It is such a breath of fresh air to learn that Medicare has offered their Nursing Home Compare service. Just like at restaurants or hotels, nursing homes will now be rated on a one to five star scale. Consumers can simply log on to www.medicare.gov and go to the NH compare section. The folks at Medicare chose three criteria in rating nursing homes; health inspections, nursing home staffing and quality measures. The health inspections section is pretty straight forward. It calculates how many times the nursing home has been found in violation of the health code, the severity of the transgressions, and translates it into a scale from 1 to 5. Quality measures look at the percentage of many different factors such as pressure ulcers, use of restraints and pain.
Since I am in the business of staff education, I have some trouble with how Medicare is rating the staffing category. They have sections for total RN hours per resident, total LPN hours per resident and total CNA hours per resident. It simply takes the average total hours of staff per day and divides it by the number of residents. Using this metric, consumers can figure out how WELL staffed a nursing home is, but not the QUALITY of staff. There are homes where the staff to resident ratio is one to one but because the staff is not well trained they can’t provide quality care.
I film directly in Long Term Care facilities and I have come across some of my favorite facilities that received a 1 or a 2. Perhaps their resident to staff ratio is on not great but the quality of their staff is superb. One home I have in mind received a 2 simply because of their ratio, but their staff is extremely well trained and stay with this home because of promotion opportunities for dedicated workers. On the flip side, I filmed in another home that received a 4 due to an awesome resident to staff ration but their workers frequently turnover and are not well trained. Thus they do not have a high quality of care.
I understand it is hard for Medicare to rate the quality of staff. Inside the rating system, they have buried some statistics that are telling as to the quality of staff. In the "Quality Measures" section one can find the rate of pressure ulcers and the management of pain. Only through direct observation however can the consumer fully determine the quality of the staff. My suggestion to the consumers remains the same: visit the nursing home and see how the staff interacts with the residents. For my White Paper on this topic, click here.
