Nursing homes losing their 5 star rating

Medicare collects data on every nursing home patient through the Minimum Data Set (MDS). The MDS is a form that describes the health, medical and nursing needs of each patient that is electronically sent to Medicare.  For example it includes whether the patient has a pressure ulcer and if so how many pressure ulcers and their severity. Medicare uses this data as well as other information about the nursing home to give each nursing home a 5 star rating which is made available to the public at Medicare.gov: Nursing Home Compare.  

Nursing home compare has been a great tool for finding a nursing home, however, I've been shocked that some of the worst Virginia nursing homes have received 4 and 5 star ratings. Medicare has recently made 3 significant improvements to the 5 star rating system.  

1. They have placed greater emphasis on the use of antipsychotic drugs into the Quality Measure Ratings.  Antipsychotic drugs can be used inappropriately as a chemical restraint, so excessive use can now lead to a rating downgrade;
2. Increased the number of points needed to earn a Quality Measure Star Rating. Therefore, unless a nursing home has recently improved its quality indicators, it's rating will probably decrease.  This change should help correct the inflated ratings nursing homes have enjoyed; and
3. Perhaps most importantly, Medicare has changed the scoring method in the staffing category. Nursing home that have inadequate staffing place patients at risk for dehydration, malnutrition, falls, pressure ulcers, and medication errors. In my opinion inadequate staffing is the number one predictor of nursing home abuse and neglect. 

The bottom line is that Medicare has wisely recognized that its 5 star quality rating system previously gave an inflated assessment of the quality of nursing home care. If a nursing home has a recent decline in ratings, that does not necessarily mean that the quality has declined. However, it probably more accurately reflects the quality of care being provided at the nursing home.  

For more information on the legal rights of nursing home patients, please click here to visit our nursing home practice section.  You can also see examples of our case results in nursing home and assisted living abuse cases in Virginia.