For a long time now, I’ve written about how consumers can use Medicare.gov’s tool, Nursing Home Compare, to get ratings for skilled nursing facilities in their area. However, today I have decided that I can no longer endorse the use of Nursing Home Compare use as a tool for deciding between facilities.
There have been complaints about the accuracy of Nursing Home Compare’s ratings for a long time, but last week, several articles came out that make it impossible to ignore the problems. According to the New York Times:
Only one of the three criteria used to determine the star ratings — the results of annual health inspections — relies on assessments from independent reviewers. The other measures — staff levels and quality statistics — are reported by the nursing homes and accepted by Medicare, with limited exceptions, at face value.
The ratings also do not take into account entire sets of potentially negative information, including fines and other enforcement actions by state, rather than federal, authorities, as well as complaints filed by consumers with state agencies.
The remainder of the article goes into greater depth about how ratings are calculated and instances in which highly-rated nursing homes did not provide adequate patient care. (It’s a good article, and well worth the read if you have family members who need skilled nursing care.)
What should consumers do with this information? Well, a few things:
You can still use the site to find nursing homes in your area. It’s pretty straight-forward to type in your city, state, and ZIP code and narrow your search to a specific area. This is super helpful if you’re just getting started and need a quick, all-in-one place to find rating information.
You can still use the site to find basic information about a community. Nursing Home Compare still has a wealth of information: ownership, inspection reports, type of payments accepted, and location. So, feel free to use the site to help you learn more about potential skilled nursing facilities.
You can’t trust the site to provide accurate ratings. Unfortunately, you just can’t trust what you see on Nursing Home Compare. It’s too easy for nursing homes to game the system right now, and that means that the ratings just aren’t indicative of quality of care. Even using it to weed out seemingly poor-performing providers isn’t a good recipe for finding the best nursing home.
However, here are a few other ways of checking the quality of care at a senior housing community:
- Call your local ombudsman. Nursing home ombudsman are awesome resources that you can use free of charge. You can find your ombudsman by searching the National Consumer Voice website and clicking “Locate an Ombudsman.”
- Make multiple (sometimes unannounced) visits to the facility. I’ve heard of unscrupulous marketing agents who spray deodorizing spray in the skilled nursing wing of a retirement community prior to a scheduled tour. Of course, they do this because the nursing staff isn’t doing a good job of removing odor-causing soiled clothing, diapers, or wound dressings. But, because you only arrived for the “official tour,” then you won’t see (or, rather, smell) the truth. Another reason to make multiple visits is that, especially when you’re not accompanied by marketing agent, you have a higher chance of observing staff members revert to their “natural behavior.”
- Talk to other families in the parking lot or hallways. Now is not the time to be a wallflower. If you want to learn more about a skilled nursing facility, the best folks to ask are those who have been through the process with a loved one. To that end, feel free to strike up a conversation with other families that you see in the facility. They’re highly motivated to share “the gossip” with you and they don’t have any competing interests (unlike the marketing agent whose job is tied to filling beds). Note: Make sure you approach families in a respectful, discrete manner. It’s one thing to do your own due diligence. It’s another to infringe on a family who is going through a difficult time. Please do the right thing, and don’t be obnoxious or ask them overly personal questions.
I’m continually reminded of the fact that skilled nursing, assisted living, and dementia care are not easy jobs. The senior housing industry has a difficult problem: How can it make money, offer the highest possible level of care, and provide an affordable product? So far, no one has been able to provide a good solution to that equation, and it’s only served to harm seniors during a very vulnerable time in their lives.
Unfortunately, the odds are not in a consumer’s favor, and it’s very difficult to find a good, one-stop source for senior housing information. Especially after this week’s article, I can no longer recommend Nursing Home Compare as a viable option.
Want to learn more? Here are a few other links that you might find helpful:
Who to call when things go wrong
Signs of trouble in any community.
Five questions to asking during your senior housing visit.
Finding communities that share your beliefs.
Crisis management 101.