The nation's first nursing home rating system is an
important tool for consumers, but changes can be expected, said the country's
highest health official on Tuesday. Health and Human Services Secretary
Kathleen Sebelius said criticism about always assigning certain percentages of
facilities “excellent” or “failing” grades is “serious” and deserves further
consideration.
“The suggestion that it's a flawed snapshot because it
forces the reviewers at the outset to make decisions that may or may not be
accurate … I think that's serious criticism that needs to be looked at,”
Sebelius said shortly before delivering a keynote address at the annual
conference of the National Council on Aging and The American Society on Aging
in Chicago. “The last thing we want to do is have an arbitrary bell curve just
for the sake of having a system.
“We need to have some standards; they need to be clear,
need to be accurately measured and if everyone ends up being excellent or
everyone ends up being failing, so be it,” she added. “But somehow this sort of
bell curve seems to have some inherent flaws.”
Long-term care providers have complained about
regulators' predetermined percentages for how many five-star and one-star
facilities are identified with each update. Providers also believe the
Five-Star Quality Rating System's foundation has relied too much on a
subjective, faulty inspection system ever since the system was hurried into
place during the last few weeks of 2008 under the previous administration.
Sebelius was clear that she expects tweaks to be made to
the system. “Absolutely. I think we need to make sure it isn't flawed
inherently. But should we have a rating system? You bet.”