Five Star Nursing Home Compare

November 17, 2008

Today I happened to read James Berklan’s Editor’s Note in Mcknight’s concerning the coming-soon Five Star rating system on CMS’ Nursing Home Compare website.  (full article here)  

He makes some awfully good points: the Five Star comparison makes already deceptive data even more important, the promised “phase two” changes that would improve the inherent flaws have no target date — so may never actually come about, it is unclear if there are any Five Star rated homes in the country under this scheme, etc.  

I’ve been tracking this 5 star rating system for some time now.  (In fact, until very recently, I was convinced the opposition would be able to continuously delay its implementation).  In that time, I think I have heard every argument against this system, including Mr. Berklan’s well-reasoned and well-written remarks.  What I have not heard is whether this 5 star system will actually affect the way potential residents and their families use the Nursing Home Compare website tool.  

The Nursing Home Compare tool, as it currently operates, is convoluted and not very user friendly. Adminstrator colleagues at other facilities complain to me that the Five Star system will confuse potential residents because it compresses dubious data into a relatively arbitrary star system; but I wonder if the charts and spreadsheets of the current system do not leave users jsut as confused?  I know DONs and Administrators who pour over each metric on the current system, looking for ways to improve overall care, as well as ways to improve key numbers over the direct competition.  But, I’ve seen no real evidence that residents and familes use the website as diligently.  They may look closely at a few key metrics, but there is little or no guidance over which spreadsheets identify “good care.”  If the current system creates arbitrary distinctions with an overload of data, is the new system which compresses data in order to create arbitrary distinctions really all that bad?  

Maybe a familiar and generally well-understood metric like a five star system will be a better occassion for resident and family education than the mountains of data the current Compare website offers.

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