Herald Journal - Enterprise Dispatch - Delano Herald Journal
Nursing home ratings are ‘oversimplified’

Jan. 19, 2009

By Starrla Cray
Staff Writer

DASSEL, COKATO, MN - Deceiving. Irrelevant. Inequitable. Oversimplified. Confusing. Those are the words area nursing home officials are using to describe the five-star nursing home rating system released Dec. 18 by the Centers for Medicare and Medicaid Services (CMS). To see a chart with the breakdown, click here.

“My initial thought is that it’s irrelevant,” Bill Ward, administrator for the Dassel Lakeside Community Home, said. “The math is indefinable. It is based upon surveys and is a very poor indicator of quality of care.”

The star rating gives nursing homes a low of one star to a high of five stars, based on health inspection results, quality measures, and staffing levels. An overall rating is also provided.

Cokato Manor Administrator Michelle Haefner said CMS made a mistake, giving Cokato’s nursing home three stars when it should have received five.

“CMS is currently working out some ‘bugs’ in the system,” Haefner said. “I don’t believe our rating is accurate.”

The Aging Services of Minnesota provided its members with access to a spreadsheet that tests the accuracy of their rating, she said. According to that information, CMS made an error in Cokato Manor’s health inspection category.

“I’m trying to get it worked out with CMS,” Haefner said.

“The federal five-star rating really provides no useful information,” Ward said. “They have created a formula that ignores real people’s real experiences in nursing homes. Quality is in the eye of the customer. It isn’t found by counting citations.”

To view ratings and compare nursing homes in Minnesota, consumers can go to www.medicare.gov and click on “compare nursing homes in your area.” From there, people can search for homes within a specified distance by name, zip code, city, state, or county.

“My best advice is to ignore the ratings,” Ward said.

“In our opinion, it’s always good to give the public as much information as possible, especially about something as big of a decision as a nursing home,” Haefner said. “The key is, it has to be accurate.”

“It’s just a snapshot of what’s happening that particular day,” Ann Dirks, administrator at Park View Care Center in Buffalo, said. “We got five stars, and I still don’t think it’s a fair system.”

Burns Manor in Hutchinson was given an overall rating of one star.

“Initially, I was very saddened by it,” administrator Linda Krentz said. “But you can’t put all your heart and soul into one rating system. We have a lot of happy families, and a lot of happy residents here. I don’t know that it’s an accurate assessment.”

While she takes these ratings seriously, Krentz also looks at many other factors when determining quality.

“The ratings are part of a picture of quality, but not all of it,” Krentz said. “Our state surveys are very good, and we have a high retention of staff. That’s a quality indicator to me.”

“We have fantastic homes in this area,” Dirks said. “When people look at these ratings, they get a skewed picture.”

Facilities with low ratings still meet federal health and safety requirements, and the ratings are not a substitute for visiting a nursing home in person, CMS stated.

“Go and see the people who are actually taking care of the residents,” Haefner said.

How to find a good nursing home
By Dassel Lakeside Administrator Bill Ward
• Make a personal visit and observe. Are residents clean and well groomed? Are residents dressed appropriately for the time of day?
• Speak with family members of other residents. Do they endorse the facility?
• Check for odors that don’t go away. Some odors happen everywhere, but does the area freshen up in a few minutes or is the whole building permeated with odor?
• Is the physical environment neat and attractive?
• Watch interactions between staff and residents. Is it positive?
• Check out the activity calendar. Is there a variety of things happening?
• Ask your physician. They know where the best care is given.
• Ask your pastor. The pastors visit all the homes. They know the good ones.
• Ask staff what the facility’s family and resident survey data says about customer satisfaction.
Does not define good quality
• State Health Department survey reports
• Staffing ratio reports
• State or federal five-star ratings


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