Nursing homes to be notified of initial 'five-star' ratings starting Monday

Nursing home operators on Monday will begin receiving advance notice of their first ratings in federal regulators’ new “five-star” system, officials said during a conference call Thursday.

Ratings will first be sent to providers’ MDS mailboxes Monday through Wednesday, Centers for Medicare & Medicaid Services survey and certification director Thomas Hamilton said. He spoke during a skilled nursing facility and long-term care “Open Door Forum” that attracted 550 listeners. A press conference and official unveiling on the CMS Web site “Nursing Home Compare” will take place Thursday.

Hamilton discussed a wide range of topics concerning the controversial “five star” ratings, which providers oppose and regulators acknowledge speeding to implementation since announcing them June 18. Among other things, a technical users manual will detail what levels of staffing and other criteria providers will need to achieve to attain a coveted five-star ranking, Hamilton said.

The manual also will explain the complex formulas that a panel of “leading academic researchers” devised to calculate the ratings. Staffing levels will be compared at a national level while survey results will be juxtaposed only in-state, thus making nationwide rating comparisons impossible. (The other rating category will be quality measures.)

“There are things that a rating system of this nature cannot address at all,” Hamilton said. “One of those is the importance of family and friends visiting and being involved in the care of the individual.”

As a result, a one- or two-star facility near a resident’s family “could be better than a remote five-star facility,” he noted.

Ratings will be updated monthly, and newer survey results will be weighted more heavily. Survey revisits will not bring a penalty unless they have to be repeated.