Posted June 23, 2008

I am not sure if you can link the article so I have copied it below.  It was written by Jane Zhang for the Wall Street Journal and I thought it was worth noting.

U.S. Preps Nursing-Home Rating System

Move for More Data 
To Appear on Web; 
Sprinklers Required
June 19, 2008; Page D2

WASHINGTON — In an effort to improve care at the
nation’s 16,000 nursing homes, the Bush administration will start
rating facilities based on a five-star system and require all of them
to install fire sprinklers.

The rating system, expected to be available on a
Medicare Web site by the end of the year, will give each nursing home
from one to five stars based on government inspection results, staffing
data and quality measures. It may also include information such as
whether a nursing home provides care to patients with dementia or those
on ventilators.

"The fact a home has a lower rating will likely put
them on a path to improvement," said Kerry Weems, acting administrator
at the Centers for Medicare and Medicaid Services, the federal agency
that manages Medicare, the health-insurance program for the elderly and
disabled, and Medicaid, the health program for the poor.

About 1.5 million Americans live in nursing homes and
each year, more than three million end up in nursing homes at least
temporarily, and the numbers are expected to rise as the baby-boom
generation ages. About 22% of 5.3 million people 85 years old and older
had a nursing-home stay in 2006.

The federal and state governments are the largest
third-party payer for nursing-home care. Medicare alone spent $21
billion on nursing homes in 2007, up from $17.6 billion in 2005.

For seniors
and their families, it is often difficult to get enough information —
the staffing level, the number of patients with bed sores, violations
and other data that shed light on the quality of care — before they
choose a nursing home. Despite government oversight, some nursing homes
repeatedly violate regulations, and lawmakers and patient advocates
have been raising questions about care at some investor-owned nursing

This year, Medicare listed some of the most troubled
nursing homes in its public database, which already has some
information on staffing and quality measures. Many consumers have
complained that the information isn’t easy to understand, and states
such as Wisconsin and California have established their own databases
to evaluate nursing homes.

Sen. Charles Grassley (R., Iowa), and Sen. Herb Kohl
(D., Wis.), have introduced legislation to allow consumers to lodge
complaints about nursing-home neglect. The lawmakers welcomed
Medicare’s move, but stressed that to make a difference, the Medicare
Web site will have to be easy for consumers to use.

Mr. Weems said the agency is aiming for easy use, and
is accepting public comments in July and August on the site and its

Mr. Weems said that requiring all nursing homes to install sprinklers by 2013 is also an important step toward safety.

Only new nursing homes and those under renovation
currently are required to have sprinklers. The Medicare agency said 80%
of nursing homes now have sprinklers. Renovation costs to meet the new
sprinkler requirement are expected to total $846.7 million over five
years, the agency said. The lack of sprinklers has been blamed for 31
deaths in nursing-home fires in Hartford, Conn., and Nashville, Tenn.

In March 2005, Medicare required all nursing homes
without sprinklers to have battery-operated smoke alarms in patient
rooms and public areas.

Larry Minnix, president and chief executive of
American Association of Homes and Services for the Aging, a trade
group, said the new rating system must be based on "reliable, validated
information for the public to trust not only nursing homes but the
rating system itself." He said the public oversight, as part of the
system, will be most controversial, because it is subjective,
inconsistent and not timely, among other things.

Toby S. Edelman, senior policy attorney with the
Center for Medicare Advocacy, an advocacy group, said two of the three
criteria that CMS plans to include "are self-reported by nursing
facilities and are inaccurate."

"Too often, nursing facilities report that residents
are doing much better than they really are and that they have more
staff than they really have," he said. "Relying on nursing homes to
describe accurately how well they are doing — and reporting that
information as fact — just doesn’t make sense."

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