If you think of CMS quality ratings as the Dow Jones index, then last Friday, February 20, was the equivalent of Black Tuesday, October 29, 1929, the day the stock market collapsed. Why? Because on February 20 quality rankings dropped for a whopping 63% of the nation’s nursing homes.
Did care at America’s nursing homes deteriorate overnight? No. There’s a simpler and less frightening explanation: CMS announced changes in the five-star rating system that it established in December 2008. And unlike many—maybe most—Medicare changes, this one went into effect immediately.
The explanation for the changes is the widespread criticism—even ridicule—of the inflated ratings under the old system. Under that system about 80% of all nursing homes qualified for a four- or five-star rating. It was better than Lake Wobegon. As of Friday the figure is down to 49%.
The new system includes refined quality standards, such as use of anti-psychotic drugs. It also focuses heavily on staffing levels and requires more verification of data than the old system.
