Medicare.gov Revamps Ratings System for Nursing Homes

Medicare.gov’s website has a useful tool titled Nursing Home Compare that helps individuals compare information about every Medicare and Medicaid-certified nursing home in the country. Nursing Home Compare includes detailed information about each nursing home, including types of skilled care provided (e.g. intravenous injections or physical therapy), any health and fire-safety inspection issues, staffing information and qualifications, any penalties assessed against the nursing home, and quality ratings.

While Nursing Home Compare and its quality ratings system is not new, Medicare.gov recently revamped its rating system to be more stringent. Prior to the revamp, there were a plethora of 5 star nursing homes in the state of New York. However, many individuals found that when they went to visit and tour these facilities, they were not deserving of their 5 star rating.

Medicare.gov now incorporates 2 quality measures for use of antipsychotics, requires a greater number of points to reach each star level, and uses a different scoring method for rating the staff. As such, many nursing homes dropped in star ratings. 28% of nursing homes nationwide dropped at least one star rating. In fact, 40% of Hudson Valley nursing homes dropped at least one star. These drops were not due to changes in the quality of the nursing home’s care but rather the change in the ratings system. Prior to this revision, a whopping 70% of all nursing homes scored 4 or 5 stars, the top scores. Now, that figure hovers around 50%.

By working to counteract inflated ratings, Medicare.gov has produced a more useful and realistic ratings system. In addition, expectations regarding quality of care have changed. Elderly residents are now demanding upgraded facilities, rehab and physical therapy, concierge services, gymnasiums and swimming pools, more scenic locations, roomier accommodations, and state of the art equipment. While top doctors and nurses, as well as comprehensive medical care, are always in high demand at nursing homes, the trend has been an increased focused on ancillary services that set the nursing home apart from its competitors.

If you or a loved one are looking for a nursing home in the New York area, a variety of different tools exist aside from the Nursing Home Compare website to help you in evaluating different nursing homes. One such tool is lohud’s map of nursing homes, found at http://data.lohud.com/maps/nynursinghomes/. The map shows every Medicare and Medicaid-funded nursing home in New York, color-coordinated by star rating. You can also color code the map based on number of stars assigned in various categories, such as health inspection, quality measures, and staffing rating. You can also color code the map based on whether anti-psychotic drugs are used against patients for both short and long-term stays.

Another helpful tool is George Coniglio’s guide to evaluating nursing homes during visits. Coniglio is a nursing home ombudsman who evaluates nursing homes and investigates complaints. He advises that when touring a facility for the first time, check to see if the facility is clean and organized. He recommends observing staff interaction with patients. Does the staff seem hurried? Are they polite? Are they responding to patient requests? In addition, how are the staff when interacting with each other? Coniglio also recommends that individuals confront nursing home administrators about any black marks that appear in their ratings, such as penalties or health inspection failures. If you do finally decide on a nursing home, visit often. Not only does visiting often raise the spirits of your loved one in the nursing home, but it also raises the level of care. Nursing home staff know you are involved and paying attention and are therefore more likely to treat your loved one well. And if the nursing home is doing something wrong or you suspect abuse, don’t be afraid to speak up!

If you or a loved one is being abused at a nursing home, don’t hesitate to contact the New York nursing home expert attorneys today at Gallivan & Gallivan to review your potential claim.

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