← Back to Insights
March 28, 2021
David W. Johnson
Outcomes Policy
Blogs Dispatches

The Sorry State of Nursing Home Star Ratings

Patient Safety Awareness Week was March 14th-20th. On cue, the New York Times released a major investigative report on nursing home corruption, dysfunction, neglect and death. We discussed the report’s depressing findings on our March 19th podcast: maggots in wounds; sexual abuse; neglect; heartbreaking stories.  

Investigative journalism has a proud history. It emerged in the early 1900s to expose cronyism, monopolies and government malfeasance. “Muckraking” pioneer Ida Tarbell’s in-depth reporting on Standard Oil led to the company’s breakup and anti-trust legislation.

Tarbell believed truthful reporting, supported by data, could “precipitate meaningful social change.” Following in Tarbell’s footsteps, current-day reporters Jessica Silver-Greenberg and Robert Gebeloff present a damning portrayal of nursing homes and the failed system the government uses to rate their quality. 

There are 15,000 nursing homes in the U.S. The Times concentrated its investigative lens on the 3,500 nursing homes that carry 5-star ratings and found the following:

  • 5-star facilities passed and failed in-person inspections at the same rate as lower-rated facilities
  • 70% received citations for inadequate infection control and/or resident abuse
  • Higher ratings correlate with increased profitability, not better outcomes 
  • Covid deaths occurred in 5-star facilities at the same rate as lesser-rated facilities

While there are some stellar performers, Covid has exposed the sector’s malfeasance. A quarter of all Covid deaths have occurred in nursing homes. Ten percent of nursing home residents nationwide have died from Covid.

The tragedy is that nursing homes should be the institutions best prepared to protect their vulnerable residents from infectious disease. 

America’s nursing home industry has hit bottom. As Ida Tarbell might observe, it’s time for meaningful change.

Read all dispatches from Dave Johnson here.

About the Author

David W. Johnson

David Johnson is the CEO of 4sight Health, an advisory company working at the intersection of healthcare strategy, economics, innovation. Johnson is a healthcare thought leader, keynote speaker, and strategic advisor to organizations busting the status-quo to reform our healthcare system. He is the author of Market vs. Medicine: America’s Epic Fight for Better, Affordable Healthcare, and his second book, The Customer Revolution in Healthcare: Delivering Kinder, Smarter, Affordable Care for All (McGraw-Hill 2019). As a speaker, Dave plays the role of rebel, challenger, industry historian, investor and company evaluator to push audiences forward. (Watch bio video.) Johnson applies his 25+ years of investment banking in healthcare to identify ways the healthcare industry must change to deliver better care. He received a Masters in Public Policy from Harvard Kennedy School, an English degree from Colgate University, and served in the African Peace Corp service. Join over 10k+ healthcare executives who read our weekly insights and commentary on www.4sighthealth.com. His third book, Less Healthcare, More Health: The Prescription for a Happier, More Equitable and Productive America, will publish in 2024.

Recent Posts

4sight Friday | April 19, 2024
4sight Friday | GoFundMe Healthcare Is Not the Solution | Don’t Cry for Acquired Physician Practices | Why… Read More
By April 19, 2024
System Dynamics
Podcast: Why Nurses Leave Their Jobs 4/18/24
A new study breaks down the reasons nurses exit their current employment. We talked about some of the… Read More
By April 18, 2024
Stop Weeping for Physician Practices
4sight Health published a blog post last month in which I said it was disingenuous of physicians to… Read More
By April 17, 2024