Editor's desk: not everyone is upset with the new nursing home five-star rating system

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James M. Berklan, Editor
James M. Berklan, Editor
The first-ever public rating system for nursing homes has kept up its ability to get people talking. And calculating. And writing letters. And scratching their heads.

I had been waiting for someone to write a letter like the piece Jim Gonzalez wrote at the highly regarded Broadway House for Continuing Care in New York (see page 39). Gonzalez points out that not everybody is upset with the system. His facility worked hard in recent years to improve and he's proud to say it is one of the several thousand communities to receive five stars.

Being a specialty unit has helped, but part of the “secret” also has simply been focusing on staff development. “You have to have staff feeling good about themselves,” Gonzalez says.

He also thinks providers must get smarter about dealing with surveyors. “Some providers ‘attack' as soon as surveyors get in the door,” he says. “At the end of the day, that's not going to work.

“The attacks of the (ratings) system from both associations is a disservice,” he adds. “(Regulators) have to have a starting point (for ratings) and they've found a good place.”

Not so fast, say many others, including staff members at PANPHA, Pennsylvania's main association for nonprofit providers. They've spent numerous hours developing an analysis showing how updates to the Five-Star system's technical manual simply don't cut it (see pp. 40-41). The comparison system is “fatally flawed,” they contend.

PANPHA folks point out that the star ratings could actually push providers away from more medically complex residents, something neither those residents nor the system could put up with for too long.

The back-and-forth can go on and on. But what I find perhaps most disturbing is the mud that's been tossed into the water. Guess who gets to deal with the mess? You.

This was reinforced recently when I spoke with an executive from one of the brightest provider groups in a major metropolitan area. Most of his facilities earned five stars overall. Yet, quality indicators were found lacking and were marked down.

“They could have gotten us for other things, but not that,” he said, shaking his head. “And then you see some other places that get four stars and you know that's (too high). I just don't understand it.”