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Did Medicare allow nursing homes to rig its 5 Star Rating System?

Medicare’s 5-Star system has long been the gold standard for rating nursing homes. Patients and their families rely on this rating scale to decide which nursing homes were best for them. Unfortunately, a New York Times investigation proved that the star review system is incomplete and can be misleading.

The New York Times article revealed that Medicare’s rating system is heavily influenced by the nursing homes themselves because they submit more than 60% of the information used. Medicare does not verify those submissions. The Star ratings are not based on a thorough review from an independent investigator, and are not based on the opinions of nursing home residents or their families.

Medicare has three criteria for its Star Ratings:

• Results of annual health inspections performed by an independent reviewer,
• Staff levels,
• Quality statistics.

Incredibly, Medicare gave the nursing homes advance notice of the inspections. Some nursing homes hired temporary employees to make it appear as if they were adequately staffed. Shockingly, there was evidence that the quality statistics do not include government sanctions against the nursing homes for patient care and safety violations.

The good news is that after the New York TImes August 2014 article was published, Medicare responded that starting in January 2015, it would more closely examine the information nursing homes provide to make sure it is accurate. Click here to read their statement.

With such an unreliable rating system, it is no wonder that nursing home abuse is easily hidden from the public eye. If you or a loved one have suffered harm in a nursing home, due to differences between Medicare’s’ 5-Star Rating and the actual services provided, please contact our office to share your story. Email info@katterlaw.com.

Ron Katter
Katter Law Firm
Phone: 844-WAS-HURT
Alt Phone: 212-809-4293