News Reports Have Raised Concerns About Integrity, Transparency of Five-Star Quality Rating System
Washington DC— Following a push by U.S. Senator Bob Casey (D-PA) and Senate Finance Committee Ranking Member Ron Wyden (D-OR), and Representative Elijah E. Cummings (D-MD), Ranking Member of the House Committee on Oversight and Government Reform, the Government Accountability Office (GAO) has agreed to conduct a review of the federal government’s nursing home rating system.
This month, Casey and Wyden wrote to GAO calling for a review of the rating system, and Cummings also joined the request. On August 26, 2014, Cummings sent a letter to the Centers for Medicare and Medicaid Services (CMS) requesting a briefing to address concerns about the Five-Star rating system after a New York Times article revealed deficiencies in the rating system, and in February CMS announced revisions to the scoring methodology for its rating system.
“The GAO’s decision to conduct a review is a first step towards ensuring the accuracy of this system that millions of families rely on,” Casey and Wyden said. “The Five-Star rating system has the potential to make a substantial difference in the lives of vulnerable seniors but the Administration has to make sure the rating system is working. We have to get this right.”
“The quality of our nursing homes is critical to our nation’s seniors and their families,” Cummings said. “That is why I sent a letter last year to CMS expressing serious concerns that some nursing home facilities were gaming the current ‘five-star’ rating system to mislead consumers about the quality of care they provide. I commend GAO for agreeing to review this system to ensure that it provides accurate and reliable information while encouraging all nursing homes to achieve a higher quality of care for our nation’s seniors.”
The Nursing Home Compare tool is a public website consumers can use to search for and compare nursing homes. The site features the Five-Star Quality Rating System that rates nursing homes on a scale of one to five in three major performance areas—health inspections, staffing and quality measures—as well as one overall rating. The rating system, along with a federal watch list of the lowest performing providers (Special Focus Facilities), is important to nursing homes not only because consumers use the ratings to evaluate nursing home options, but also because doctors often base their referral decisions on the ratings and insurers do the same when designing their networks.
Click here to read Casey and Wyden’s letter to GAO.
Click here to read Cummings’s letter to CMS.