Placing a loved one in a nursing home is one of life’s toughest decisions. Making sure your loved one receives proper care may be the second hardest, says Stephen Samuelian. According to Samuelian, the federal government is now making it harder for nursing homes to get top grades on a public report card, raising the bar on an array of quality measures. Those grades – in the form of one- to five-star ratings – are part of Nursing Home Compare, a Medicare and Medicaid website to help consumers evaluate nursing homes, says Stephen Samuelian.  While the ratings, which debuted in 2008, are lauded as an important tool, Stephen Samuelian says the system relies too heavily on self-reported data, allowing a majority of homes to score high. “It needs to be trustworthy,” says Stephen Samuelian.

Nursing Home Compare, says Stephen Samuelian, rates more than 15,000 nursing homes in three broad categories: government inspections, staffing, deficiencies and complaints.

According to Stephen Samuelian, the system has come under recent criticism, with complaints that some high rated nursing homes face fines and other regulatory actions. With the new rules, the federal government would require nursing homes to do more to get higher quality scores, says Stephen Samuelian.

According to Stephen Samuelian, one of the biggest concerns factoring into quality scores are the percentages of residents who develop bed sores or suffer injuries from falls.  The scores will now include the percentage of residents given antipsychotic drugs, says Stephen Samuelian, reflecting concern that too many residents are unnecessarily drugged to make them easier to manage. However, all of those procedures will continue to be reported by the facilities themselves, cautions Stephen Samuelian.

According to Stephen Samuelian, these changes mean many homes could drop a star or more from their January levels, even though nothing may have changed.

While consumer advocates welcome the adjustments, says Stephen Samuelian, industry officials believe the new rules may confuse patients and their families if scores change suddenly. Nursing homes fear losing star ratings overnight could send a signal to families and residents that quality is on the decline, says Stephen Samuelian.

Advocacy groups for nursing home residents and their families believe the shift is important and necessary. These groups have previously raised concerns that high rates were too easy to achieve, according to Stephen Samuelian.