

To read the full article, click here.

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