The Centers for Medicare & Medicaid Services (CMS) recently unveiled
a significant overhaul of its Nursing Home Compare rating system. The
new changes will hold facilities to higher standards and should help families
make more informed decisions when selecting a nursing home for a loved one.
According to CMS, “Changes in ratings reflect that CMS raised the
bar for performance that should be recognized as high quality and anticipates
nursing homes will make quality improvements to achieve these higher standards.”
The Nursing Home Compare system, which is available online, provides information
about the quality of care in the 15,800 nursing homes that participate
in Medicare or Medicaid. While the rating system tracks several quality
of care measures, including pressure ulcers, use of restraints, extent
of injurious falls, and staffing levels, it has received criticism after
many poor-quality nursing home facilities were able to achieve high ratings.
In response, CMS has now raised the bar, making it more difficult to attain
the best rankings. As detailed in a
CMS factsheet, Nursing Home Compare 3.0 will include:
New Quality Measures (QMs): The rating system will now take into account the use of antipsychotic
medication in nursing homes. One new measure addresses the use of antipsychotics
for short-stay residents without diagnoses of schizophrenia, Huntington’s
disease, or Tourette syndrome, while a second measure reflects continued
use of such medications for long-stay nursing home residents without such
Adjusted Staffing Algorithms: Nursing homes must earn 4-stars on either the individual “Registered
Nurse” category or one of the other staffing categories to receive
4-stars on the “Overall” staffing rating and can have no less
than a 3-star rating on any of those dimensions.
Expanded Targeted Surveys: State agencies will conduct specialized, onsite surveys of a sample of
nursing homes across the U.S. to assess the adequacy of resident assessments
and the accuracy of information reported to CMS.
As San Diego elder abuse attorneys, we are pleased that CMS is taking steps
to refine its rating system, particularly by incorporating measures regarding
the use of antipsychotic medications. While nursing homes are tasked with
protecting the most vulnerable patients, studies have revealed that many
facilities administer unnecessary or potentially inappropriate antipsychotic
drugs to nursing home residents rather than treat the root cause of their behavior.