Star ratings for elder care face opposition

Plan to gauge quality concerns industry

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CORRECTION

A story Wednesday on Page 1B incorrectly identified the chairwoman of the state House Aging Committee who set up a subcommittee on the state's proposed star rating system for adult care homes earlier this month. Rep. Jean Farmer-Butterfield is the chairwoman.

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The long-term care industry in North Carolina is working to derail a proposed star ratings system for adult-care homes that has been introduced at the state legislature.

The ratings would give adult care homes -- assisted-living facilities, rest homes and smaller family-care homes -- from one to five stars so that people looking for care for older relatives could be guided by a uniform measure of quality.

Legislation before the General Assembly says the ratings would reflect how well the centers meet minimum standards in state laws and regulations. They would take into account serious rule violations found by state inspectors and give points for extra measures to improve care.

"Things that facilities do that go above and beyond the minimum level of standards, we felt strongly that they should be rewarded for," Jeff Horton, a Division of Facility Services official who helped develop the system, told a long-term care conference Monday.

The state health and human services department developed a plan for star ratings after the legislature instructed them to in 2005. Advocates want the ratings to mirror the state's five-star system for child-care centers. But the measure isn't well liked by the industry.

"This is not like the child-care rating system," said Lou Wilson, lobbyist for the North Carolina Association of Long-Term Care Facilities. The child-care program, she said, "has dollars attached to it" for centers to help offset the costs of making improvements.

Wilson and other long-term care lobbyists said ratings for adult-care centers with high numbers of Medicaid residents could suffer in comparison to facilities that mostly house private-pay residents. Industry leaders would favor what they consider more objective standards, Wilson said.

"It should be based on whether they meet sanitation standards and ... whether they are out of compliance or are more than compliant," she said.

The bill would authorize the state Medical Care Commission to come up with specific rules and issue certificates to facilities. Older people and their advocates pushed its passage at Tuesday's Long Term Care Advocacy Day.

"Stars would recognize how much homes are actually doing for residents," Polly Williams, a Raleigh activist for seniors, told those gathered for the advocacy day. "All of the minimums are already in place, so it can go forward without additional cost."

Estimated costs for the state to manage the system include $153,000 in startup money in 2007-2008 and $108,000 the next year.

The bill ran into trouble in the House Aging Committee earlier this month. In response to questions raised by several representatives, committee chairwoman Rep. Beverly Earle, a Charlotte Democrat, decided she wanted more information about how the system would affect some homes. Earle set up a subcommittee on the issue, which is to meet at noon today in Room 1415 of the Legislative Office Building.

"I want to hear from the facilities," Earle said. "Certainly, it is not our intent to put anybody out of business."

Rep. Jennifer Weiss, a Cary Democrat, said members are getting pressure from industry representatives on the proposed system. The subcommittee she'll preside over today hopes to answer some of the questions being raised, Weiss said.

"I think it's really important for the public to know this information," she said. "It's being based on some very basic criteria."

Earle predicted the legislation will pass, although not necessarily this year. Weiss said it's important that the bill pass in this session so that owners could have time to prepare before the proposed January 2009 start date.