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Poor Rating For One In Five U.S. Nursing Homes

Posted by Jane Akre
Thursday, January 28, 2010 4:51 PM EST
Category: Protecting Your Family
Tags: Nursing Homes, Nursing Home Abuse, Elders, Abuse, Neglect Medicare

A report on nursing homes finds 20% are reporting a low quality and all are for-profit homes.

Low Overall Quality For Quarter-Million Patients


IMAGE SOURCE: ©iStockphoto/ nursing home resident/ author: MarkPapas

Nursing homes are not always what they are advertised to be, finds a survey by USA Today.

An analysis by the newspaper finds that among 15,700 nursing homes nationally, about 20% receive low marks for overall quality, and those with the lowest ratings – one or two stars - were owned by for-profit companies.

There are an estimated 1.4 milion Americans in nursing homes. About a quarter-million live in the low-ranked nursing homes.

USA Today examined the federal government's data from the first ratings of the homes' performance.

Late in the Bush administration, the Centers for Medicare & Medicaid Services (CMS) began assigning the Zagat-like ratings based on quality, staffing, and health inspections. The Five-Star Rating System launched at www.medicare.gov.

A Medicare spokeswoman tells USA Today that even a one-star nursing home must satisfy basic Medicare requirements.


Among the lowest rating - one star- nursing home, there was an average of about 14 deficiencies per home, including safety violations and quality-of-life measures.

Unfortunately, in many states, homes with poor ratings may be the only nursing homes for miles.

CMS adds that many nursing homes have improved their overall quality since the start of the rating system.

Before the rating system was initiated, a September 2008 federal report found, among for-profit nursing homes, 94 percent were cited for health and safety standard violations in 2007.

And 17 percent had deficiencies that caused “actual harm or immediate jeopardy” to patients.

Problems include infected bedsores, medication errors, poor food, and abuse and neglect of patients. About 20 percent of the more than 37,000 complaints inspectors received last year concerned abuse or neglect of patients.

What Consumers Can Do

“From a consumer viewpoint, it’s not stringent enough,” says Alice Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform, about the rating system.

Hedt says consumers need to consider not just the star ratings, but also their own sense of a place. Ask the question - what is the customer satisfaction among those already there?

In Indiana, eight nonprofit nursing homes got one-star for staffing even though they have some of the highest staffing ratios in the state, reports AP. The group’s owner believes the one-star rating is the result of a glitch.

As far as staffing data, it is self-reported and widely recognized as unreliable.

Other critics say the system is not ready to launch because it is poorly planned and prematurely implemented.

What to look for in a nursing home?

  • Visit the home and review staffing data to make sure that every shift, every day is covered

  • Observe – do residents look clean and well groomed? Are call lights answered in a timely Manner? Does the staff address one another and residents with respect? How does the place smell?


State and local long-term care ombudsmen advocate quality of life and care as well as respect for individual rights. They can provide consumers with information about homes in their area and explain regulatory survey results. Consumers looking for the State Ombudsman phone number at www.medicare.gov or at www.nasop.org

Binding Arbitration

Consumers may also want to consider the small print on a nursing home or care facility contract. Binding arbitration clauses have become standard.

The Fairness in Nursing Home Arbitration Act (S. 2838 and H.R. 6126), would have invalidated mandatory arbitration clauses in nursing home and long-term care facility contracts. Under the language, residents would no longer be required to give up their right to sue a facility if it abuses or neglects residents. The bill died in committee last year.

Consumers should know they are signing away their right to a civil remedy through the courts if they sign a binding arbitration clause. #

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