A recently released government survey shows that one in five
nursing homes received low scores on a five star rating system. Out of the
15,700 facilities surveyed, 3,140 received a one or two star and approximately
250,000 people are currently enrolled in these lower end nursing homes. This
data has raised concerns over the quality of care being provided to our elderly
citizens while simultaneously calling the validity of this relatively new
system into account.

The five-star rating system is based on three sets of criteria;
health inspections, staffing and quality measures. Health inspections are
conducted annually onsite by government officials over a three-year period.
Infractions are weighted differently according to their prevalence and
potential or real harm to people. During the most recent survey, over 200,000
onsite reviews were taken into account when allotting scores.

Staffing data ratings are based upon the average number of
hours of care given to each patient during the course of a day. The rating is
adjusted to reflect the special needs of patients based on the severity of
their condition. Nursing homes with patients who require more attention
therefore need to have a higher average number of hours.

Quality measures are rated on the basis of a list of ten
conditions that indicate the health status of a patient and are collected
during the three most recent quarters. Items on this list include changes in
mobility, the use of physical restraints, incidents of
high-risk pressures ulcers and number of long-term catheters. This information
is provided by the nursing homes rather than being gathered by government
agents.

In the recent survey, the
lowest fifth of care facilities received and average of 14 infractions.
Proponents of the rating system hope that the findings will urge these nursing
homes to improve the quality of their care but do not expect a drastic change
in the near future. “We want
to see improvements, but we don’t expect a nursing home will jump to a
five-star rating within a one-year time period,” explains Medicare’s
Thomas Hamilton. However, they also note the number of one star nursing homes
has decreased, a trend that could continues if people opt for high scoring
facilities. This may provide the financial incentive for the lower end homes to
improve their services and facilities.