How Accurate and Helpful is the CMS 5 Star Rating System When Choosing a Nursing Home? Part 2

When a family is considering the need to partner with a nursing home for the care of a loved one it can be a frustrating and difficult process. One of the tools that has recently come on the scene is called the Five Star Quality Rating System.

This post is the second in a series of two articles that take a look at the Five Star to give our readers some perspective on the strengths and weaknesses of this nursing home comparison and rating system. This series takes more of an in-depth dive into Five Star and point out some things from our local area.

The Center for Medicare/Medicaid Services (CMS) describes the Five Star Quality Rating System this way: “The Nursing Home Compare Web site features a quality rating system that gives each nursing home a rating of between 1 and 5 stars. Nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average.”

Access the Five Start Quality Rating System here.

As we look at Maplewood and all the nursing homes within a 25-mile radius of Maplewood for comparison the results are interesting. For the purposes of this second post in my series, I looked at overall ratings and health inspections categories. What I found today is listed below:

Overall Rating Health Inspections
4-5 star facilities 12 (35%) 7 (21%)
3 Star 10 (29%) 7 (21%)
2 Star 7 (21%) 14 (42%)
1 Star 5 (15%) 5 (16%)

**** Maplewood rates 4 stars in both Overall and Health Inspection ratings ****

Let’s first look at the facility overall rating. In reviewing the data for the Rochester area, 64% of facilities are rated as being 3 stars or above and 36% are rated at 2 stars or below. Now looking at the category of Health Inspections, 42% of facilities are rated at 3 stars or above and 58% of facilities are rated at 2 stars or below.

This data seems to indicate that more than half the facilities in the Rochester area have a decent Overall Five Star rating. My experience tells me that this is true. As we move to the area of Health Inspections things get a little more difficult. Less facilities (42%) have ratings of 3 stars or above vs. (58%) of facilities that have ratings of 2 stars or below. At the lowest level it would seem that the 1-star percentages do match up. As you travel up the scale toward 5 stars the picture gets a bit more foggy.

One might ask several questions:

  • Why don’t the Health Inspection ratings match the overall ratings that are produced by the Five Star System?
  • Which one should I believe?
  • Are nursing home inspectors more difficult and punitive than those in other areas?
  • Are facilities around here lacking in paper compliance?
  • Did Albany tell the inspectors in our area to hand out more deficiencies?
  • Is the measure of quality as seen by inspectors different than the measures of quality that are reflected by the other data elements used in the Five Star system?
  • Might this situation just be a little of all of these factors above?

The bottom line is that I don’t think it would be smart to make any broad assumptions about why this is so.

My personal opinion is that this example just points out the short coming of relying on one system as a be-all and end-all way of measuring a facility. An accountant once told me to never call the IRS with a tax question. It makes me chuckle but there is some truth there.

The best measurement of nursing homes following an exhaustive web search is to visit each facility that you have not crossed off the list. The consumer can usually get a pretty good idea about a place after about 10 minutes of walking in the door. Don’t trust the web or anyone survey. There is no substitute for visiting a facility and making your own judgements and decisions about what is right for your particular situation.