Five-Star Rating: Constructive Re-Alignment
December 30, 2008
The following is a comment to my post titled: Five Star Rating Techincal Manual: Staffing Domain Accuracy.
I copy it here becuase the author makes a very good point w/r/t where the focus should be for Nursing Home Administrators, and I wouldn’t want it to get lost:
“As a member of the Technical Advisory Panel for the 5-Star system and a co-author of the paper cited in this discussion, I am in a relatively unique position to comment. The author of the posting is correct about the potential effects of errors in reporting staffing.
However, the study showed that for-profit homes tend to over-report, and it was for-profit homes that fared the worst in the 5-Star system. So, it seems that the effects of over-reporting may not be as dire as suggested.
In addition, I would suggest that instead of trying to cast doubt on the 5-Star system, which we all admit is not perfect, the industry should push for a new reporting system for staffing. That is what NCCNHR is doing. Join them. After all, the staff data are self-reported by homes. If your fellow administrators are “cheating you,” then I suggest that you advocate a reporting system that doesn’t allow them to do that.”
To Dr. Phillips I say, yes, you are absolutely right to point out that the energy should not be soley on casting doubt on the Five-Star system, but instead should be focused on the constructive work of fixing the public rating system as a whole. The Five Star data just makes more accessible the already flawed Nursing Home Compare data. Therefore, it is important to focus the anger we feel at being “cheated” by an innacurate system into 1) convincing the public and legislators that this is a poor tool for researching nursing homes and 2) helping to devise a new system. We must be careful of doom and gloom predictions and overactions like calling the Five-Star system a “travesty of justice,” as Larry Minnix, president and CEO of the American Association of Homes and Services for the Aging said to members of Dec. 18th.
On a personal note, though, I still find my blood pressure rises when I think about how the quality of care I know my home provides is not as well reflected as I think it should be in its Five-Star rating. Maybe the advice from older DONs than Directors of Nursing is appropriate here: (in Latin) “pace. pace. pace (peace. peace. peace.)”. Let’s take a breath and work the problem instead of rail at it.