GAO will investigate Five-Star rating system

An investigation into the Five-Star system was requested by Sen. Casey
An investigation into the Five-Star system was requested by Sen. Casey

In a move sure to surprise many providers, the Government Accountability Office will investigate the Centers for Medicare & Medicaid Services' Five-Star Quality Rating System, according to a published report.

Notice of the investigation appeared in a Bloomberg BNA article, following a request first reported by McKnight's from Sens. Robert Casey (D-PA) and Ron Wyden (D-OR). The lawmakers want the government watchdog to investigate the system, which is part of the CMS' Nursing Home Compare web tool.

Casey and Wyden's request for the examination specifically called for the GAO to examine how CMS ensures the data used in the Five-Star system is reliable and timely; if there are meaningful differences between the star levels; and how the number and types of complaints  a facility receives align with the rating system. Casey also asked that stakeholders identify what they believe to be the strengths and weaknesses of the system, and for insights into how residents and their families use the Nursing Home Compare web tool.

Many, including leading long-term care lobbyists, had doubted that the GAO would delve into Five-Star again so soon. But a spokesman for the largest nursing home association in the country said Thursday that he looked forward to the further review.

“Any opportunity to work with stakeholders and interested parties to refine and improve this important ratings system is welcome,” American Health Care Association Senior Vice President Greg Crist told McKnight's on Thursday. “We hope GAO will take a closer look at what exactly goes into the ratings system, and how that can be enhanced to include critical elements such as post-acute care/short-stays beyond longer-term residential care.”

The Five-Star system was rebased earlier this year, with added metrics related to antipsychotic use and adjusted staffing algorithms. Last November, the GAO released a report that found government web tools like Nursing Home Compare can be hard for consumers to comprehend, and don't contain enough information on how much nursing home services cost.