Nursing-home rating tool has added 5 new quality measures; here are tips for choosing a facility, and Kentucky’s worst-rated

By Melissa Patrick
Kentucky Health News

Choosing a nursing home is a daunting task and often done in the middle of a crisis, but it doesn’t have to be if you do your research.

One tool to help you choose a facility is “Nursing Home Compare.” This online tool provides information on how well Medicare- and Medicaid-certified nursing homes provide care through individual star ratings in three sub-categories: health inspections, staffing and quality measures, which are then combined to calculate and overall star rating.

The Centers for Medicare and Medicaid Services recently added five new quality measures to the tool, all of which will gradually be factored into its five-star quality rating calculations, says a CMS news release. A five-star rating is considered best.

Four of the new measures are tied to the outcomes of short-stay residents, which reflect care provided in a nursing home for less than 100 days. They include the percentages of short-term residents who are successfully discharged; experience an outpatient emergency department visit; are re-hospitalized; and make improvements in function. The fifth measure looks at how many long-stay residents experienced a decrease in their ability to move independently.

“With this update, star ratings will provide an even more accurate reflection of the services that nursing homes provide,” Dr. Patrick Conway, the CMS’ deputy administrator and chief medical officer, told Elizabeth Whitman of Modern Healthcare.

The new measures are being phased in slowly, starting with half of their full value in July, and will be fully counted by January 2017.

Nursing Home Compare measures have historically been based on self-reported data from nursing homes, but now three of the five new measures are based on Medicare claims data submitted by hospitals. The ratings are also affected by annual state inspections and staffing levels.

Critics of Nursing Home Compare say the star ratings are not reliable because most of the information used to calculate them is based on self-reported data and is not verified by the government, and that the annual health inspections are the only findings in the report that comes from independent reviewers.

Another tool at your disposal is “Nursing Home Inspect.” This user-friendly online tool, offered by ProPublica, a nonprofit investigative journalism enterprise, allows consumers to search and analyze the details of recent nursing home inspections using keywords and by sorting results based on the severity of the violation and by state. Data come from CMS.

The Nursing Home Inspect website says 88 of the 289 nursing homes in Kentucky have serious deficiencies, and that they collectively owe $12 million in penalties and 43 have payment suspensions.

It also reports that three Kentucky nursing homes were in the top 20 nationwide for having the most fines, including: Somerwoods Nursing and Rehabilitation Center in Somerset ( $564,000); Brownsboro Hills Health Care and Rehabilitation Center in Louisville ($522,000); and Golden Livingcenter-Camelot in Louisville ($508,000).

It also found that five of Kentucky’s nursing homes were in the top 20 nationwide for homes with the most serious deficiencies, including: Signature Healthcare of Pikeville (18); Edmonson Center in Brownsville (14); Fountain Circle Care and Rehabilitation Center in Winchester (14); Barkley Center in Paducah (14); and Bluegrass Care and Rehabilitation Center in Lexington (12).

In addiion, US News & World Report offers 10 tips to finding the right nursing home and reminds its readers that the aforementioned rating tools are just a place to start. Here are the tips:

  • Take a “just in case” tour before your family member actually needs the facility;
  • Sit in on a meal service while you are there; 
  • Listen to how the staff talks to and about residents;
  • Observe how residents pass the time, make sure there are choices.
  • Ask about resident choices, including flexibility in personal schedules and room personalization options; 
  • Ask about who is in charge, ask about management turnover and if there is a medical director on staff and on site;
  • Check references and ratings, suggesting that you use the rating systems as a starting point only;
  • Consider specialty care options, depending on your loved ones needs;
  • Find out what happens if your loved one needs more care; and 
  • Talk about payment options.
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