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The idea, according to the Centers for Medicare and Medicaid Services(CMS), is to give consumers an easy, short hand way to compare data on thequality of care and other measures at nursing homes locally, regionally andnationally.
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The need is real: More than 1.5 million people live in the 15,000 U.S.nursing homes. But experts warn that the system could actually cause moreconfusion when trying to find the right facility for a patient's particularneeds, increase the risk of lawsuits against nursing homes and unfairlydisadvantage facilities that care for the most frail patients.
"Today, more than 19 different quality and safety measures are reported onMedicare's 'Nursing Home Compare' web site but the star system only includesonly a subset," said attorney Mark Kopson, who leads the healthcare industrypractice at the law firm of Plunkett Cooney in Bloomfield Hills, Mich. "Onerisk of the star system is that consumers might not consider a very goodfacility because they didn't investigate it thoroughly. That could lead tofacilities refusing to accept high-risk patients. No one will want to risklosing a star in their overall rating."
Kopson said that facilities that treat patients who need the mostintensive care, including stroke victims, those with dementia and people withpotentially debilitating conditions like advanced diabetes, may offerexcellent care but score low on the star system because their residents areinherently more prone to pressure sores, urinary tract infections and othercommon - and often unavoidable - complications of nursing home care.
"If Medicare and private insurers were to reduce reimbursements tofacilities that don't earn the highest scores, there probably would be evenfewer facilities willing to accept the neediest patients," he added.
The risks don't end there, he said. "It's easy for consumers - andpotentially jurors - to misinterpret or take out of context data that'sincomplete. And that's exactly what the star system is: a well-intentionedbut potentially superficial analysis of the quality of care."
Kopson's advice to families searching for nursing home care is to lookdeeper than the star system when evaluating a facility. "Fundamentally, youneed to be confident that the facility's doctors and nurses can develop andimplement a care plan that addresses the individual physical and mental needsof the patient."
For nursing home operators, he advises them to be diligent in monitoringthe data reported on Medicare's web sites for errors. But it's even moreimportant to communicate clearly and candidly with families and prospectiveresidents.
"Caring for the elderly and the infirm is one of the most challengingfields in healthcare," Kopson said. "Understanding the facts about aging, thecare and treatment options that different facilities offer and the full storybehind the surveys and rankings is in everyone's best interest."
Established in 1913, Plunkett Cooney employs more than 150 attorneys innine Michigan cities, Columbus, Ohio and Indianapolis, Indiana. The firm hasachieved the highest rating (AV) awarded by Martindale-Hubbell, a leading,international directory of law firms.
SOURCE Plunkett Cooney, P.C.
