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Using the Five-Star Quality Measure to Mask Bad Care

March 22, 2022

On February 28, 2022, President Biden announced a set of wide-ranging nursing home reforms aimed at addressing problems that have plagued nursing homes for years and led to the devastating effects of COVID-19 on nursing home residents. One of these reforms was to enhance the Center for Medicare & Medicaid Services’ Care Compare website. This website is the primary tool for consumers to investigate nursing homes and the quality of care they provide. One of the administration’s stated goals was to rely more heavily on verifiable data, rather than self-reported data provided by nursing homes.

Consumer Voice strongly supports this reform and is releasing a report detailing how necessary these changes are to ensure consumers are receiving accurate and reliable information. The report, Using the Five-Star Quality Measure to Mask Bad Care, looks at how largely self-reported data of the Quality Measures can obscure poor ratings in the other categories of staffing and health inspections. A frequent refrain from nursing homes with overall poor ratings is that their Quality Measure (QM) rating is very high. Consumer Voice’s report reveals how nursing homes with 5-star QM ratings can have the lowest ratings in staff or health inspections and, as the examples in our report demonstrate.

This report also highlights the importance of other reforms announced by the Biden Administration, including a minimum staffing standard and increased enforcement and oversight of nursing homes. Homes with poor staffing ratings often have long histories of poor care, including neglect and abuse. Almost invariably, when looking at nursing homes with poor ratings in staffing and health inspections, you find inspection and complaint reports detailing substandard care often leading to resident harm.

As part of the Biden Administration’s call for reforms of the Care Compare website, we urge them to cease use of the QM rating, until and unless it incorporates data that can be audited or independently verified. It is less reliable than verifiable data, and most importantly, misleads consumers by leading them to believe that despite poor ratings in staffing and/or health inspections, a facility is still providing quality care.

Read our full report.

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