CMS on Thursday will post online the quality ratings of 16,000 individual nursing homes across the U.S. based on a one- to five-star scale, USA Today reports (Appleby et al., USA Today, 12/18). The ratings are based on data from state inspections, reports on staffing and quality measures. The homes received stars for each category and for overall quality (Freking, AP/Philadelphia Inquirer, 12/18). Overall ratings, which will be posted online at www.medicare/nhcompare, mostly were based on how well homes scored on staffing and on 10 quality measures -- including how homes respond to a patient's declining mobility, high-risk bed sores and pain. To receive a five-star rating on staffing, registered nurses and other nursing staff must provide at least four hours of care per patient daily.

According to a USA Today review of the ratings, Louisiana had the highest percentage of nursing homes that had an overall one-star ranking with 39% of its 285 homes in that category. The review also found that 23% of homes across the U.S. received a one-star rating. Delaware had the highest percentage of homes with five-star ratings, with 29% of its 45 homes in that category, according to USA Today. Homes that were affiliated with hospitals had higher rankings than those that were not, USA Today reports.

Reaction
Some nursing home officials criticized the rating system, saying that using state inspections provides a skewed picture of home care because the inspections focus largely on problems, according to USA Today. Stephen Morrisette, president of the Virginia Health Care Association, said, "There is no provision in the survey process to note ... areas where nursing facilities are doing an excellent job." In addition, Joe Donchess, executive director of the Louisiana Nursing Home Association, said a shortage of nurses and low Medicaid payments of about $115 per patient daily make it difficult for homes to hire enough workers to score highly on the rankings (USA Today, 12/18).

Alice Hedt, executive director of National Citizen's Coalition for Nursing Home Reform, said the Web site is "basically taking information already available on Medicare's Nursing Home Compare Web site and pulling it into an easier system for consumers to use, and that is a good thing." However, she said, "From a consumer viewpoint, it's not stringent enough" (AP/Philadelphia Inquirer, 12/18). Janet Wells of the NCCNHR said, "We hope that nobody looks at the five-star rating system and bases their decision entirely on it."

Acting CMS Administrator Kerry Weems said the Web site can aid families in searching for a nursing home, but it "is not a substitute for actually visiting" a home (USA Today, 12/18).

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