Why You Cannot Rely on Medicare’s Star Rating When Choosing a Tennessee Nursing Home

By Thomas Greer | September 12, 2014

Ratings and reviews are everywhere nowadays, and if you are considering placing an elderly relative in the care of a nursing home, you may be happy to learn that there is a rating system for nursing homes. Deciding which nursing home will take care of someone that you love is never an easy decision, but ratings appear to be a decision making tool that could help time-strapped families choose appropriate nursing homes for their relatives without spending hours and hours researching and analyzing the issue. You may be even more pleased to know that not only is there a rating system for nursing homes, the ratings are issued by Medicare, the agency which is charged with regulating nursing homes. This aspect of the Medicare star rating system gives the nursing home ratings an aura of credibility and trustworthiness.

Unfortunately, the Medicare star rating system has not proven to be a tool that families can rely on in selecting the best care for their loved ones. Some families who have selected nursing home care for relatives based upon the Medicaid star rating system have reported that their decisions have not worked out in the way that they believed that they would. One man chose a nursing home for his mother based in large part upon its five star rating from Medicaid, a distinction which is shared by only a small percentage of nursing homes nationwide. When he made his decision, he felt that he was placing his mother in the care of a facility which would provide her with the very best of everything that she needed. Instead, he later learned that many complaints have been filed against the facility, more than twice as many as have been filed against most other nursing homes in the states. In addition to the complaints, there have been quite a few lawsuits filed against the facility recently by family members of residents.

The rating system which is used by Medicaid to assign stars to nursing homes contains multiple flaws. The first of these flaws is that the ratings are based on a small subset of all of the information which is available regarding nursing homes. Because of this, it can be said that the ratings provide an incomplete picture of the quality of care at the facilities that have been rated. Another flaw in the ratings system is that approximately two thirds of the information which factors into the ratings is reported by the nursing homes themselves, and not measured by independent, outside persons or agencies. The information which is not self-reported, the results of annual health inspections, provides a very narrow view of the quality of care which is being provided at each facility. State-level fines and enforcement actions are not included in the ratings, nor are consumer complaints.

The nursing home rating system which is used by Medicaid is not a reliable indicator of the quality of care that is provided at nursing homes across America. Placing a loved one in the care of a nursing home is a difficult decision, and, unfortunately, it can take a bit of time to research and visit facilities before selecting one which feels like it will be a good fit for your relative. Even when families choose nursing homes carefully, abuse and neglect may occur. If you suspect that your elderly relative is being abused or neglected by nursing home staff, report the abuse immediately and contact the Tennessee Nursing Home Abuse and Neglect Attorneys at Bailey & Greer, PLLC as soon as you can. Call our office at 901-680-9777 to schedule a time to discuss your case with us.  At Bailey & Greer, PLLC, we are small enough to care, big enough to fight, and experienced enough to win.

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