CMS' Five-Star Rating System Fails Facilities, Residents, and the Public

Intended to be much like the one used for restaurants’ health ratings, the Centers for Medicare & Medicaid Services’ (CMS) Five-Star Rating System was designed to be posted conspicuously in the front window of a nursing home for all to see.  The facility's rating of 1 to 5 stars is intended to give consumers the ability to compare nursing homes in order to make discerning judgments about resident care. Recently published research findings that compared the Five-Star Quality Rating scores of nursing homes to the actual satisfaction level of residents and family members suggest that there is little correlation between customer satisfaction ratings and facility five-star ratings from CMS.

This is quite a problem because facilities will soon be required to post their ratings -- and yet apparently the ratings do not predict how satisfied consumers will be with the care they will receive nor whether residents of that facility are inclined to refer their friends and family.

According to Holleran, the national research firm specializing in the not-for-profit senior living sector that conducted the study, this lack of relationship with customer satisfaction is shown in several areas of satisfaction. “One such example is the fact that those nursing homes rated as a 1-star facility (the lowest according to CMS’ standards) overall had a higher willingness, on average, to select the facility again than all other facilities.”

Essentially, what is being said here is that once the ratings of CMS are posted in facilities, some of those most preferred by customers will be the lowest rated.

Turning people away from the places preferred by their peers is a striking failure for a rating system. These ratings will influence customer perceptions of care and potentially do harm to some of the facilities that residents consider to be the best for their comfort and care.  This gap must be understood and closed before consumers should rely on these ratings in their decision making.