By Julie Appleby for The Washington Post
Starting immediately, the federal government is making it harder for nursing homes to get top grades on a public report card, in part by increasing scrutiny of the facilities’ use of anti-psychotic drugs and raising the bar on an array of quality measures.
The grades — in the form of one- to five-star ratings — are part of Nursing Home Compare, a government Web site to help consumers evaluate nursing homes. While the star ratings, which debuted in December 2008, are lauded as an important tool, critics say they rely too heavily on self-reported data and allow a majority of homes to score high ratings.
The Web site rates more than 15,000 nursing homes in three broad categories: government inspections, quality measures and staffing levels. An overall score is a fourth category.
The system has come under recent criticism because of complaints that some highly rated nursing homes have numerous problems and face fines and other enforcement actions. The federal government said Thursday it would require nursing homes to do more to get high scores.
Among the better-known measures that go into quality scores are the percentages of residents who develop bedsores or are injured in falls. The scores will now count the percentage of residents given anti-psychotic drugs, reflecting concern that too many are unnecessarily drugged to make them easier to manage.
Those measures will continue to be reported by the homes themselves, however.
The changes mean many homes could drop a star or more from their January levels, even though nothing may have changed, officials from the Centers for Medicare and Medicaid Services said. They declined to say how many might see a ratings drop.
Consumer advocates welcomed the adjustments, but industry officials said the new rules may confuse patients and their families if scores change suddenly.
