One in five of the nation's 15,700 nursing homes have consistently received poor ratings for overall quality, a USA TODAY analysis of new government data finds.
More than a quarter-million patients live in homes given another set of low scores within the past year, according to data released today by Medicare, which first released the star ratings of the nation's nursing homes in late 2008. The ratings are derived from inspections, complaint investigations and other data collected mostly in 2008 and 2009.
USA TODAY found that all 50 states and the District of Columbia have homes with poor ratings from one year to the next. And dozens of those facilities are the only nursing homes for miles.
Late in the Bush administration, the Centers for Medicare & Medicaid Services began assigning nursing homes one to five stars for quality, staffing and health inspections, as well as an overall score. Nearly all homes that repeatedly received few overall stars -- one or two stars -- were owned by for-profit corporations, the data show.
"We want to see improvements, but we don't expect a nursing home will jump to a five-star rating within a one-year time period," says Medicare's Thomas Hamilton, who led the development of the rating system. He points to "positive trends" within the past year, including the reduction of one-star homes and vigilance among providers in the use of restraints.
"The issue is the owners have to take responsibility for the consequences" of poorly performing homes, says Larry Minnix, CEO of American Association of Homes and Services for the Aging. He says the nascent star-rating system should account for patient satisfaction.
Medicare spokeswoman Mary Kahn says a one-star nursing home is not necessarily a terrible facility. Even the lowest-rated homes must still meet baseline Medicare conditions, she says.
The newspaper's analysis found the lowest-rated homes had an average of 14 deficiencies per facility, which can include quality-of-life measures and safety violations.
"Families can show (a home's rating) to a hospital discharge planner and say, 'I'm not going to send my mother to a home with one or two stars,' " says Janet Wells, public policy director of NCCNHR, formerly the National Citizens' Coalition for Nursing Home Reform.
"If homes are not motivated to get better, chances are they won't, and you'll wind up in homes in poor-quality purgatory," Minnix says. "There should be two types of homes: the excellent and the non-existent."
To see more of USAToday.com, or to subscribe, go to http://www.usatoday.com
Copyright 2009 USA TODAY, a division of Gannett Co. Inc.