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FEATURED NEWS: CareScout Raises Concerns About CMS Nursing Home Quality Data

  • December 6th, 2002

The Center for Medicare & Medicaid Services (CMS) recently issued quality indicators for nursing homes across the U.S. (See ElderLawAnswers news article, 'Report Cards on 17,000 Nursing Homes Released,' Nov. 14, 2002.) The CMS data presents the results of up to 10 measures of quality or performance for each nursing home. The measures include the percentage of residents who are in physical restraints or who have infection, bedsores or pain.

CareScout, a Web site that already rates and ranks nursing homes and thousands of other providers, is raising concerns about whether the CMS data actually reflects nursing home quality. 'Reliance on CMS'' limited 10 indicators, we believe, may lead people to make poorly informed decisions about quality of care,' CareScout said in a press release.

For example, when CareScout compared nursing home quality as defined by the CMS quality indicators and by CareScout Ratings, it found that the assessments were often at odds:

  • More than half of nursing homes reviewed that had CMS quality indicators suggesting above-average performance, received below-average CareScout Ratings. This means that a consumer who relied solely on CMS'' quality indicators to select a "high quality" nursing home for a loved one might in fact select a D rated (i.e., lowest quality) facility.
  • More than 20 percent of nursing homes that had CMS quality indicators suggesting below-average performance, received above average CareScout Ratings. Thus, a consumer who might choose not to pursue a facility because it received a "low quality" mark by CMS might actually miss a AAA rated facility and consequently choose a lower quality one instead.

'Because CMS does not provide an overall rating or ranking of each nursing home, consumers are unable to make accurate or comprehensive quality assessments,' CareScout says, noting that its own system provides an overall rating and ranking for each facility so that facilities can be more readily compared.

'In addition,' CareScout goes on, 'CMS is a politically influenced organization (its leadership changes with new administrations in Washington), [so] there is always the risk that this approach may be influenced by changing political agendas.'

To read the CareScout press release, click here.

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Loretta Williams

Hale Ball Carlson Baumgartner Murphy PLC
Fairfax, VA

Mindy Felinton

Felinton Elder Law & Estate Planning Centers
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Ron Landsman

Ron M. Landsman, P.A.
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Last Modified: 12/06/2002

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