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State Attorneys General Question Five-Star Quality Rating System for Nursing Homes

MacKenzie Kimball, for HealthLeaders Media, August 31, 2009

Thirty-one state attorneys general sent a letter to Health and Human Services Secretary Kathleen Sebelius last Thursday, which highlighted the alleged weaknesses of CMS' Five-Star Quality Rating System for nursing homes and requested the feds suspend or revise the system.

The Five-Star Quality Rating System, which uses data from surveys, staffing rates, and quality measures to rate nursing homes on a scale of one to five stars, has faced opposition since its introduction in December 2008. Many industry leaders, associations, and long-term care providers have voiced concerns that the rating system is based on a flawed survey system and provides inaccurate information to consumers.

According to the letter from the state attorneys general, the Five-Star Quality Rating System "can be misleading and create significant confusion for seniors."

"I am very excited that the state attorneys general are calling attention to the flaws of the system because I fear that inaccurate ratings have been steering people in the wrong direction," says Deborah Franklin, director of operations at Florida Living Options in Dover, FL, and president of the Florida Health Care Association. "Minor errors or mistakes can greatly affect a facility's rating and these errors cannot be corrected right away. The system should be revised to provide consumers with more updated and useful information."

Consumers still have access to CMS' Nursing Home Compare System, which was developed before the Five-Star Quality Rating System. Therefore, if CMS decides to temporarily suspend the Five-Star Quality Rating System in order to make revisions, consumers will still have a tool to aid them in nursing home selection.

"The letter from state attorneys general is a clear indication that the rating system is flawed and should be revised, for the sake of both providers and consumers," Franklin says. "I truly hope Secretary Sebelius will see the seriousness of the issue and work toward a solution."


MacKenzie Kimball is an associate editor in the long-term care market at HCPro. She writes PPS Alert for Long-term Care and manages MDSCentral.

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