Rep. Elijah Cummings (D-MD)

Call it a write-in campaign.

After The New York Times noted that providers are apparently gaming the Five Star rating system by enhancing staffing and quality data, federal lawmakers quickly put an indignant pen to paper.

Members of the Congressional Seniors Task Force sent correspondence to the Centers for Medicare & Medicaid Services, insisting that staffing data be pulled from payroll systems as quickly as possible. Providers currently supply both staffing and quality data, which constitute two of the three components that determine five-star grades. 

In separate correspondence, Rep. Elijah Cummings (D-MD) requested that CMS officials brief his staff about flaws and planned fixes. 

Of particular concern to many is the heavy reliance on self-reported data, which is rarely audited for accuracy.

The Times also reported that nursing homes can temporarily boost staffing before an anticipated survey to inflate their rating in this category, Cummings noted. 

Provider advocates pushed back, citing a lack of evidence that gaming the system is widespread. The American Health Care Association supports expanded audits of data, but emphasized to McKnight’s that nursing homes are routinely assessed by auditors and government watchdogs, and five-star improvement trends are reflected in other measures as well. Furthermore, “staffing up” before a survey would require time and resources that simply are unrealistic for the majority of providers.