Medicare report shows NC nursing home quality is improving

relder@newsobserver.comJuly 16, 2013 

Conditions in North Carolina nursing homes are better today than they were in 2009 but still just slightly above average compared with those in other states, according to a survey commissioned by the U.S. Centers for Medicare &Medicaid Services.

The survey was based on reports of nurse staffing levels, health inspection results and a “quality measure” of patient-related factors, such as how many long-term residents have bedsores or urinary tract infections or are experiencing moderate to severe pain.

The data are used to create the federal government’s star-rating system, which categorizes nursing homes on a scale of one to five.

The recent report shows that 16.4 percent of North Carolina’s 420 nursing homes earned five-star rankings on the combination of factors, compared with 11.4 percent in 2009. The state now ties with Indiana for the No. 23 spot among states and the District of Columbia. Nationally, 15.9 percent of nursing homes were given five stars.

“The ratings have gone up in North Carolina, particularly on the quality measure,” said Alan White of Abt Associates, which conducted the study in 2009 and again in 2011 on behalf of the Centers for Medicare & Medicaid Services, part of the U.S. Department of Health and Human Services that administers the Medicare program. Results from the 2011 survey were released earlier this month.

The percentage of nursing homes earning five stars in the category focused on patient conditions jumped from 5.7 to 16.4 between 2009 and 2011. The portion of nursing homes earning at least three stars on patient quality measures jumped from 62 to 80.

Bill Lamb, who works for the Consumer Voice, an advocacy agency for residents of long-term care, said the star rating system is a good point of reference for comparing facilities and also may help encourage nursing homes to improve their quality of care.

“The simple act of having a benchmark causes folks to do better because they want to have the highest rating they can,” Lamb said.

But he also urges consumers to do additional checking before choosing a facility for themselves or a family member.

“It’s just as important for people to make their own observations,” he said. “If a place doesn’t have all five stars, ask what happened.”

Lamb said there’s often a difference between what regulators require of a nursing home and what’s important to residents and their families.

“The stuff that drives the rating system tends to be black and white,” he said. “It doesn’t include, for example, how well the staff relates to the individuals in their care.”

The national survey shows that North Carolina nursing homes overall performed as well as or better than those in most other Southeastern states. The exceptions were South Carolina, with 20.4 percent in the five-star category, and Virginia, with 17 percent earning five stars.

The percentage of low-performing facilities that earned only one star dropped in North Carolina from 26.9 percent to 16.6 percent between 2009 and 2011, another sign that conditions are improving, White said.

Alaska had the greatest portion of five-star ranked nursing homes, at 33.3 percent; Louisiana had the smallest at 6.5 percent.

Consumers can read more details from the report and compare ratings for individual nursing homes at

Elder: 929-829-4528

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