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The fault in the star system for nursing homes


Watch any car commercial or visit any online store, and you’ll see star ratings. Consumers rely on that feedback to ensure that they are getting what they are paying for.

A dozen years ago, the U.S. government started its own star rating system for more than 15,000 nursing homes nationwide. A large volume of data is analyzed in an effort to take a highly personal service for families and provide some level of objectivity on the quality of care in care facilities.

One represented the worst while five heralded the best. Categories include inspection results, nurse-resident time, and overall quality of care.

Confusion instead of clarity

Never was this system more critical than during the global COVID-19 pandemic. However, evidence has revealed that the program is broken and primed for manipulation. Sadly, the picture provided to families looking for reassurances is distorted and unreliable.

From the moment the star system was implemented by the U.S. Centers for Medicare & Medicaid Services, many warned that nursing homes could effectively game the system by deliberately concealing the facts. Then coronavirus breached the U.S. borders, subsequently taking the lives of more than 130,000 nursing home residents.

COVID seemingly lifted the veil on these so-called “five-star homes,” revealing that death in those facilities was equally as likely as the lowest-rated nursing homes. Out of more than 3,500 of these well-reviewed care facilities, nearly 70 percent were cited for severe problems that involved infection control or patient abuse. In some, health conditions ranged from bedsores that actually exposed their bones to residents unable to move.

The government bears much of this burden for the lack of auditing data self-reported to them and letting nursing homes know in advance of pending inspections. This combination of negligence, abuse, and seeming indifference is a dangerous recipe for disaster that could lead to even more tragic losses.