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The Sorry State of Nursing Home Star Ratings

COVID-19 | 
Outcomes | 

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.

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