Wills, Trusts & Estates Prof Blog

Editor: Gerry W. Beyer
Texas Tech Univ. School of Law

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Tuesday, August 26, 2014

The Medicare Star System

Medicine

For the last five years, Medicare has been assigning hotel-style ratings to nearly every nursing home in the country.  An examination of this rating system has found that many top-ranked nursing homes have been given a seal of approval that is based on incomplete information and can mislead consumers, investors, and others about the home’s conditions. 

The Medicare ratings are based in large part on self-reported data by the nursing homes that the government does not verify.  The ratings do not take into account entire sets of potentially negative information, including fines and other enforcement actions by state authorities, as well as complaints filed by consumers.  For example, the State of California fined a five star rated nursing home $100,000 (highest penalty possible) for causing the death of a woman who was given an overdose of a powerful blood thinner.  Furthermore, this nursing home has been the subject of around a dozen lawsuits from patients and their families claiming substandard care. 

Widespread acceptance of the ratings system is leading to use beyond the eldercare industry.  Beginning this year, Medicare plans to introduce similar five-star ratings for hospitals, dialysis centers and home health care agencies.  Federal officials say that while the rating system can be improved, it incentivizes nursing homes to get better.  Unfortunately, some nursing homes are not improving, but rather, learning how to game the rating system. 

See Katie Thomas, Medicare Star Ratings Allow Nursing Homes to Game the System, The New York Times, Aug. 24, 2014. 

http://lawprofessors.typepad.com/trusts_estates_prof/2014/08/the-medicare-star-system.html

Disability Planning - Health Care, Elder Law, Estate Planning - Generally | Permalink

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