CMS' Nursing Home Compare ratings may not reflect patient safety

The quality measures used for CMS' Nursing Home Compare star ratings may not entirely reflect aspects of patient safety, a study published in Health Affairs found.

The researchers used data from Certification and Survey Provider Enhanced Reporter and Nursing Home Compare archives to analyze six patient safety measures in nursing homes. They compared nursing homes' performance in standard quality measures overall and measures specific to patient safety, such as pressure sores, infections, falls and medication errors.

Overall, the researchers found nursing homes' performance on patient safety measures related to falls, urinary tract infections for long-stay residents and the pressure sore measure for short-stay residents had little meaningful difference across Nursing Home Compare star ratings. While medication errors and pressure sores for long-stay residents tracked more consistently with star ratings, the correlation was still not strong.

"Although Nursing Home Compare captures some aspects of patient safety, we found the relationship to be weak and somewhat inconsistent, leaving consumers who care about patient safety with little guidance," the researchers concluded. "We recommend that Nursing Home Compare be refined to provide a clearer picture of patient safety and quality of life, allowing consumers to weight these domains according to their preferences and priorities."

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