It turns out that Medicare’s rating system for nursing homes is deeply flawed. A New York Times analysis has revealed that several of the factors are self-reported, unverified, and negative information, like complaints and state fines, are often not reflected.
Patients and families are not getting the whole picture and sometimes appear to be getting a distorted picture. The Medicare ratings – one to five stars – are supposed to reflect a home’s quality in three areas. The Medicare.gov website describes those categories as follows:
1. Health Inspections rating:
These ratings are based on the three most recent, comprehensive inspections annually, as well as inspections due to complaints in the last three years. We place more emphasis on the more recent inspections.
2. Quality Measures (QM) rating:
Combining the values of nine QMs (a subset of the 19 QMs listed on Nursing Home Compare) we create the QM rating. QMs are derived from clinical data reported by the nursing home.