Monday, August 25, 2014

Self-reporting may not be the most accurate

Every year Medicare rates nursing homes, using a rating of 1 to 5 stars. Over the past few years the percentage of nursing homes receiving top ratings has increased from 37% to 50%.

The ratings use three criteria: the results of annual health inspections, staff levels and quality statistics. The health inspection is performed by state authorities. Staff levels and quality statistics are supplied by the nursing homes. All three criteria are accepted at face value by Medicare with very few exceptions. Why the ratings don't take into account other factors - e.g., fines and other enforcement actions by state authorities, as well as complaints filed by consumers with state agencies - is a mystery. As a side note, Medicare gave a California nursing home a 5-star rating despite the fact that California had fined the home $100,000 for causing the 2006 death of a woman who was given an overdose of a powerful blood thinner.

Medicare is apparently pleased with this system as they will begin using it to rate hospitals,dialysis centers and home-health-care agencies.

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