Department of Health and Human Services Secretary Kathleen Sebelius

The nation’s first nursing home rating system is animportant tool for consumers, but changes can be expected, said the country’shighest health official on Tuesday. Health and Human Services SecretaryKathleen Sebelius said criticism about always assigning certain percentages offacilities “excellent” or “failing” grades is “serious” and deserves furtherconsideration.

“The suggestion that it’s a flawed snapshot because itforces the reviewers at the outset to make decisions that may or may not beaccurate … I think that’s serious criticism that needs to be looked at,”Sebelius said shortly before delivering a keynote address at the annualconference of the National Council on Aging and The American Society on Agingin Chicago. “The last thing we want to do is have an arbitrary bell curve justfor 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 oreveryone ends up being failing, so be it,” she added. “But somehow this sort ofbell curve seems to have some inherent flaws.”

Long-term care providers have complained aboutregulators’ predetermined percentages for how many five-star and one-starfacilities are identified with each update. Providers also believe theFive-Star Quality Rating System’s foundation has relied too much on asubjective, faulty inspection system ever since the system was hurried intoplace during the last few weeks of 2008 under the previous administration.

Sebelius was clear that she expects tweaks to be made tothe system. “Absolutely. I think we need to make sure it isn’t flawedinherently. But should we have a rating system? You bet.”