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Nursing Homes Are Exploiting U.S. Rating System, The New York Times Reports

According to recent reporting from The New York Times, nursing homes throughout the United States have been found guilty of regularly exploiting the star rating system run by the U.S. Centers for Medicare & Medicaid Services (CMS).

The CMS rating program compiles self-reported data and information from on-site examinations conducted by state health inspectors to compute each nursing home’s rating, primarily with the three following categories in mind:

  • Any state health inspector findings
  • The quality of resident care
  • The amount of time nurses spend with each resident

Reporters from the Times took a deep dive into current CMS ratings, building a database and analyzing millions of nursing home payroll records, state inspector reports, and financial statements. They were even able to obtain exclusive access to rating data not available to the general public via academics with active CMS research agreements.

Their in-depth investigations revealed the following:

  • A lot of the information submitted to CMS by nursing homes was incorrect and painted the facilities as being “cleaner and safer than they are,” having more employees than they do, and understating the amount of patients taking opiates and antipsychotic medications in addition to fudging the number of patient accidents and health issues.
  • A five-star nursing home has no guarantee of passing a state health inspection; in fact, it is just as likely to pass as it is to fail.
  • Self-reported data often goes unaudited by the government.
  • Nursing homes are often aware of so-called surprise inspections.
  • Abuse and neglect are frequently identified at five-star nursing homes, but health inspectors do little to address the problem or adjust the rating.

The Times went on to explain how five-star facilities were found to have left residents to develop “bed sores so severe that their bones were exposed [or they] lost the ability to move.” Reports from other five-star facilities revealed instances of uncared for wounds, with one resident being left with unchanged bandages for so long that they “became infested with maggots.” Per the Times, even the nursing home industry’s extremely poor handling of COVID-19 may be reasonably attributed to the exploitation of the rating system.

“The problems with the five-star system left these homes less prepared in the pandemic,” said Charlene Harrington, who advises CMS on its star rating system, to the Times. “They were allowed to not have enough staffing, and they were allowed to ignore infection-control deficiencies, so they had poorer quality than the public knew about, and they were in the worst position to manage Covid.”

Holding Nursing Homes Accountable

Due to how much the public relies on the CMS rating system when finding a suitable home for their loved ones, the fact that nursing homes across the country have abused and exploited it is unforgivable. If you or a loved one has been victimized and misled by a nursing home that you believe exploited the CMS rating system, you may be able to file a lawsuit against that facility for any abuse and/or neglect suffered.

For over 65 years, Ashcraft & Gerel has stood up against negligent nursing homes because we are passionate about protecting the safety of the public by taking legal action. Through our work, the investigative reporting of journalists, and the litany of issues exacerbated and brought to light by the COVID-19 pandemic, it has become more than clear that it is time for the nursing home industry to change to benefit residents and their families.

Contact our lawyers online or call us at (800) 674-9725. We accept cases throughout Washington, D.C., Virginia, and Maryland.

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