Marys Take: Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public

Mar 16, 2021 | Five Star Staffing Ratings, Nursing HPRD & Turnover

News Digest: New York Times Takedown Makes Headlines

The payroll-based journal data collection is a new playground for journalists and researchers.  The more data you have, the more you can analyze and interpret it.  With academic researchers, and the peer review process, you can expect some level of peer review and documentation of how conclusions are drawn.

And with journalists, much the same.  But not always.  A New York Times sensational headline and sweeping conclusions delivered a collective cringe to the senior care industry – 12 months into an unprecedented crisis and ongoing staffing issues.

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Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public

Twelve years ago, the U.S. government introduced a powerful new tool to help people make a wrenching decision: which nursing home to choose for loved ones at their most vulnerable. Using a simple star rating — one being the worst, five the best — the system promised to distill reams of information and transform an emotional process into one based on objective, government-blessed metrics.

The star system quickly became ubiquitous, a popular way for consumers to educate themselves and for nursing homes to attract new customers. During the coronavirus pandemic, with many locked-down homes unavailable for prospective residents or their families to see firsthand, the ratings seemed indispensable.

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Silver-Greenberg, Jessica, and Robert Gebeloff. “How U.S. Ratings of Nursing Homes Mislead the Public.” The New York Times, 13 Mar. 2021, www.nytimes.com/2021/03/13/business/nursing-homes-ratings-medicare-covid.html

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Marys Take: Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public

I hesitated about 24 hours on whether to share this New York Times article with this title posted March 13, 2021 then decided that we all needed to see this – to be aware of what’s “out there.” Sit down with a cup of coffee and review the piece. Warning: It will take a few passes to digest if that’s even possible. It’s scathing.

You’ll likely hear that others in your community have seen it as well. Best to be prepared as you may receive questions on how your facility looks in comparison.

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Madison, Mary. “Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public.” BriggsNetNews, 16 Mar. 2021, briggshealthcare.blog/2021/03/16/maggots-rape-and-yet-five-stars-how-u-s-ratings-of-nursing-homes-mislead-the-public.

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NYT: You are as much of the problem as the Five-Star system

“Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public,” published March 13, 2021, is one of the sloppiest pieces of reporting that I have ever read from the New York Times.

It is nothing less than shameful how this lazy journalism, coupled with the need to sell advertising space, purposefully perpetuates misunderstandings about nursing homes, caregivers and government surveyors alike.

To be completely honest, I am sure most nursing home professionals would match your over 5,000 words of damnation with their own sincere and objective analysis of what is wrong with nursing homes. Some of my negative critique would include the Five-Star Quality Rating System itself — the very system you examined yet clearly misunderstood.

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Littlehale, Steven. “NYT: You Are as Much of the Problem as the Five-Star System.” McKnight’s Long-Term Care News, 2 Apr. 2021, www.mcknights.com/blogs/guest-columns/nyt-you-are-as-much-of-the-problem-as-the-five-star-system.

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The average national turnover rate across executive-level positions and those in dining services, environmental services, marketing and therapy was 29.17%, according to the report. The national average turnover among registered nurses, licensed practical nurses and certified nursing assistants was 38.68%.

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Nursing facilities should work now to determine changes that can be made – clinically, operationally, and financially – for better or more strategic outcomes.

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How to Boost Your Nursing Home Star Rating

For the administrator looking to improve an overall quality score quickly, the staffing score is a good place to start.

The staffing score will boost a facility’s overall score by one star if it: exceeds the health inspection score, and is either four or five stars.

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Staffing Rating Under 4 Stars? Review PBJ Data; Set and Monitor Goals

Staffing is difficult—that was a defining truth for nursing homes before the COVID-19 public health emergency created a full-blown staffing crisis that still is harming providers throughout healthcare. So, it may seem like the wrong time for directors of nursing services (DNSs) to pay much attention to the staffing domain in the Five-Star Quality Rating System.

“However, all of the Five-Star data—the staffing, health inspections, and quality measures domains—funnels into multiple parts of a facility’s life,” says Shelly Maffia, RN, MSN, MBA, NHA, QCP, CHC, director of regulatory services for Proactive Medical Review and Consulting in Evansville, IN.

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