Comparison Shopping
Medicare and CMS sponsor the Nursing Home Compare website where consumers can theoretically find statistical information about how well a nursing home meets quality measures. Facilities can be located by name or by zip code, and then compared on a series of comparison factors determined by the government. The service provides an overall rating of 1 to 5 stars, and then individual ratings in health inspections, staffing, quality measures, and the like. It also provides information about the number of certified beds and whether the facility is privately owned or managed by a non-profit organization.
The problem with Nursing Home Compare is that it effectively grades every nursing facility with measures that really mean very little to most families looking for nursing facilities. Does the facility have open beds, will it accept the resident, and can it take care of him or her in a proper manner.
In the past few years I've had the opportunity to interview more than 30 people who lost loved ones in nursing facilities and who claimed that the facility's negligence caused the death. In all those cases except one the family members making the decision had gone with the first nursing facility recommended by the doctor or hospital. Only one had actually checked the federal website, and they were "falsely reassured" by the five star rating the facility received.
Consumer protection laws require full disclosure of information about quality measures in most states when a family member asks for that information. The facility must share the NH Compare ratings, as well as the results of the last survey. But most prospective residents don't even know they can ask for these things, and frankly, few would know what they were reading if they read them.
As more and more computer-literate people start making nursing home placement decisions, however, it will become much more common for these sites to be used by prospective consumers. Facilities are well-advised to maximize their NH Compare ratings. Facilities with high ratings will stay full with waiting lists, and those without such ratings may find residents more difficult to attract.
What if the NH Compare site gets it wrong? Does a facility have recourse? Other than sending correspondence advising the site about the discrepancy, it would be difficult for most facilities to challenge the ratings in court since they are specifically provided for by Congress.
For that reason the wisest move is to maximize the ratings to the extent that the facility can feasibly do so.