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Q: Sometimes providers can help sway government officials' opinions about programs, but that doesn't appear to have happened with the new “five-star” rating system, does it?

A: On this one, they developed a timeline and they're sticking to it. Dec. 18 is the start-up day.

Q: How are providers responding at this point?

A: There have been a lot of inquiries about the scoring methodology. There are basic concerns over whether we're adding a real qualitative value with this. More points will be awarded as the scope and severity (of resident conditions) go higher. Weighted scores will be summed, and more recent data will be weighted more heavily.

Q: How has the government's survey and certification director soothed concerns?

A: He's always said the expectation is that the vast majority of providers are going to fit in the middle category.

Q: What's the biggest objection to this new system?

A: That you're building on a fundamentally flawed (survey and certification) system. There's nothing wrong with disclosure, as long as you're disclosing good information.

Q: What have they done right with this?

A: They're doing state-by-state comparisons rather than national. But if it's still built on a “bed” that's not well made, that's a problem.

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