The U.S. Nursing Home rating system was introduced twelve years ago, providing for ratings from one to five stars. It was meant to provide a way for people to evaluate and compare nursing homes for their loved ones. However, an investigation by the New York Times recently revealed that the rating system is not an accurate reflection of the quality of care given at a nursing home. The investigation found that many nursing homes have manipulated the system to improve their ratings and hide problems, raising serious concerns for Maryland nursing home residents.
The rating system is based on a combination of self-reported information and on-site inspections. The investigation found that the information submitted to the Centers for Medicare & Medicaid Services (C.M.S.) is often wrong, making facilities appear cleaner and safer, and that the government rarely audits the data provided through self-reporting. Accidents and health issues are often unreported, it also found. Abuse and neglect were discovered through inspections at five-star facilities, but the inspectors rarely found the infractions serious enough to lower the ratings. A previously conducted study from the University of Chicago found that nursing homes did not report about 40 percent of residents who were hospitalized after serious falls.
It also found that the nursing homes were not prepared for the pandemic in part because the rating system allowed them to ignore staffing requirements and infection-control deficiencies. Over 13,000 nursing home residents have died due to COVID-19. The Times found that residents at five-star facilities were about as likely to die due to COVID as residents at one-star facilities. At some nursing homes with five-star ratings, “residents developed bed sores so severe that their bones were exposed.” The son of a resident at a five-star facility on Long Island who died from COVID-19 in the spring believed that the facility was short-staffed or overcrowded because before contracting COVID-19, his mother was moved from a private room into one with other residents.