Federal regulators plan to adopt a five-star rating system to assess quality care in nursing homes. Respective facility rankings will be posted on the government's Nursing Home Compare Web site, officials announced this afternoon at a press conference in Washington.

They also announced that all nursing homes — not just new ones — will be required to have fully automated sprinkler systems throughout their facilities by 2013 if they wish to be included in the Medicare and Medicaid systems.

The shift to the five-star rating system marks the first time regulators will make qualitative judgments. In the past, the site has simply noted survey citations. The new system, outwardly similar to rankings for movies or restaurants, could be in effect later this year, said Kerry Weems, acting administrator for the Centers for Medicare & Medicaid Services.

“This is definitely going to happen. The actual data and the way those data get weighted are things that are up for discussion,” Weems told a conference call from Washington. He said data and methods for determining ratings would need to be determined by the end of summer to achieve timing goals, “and we ARE going to make our December date.”

He said that state survey results, information on 19 quality measures and staffing data are likely to form the backbone of rating criteria. Other information could also be considered, he noted, encouraging nursing home advocates, consumers and others to contribute comments over the coming months.

While consumer advocates welcome the new requirements, providers are concerned about subjective views being presented as objective assessments. Providers have historically opposed such efforts on the grounds that they fail to account for legitimate differences across various facilities.

But it appears that federal regulators and lawmakers are bent on making the industry more accountable and transparent. Lawmakers have successfully pressured CMS to reveal the names of the worst performing facilities. In addition, pending legislation would require ownership information and expanded legal protections for dissatisfied residents and their families.

On the sprinkler issue, Weems said that providers could expect no special funding help from the government since facilities routinely must prepare for physical plant improvements anyway. Providers without full sprinklering have been required to have smoke detectors installed since March 2005.

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