Newspaper article Sarasota Herald Tribune

Star Ratings Changing for Nursing Homes

Newspaper article Sarasota Herald Tribune

Star Ratings Changing for Nursing Homes

Article excerpt

Because the federal government's popular star ratings for nursing homes have lately been reaching the every-kid-gets-a-trophy stage, the Centers for Medicare and Medicaid Services announced some important changes Friday, with more in the works.

In addition to raising the bar for what it takes to earn a five- star rating, the agency will add an important new measure to its quality indicators: the amount of powerful antipsychotic medications administered to residents who don't have diagnoses of schizophrenia, Huntington's disease or Tourette syndrome.

CMS, as well as many state regulators, have sought to discourage the improper use of these drugs to sedate people who may exhibit behavior difficulties related to dementia. Antipsychotics have a swarm of side effects, including a sharp increase in elders' falls, and can be lethal for someone with Lewy body disease, the second- most-common form of dementia. So far, nursing homes have achieved a 15 percent reduction in reliance on the meds from 2011 to 2013.

CMS will also tinker with its algorithms that calculate all- important facility staffing levels, which many experts consider the most crucial ingredient in residents' wellbeing. And it has a new program of targeted state surveys that will help further refine the rating system.

The website -- medicare.gov/nursinghomecompare -- was launched in 1998 to publish the results of state inspections for more some 15,000 U.S. nursing homes. The star ratings, a compilation of inspection reports, quality measures and staffing levels, were added in 2008.

Since then, the very public carrot-and-stick ratings have prodded long-term care facilities to get their acts together, and they were rewarded with more stars by their names. You could say it's a good problem to have.

But feedback from consumers and nursing home residents convinced CMS that "when there's bunching or grouping at the high point of the scale, it doesn't help them make decisions," said Patrick Conway, deputy administrator for innovation and quality and chief medical officer at the agency.

And Thomas Hamilton, director of survey and certification for CMS, noted that even five-star facilities have plenty of room for improvement. …

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