The Smoke Curtain of Nursing Homes – Are You Seeing The Real Deal?

Date: September 10, 2014

When starting the process of looking for a nursing home for a loved one, research is part of the process. The constant reading of reviews and description of nursing homes can be timely and exhausting. But when Medicare set up its own “gold standard” rating system for these facilities, it seemed to be just a click away. However it has been reveled in recent news that this “gold standard” might not be as shiny as it seems.

A recent article has not only pointed out the flaws in the Medicare rating system but how nursing homes can “game the system”. In other words, the ratings presented by the Medicare system to rate these facilities might not be as accurate as once thought and can be seen as an opportunity for these nursing homes to present misleading information to potential customers.

The article presents as an example Rosewood Post-Acute Rehab. This facility of the Medicare rating system has a five out of five star rating which has been taken to be known as a “luxury hotel” of nursing homes. Many people send their family members with the hope of good care with the highest of quality. The information from the article however presents a different story. These five stars don’t take into account fines by the state and complaints by customers. Rosewood Post-Acute was showed to have had twice the state average of complaints while also interviews from patients, families and past employees say that this high rating is inaccurate. According to the information “Many residents live three to a room and there is often a scarcity of basic supplies like washcloths as well a shortage of quality staff” Doesn’t sound like a luxury hotel anymore does it?

How are these nursing homes fixing the ratings? How is the system fooling us? Most of the criteria used to determine this data is self-reported by the nursing homes. The facilities know when the information for the criteria must be submitted so the facilities increase their staff and perhaps clean up a bit more during that time. This self-reporting data is inaccurate as the numbers show that “more than 95% of the homes on the watch list received one or two star for the health inspection, which is conducted by state workers.” Some of the facilities included in this study have some four or five star ratings in the Medicare system.

A major concern presented in this article is the lack of information regarding complaints and suits against the nursing home. For example in a nursing care facility called Medford, according to the article, “since 2008, more than a dozen employees at the Medford home have been convicted on charges of patient neglect and falsification of records.” In addition employees are being investigated for a death of an elderly women this past June and yet this facility still maintains a three star rate and four for health inspection.

Despite this alarming information, the defense in this argument regarding the Medicare star system is that this is an incentive for nursing homes to improve quality of care and produce better services for their customers. However, although this could be a pro of this rating system, it seems that at least in some cases like Rosewood Post- Acute and Medford are benefiting from this misleading facility.

What is important to take from this information is that when looking for a nursing home, don’t make this very important decision solely on a rating of five stars. In order to get a complete sense of what care is given at a facility, look at where the care will be given, talk to the staff and other patients, research information from independent sources and visit multiple times. The trend in these nursing homes gaming the system or benefitting from misinformation is also increasing as data from the article shows that in 2009 only 37% received four and five star ratings while by 2013 about 50% did. And so, it is important to be critical in your researching finding a nursing home.

Sean McDonough has been a partner for Dougherty, Leventhal and Price law firm for over twenty years. He concentrates his practice in personal injury cases with an emphasis on nursing home abuse. If you believe someone you love is suffering from nursing home abuse, don’t wait and make an appointment with Sean McDonough today.

Sean McDonough
Upon graduation from law school, he entered the private practice of law with Dougherty, Leventhal & Price. He has been a partner with the firm since 1993. Over the years, Sean has concentrated his practice in the areas of personal injury litigation; he has also represented governmental entities and officials in federal civil rights and employment lawsuits. Sean also works on many of DLP's Nursing Home Abuse cases.