NY Times Investigates Medicare’s Flawed Nursing Home Ratings System

According to an investigative report by the New York Times, the current Medicare Star Ratings allows nursing homes to “game the system,” potentially misleading consumers and investors about the safety of their facility.

These government ratings – deemed the industry’s gold standard – are heavily scrutinized by families when selecting a nursing home or rehab center for a loved one they can no longer care for themselves.  The investigation uncovered major flaws in this once respected rating, and further highlighted the need for due diligence to help prevent seniors from being subjected to subpar care or incidents of elder abuse.

At Edelman, Krasin & Jaye, our New York nursing home abuse lawyers understand the betrayal felt by families who entrusted a highly-rated center to care for their aging relatives, only to discover that staff were improperly trained, abusive to their loved ones, or neglected their basic daily needs.

Our mission as one of the most trusted personal injury law firms in New York is to help nursing home abuse victims pursue justice, and hold negligent parties liable for their actions.

Medicare ratings rely largely on self-assessments

The crux of the problem is a rating system that relies mainly on nursing home self-assessment.  Medicare looks at three major areas when ranking nursing homes, but only health inspections are conducted by a third party, while measures of staff and quality are self-reported.  Prior infractions and negative complaints filed with state agencies are not even considered during the evaluation, giving a distorted picture of the facility’s overall quality and safety levels.

The report chronicles the heartache suffered by Sacramento resident Ken Chandler, who placed his 90-year-old mother in a 5-star acute care center called Rosewood, based largely on its rating. If he had known that the facility had a long track record of state complaints regarding elder abuse, insufficient staffing, failure to treat and other cases of negligent care, he would have considered other options. In fact, at least twelve malpractice suits had been brought against the center, filed by clients who claimed their loved ones suffered substandard care.

Impressed by the center’s posh interior and top-level rating, Chandler admitted his mother to Rosewood after a hip surgery, where during her brief stay, she suffered frequent falls and purportedly went more than a week without proper bathing, leaving her with repeat urinary traction infections. Chandlers says that she returned home 40 pounds lighter and died just six months later.

A close look at the Medicare nursing home ranking system shows that it never includes state-level violations, and as such, their ratings are based on an incomplete set of information. Government officials admit that the methodology needs improvement, and encourages families to thoroughly vet a prospective facility before making their decision.  Families should look at the whole picture, including levels of staff training and engagement with patients, while using the Medicare website as a starting point only.

As leading NY medical malpractice attorneys, Edelman, Krasin & Jaye believe there is no excuse for elder abuse or mistreatment, whether at a private nursing home or a Medicare-funded facility. If you believe that your relative has been subject to neglect, mistreatment or abuse, there are options for legal recourse.

Speak with NY nursing home injury attorneys

In addition to our seasoned team of New York nursing home abuse lawyers, our firm works with health care and other industry experts who will investigate and determine if you have a viable claim for damages. Emotional and physical suffering, economic losses and other damages may be recovered through successful litigation. To arrange a free consultation and learn more about your options, we invite you to call 516-742-9200.