Don’t trust Medicare nursing home star ratings

Two and a half years ago, I warned people not to be misled by Medicare five-star nursing home ratings. Unfortunately, you still can’t trust these nursing home star ratings. If Medicare can’t ensure that all nursing homes deliver high quality care, at the very least it needs to rate them appropriately.

The New York Times reports that the nursing home gaming of Medicare star ratings continues. The star-rating system is broken. More than two-thirds of the 3,500 nursing homes with five-star ratings have been cited for problems with infection control and patient abuse.

Five-star nursing home ratings continue to be misleading. Of the 130,000 nursing home residents who have died of COVID-19, those in five-star nursing homes were as likely to die as those in one-star nursing homes. Five-star nursing homes often fail in-person inspections.

The New York Times reports that California is suing Brookdale Senior Living, the nation’s largest nursing home chain, for filing false information about its services to Medicare, with the goal of getting a high star-rating. Part of the problem is that Medicare relies mostly on unaudited and self-reported data to determine the number of stars it gives a nursing home.

Naturally, nursing homes have an incentive to game the system. A five-star rating can lure more people to them and boost profits. Brookdale is alleged to have cooked its payroll books so that CMS would see high staffing levels at its nursing homes, Brookdale also allegedly asked its staff to misrepresent the amount of care their patients receive.

Here’s more from Just Care:

• Coronavirus: Senator Casey proposes legislation to protect nursing home residents and workers
• Medicare coverage of nursing home care is very limited
• Traditional Medicare offers better home care benefits than Medicare Advantage
• For-profit nursing homes more likely to deny residents hospice care at the end of life
• Well-kept secrets of Medicare Advantage plans