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I am not sure if you can link the article so I have copied it below.  It was written by Jane Zhang for the Wall Street Journal and I thought it was worth noting.

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U.S. Preps Nursing-Home Rating System

Move for More Data 
To Appear on Web; 
Sprinklers Required

June 19, 2008; Page D2

WASHINGTON -- In an effort to improve care at thenation's 16,000 nursing homes, the Bush administration will startrating facilities based on a five-star system and require all of themto install fire sprinklers.

The rating system, expected to be available on aMedicare Web site by the end of the year, will give each nursing homefrom one to five stars based on government inspection results, staffingdata and quality measures. It may also include information such aswhether a nursing home provides care to patients with dementia or thoseon ventilators.

"The fact a home has a lower rating will likely putthem on a path to improvement," said Kerry Weems, acting administratorat the Centers for Medicare and Medicaid Services, the federal agencythat manages Medicare, the health-insurance program for the elderly anddisabled, and Medicaid, the health program for the poor.

About 1.5 million Americans live in nursing homes andeach year, more than three million end up in nursing homes at leasttemporarily, and the numbers are expected to rise as the baby-boomgeneration ages. About 22% of 5.3 million people 85 years old and olderhad a nursing-home stay in 2006.

The federal and state governments are the largestthird-party payer for nursing-home care. Medicare alone spent $21billion on nursing homes in 2007, up from $17.6 billion in 2005.

For seniorsand their families, it is often difficult to get enough information --the staffing level, the number of patients with bed sores, violationsand other data that shed light on the quality of care -- before theychoose a nursing home. Despite government oversight, some nursing homesrepeatedly violate regulations, and lawmakers and patient advocateshave been raising questions about care at some investor-owned nursinghomes.

This year, Medicare listed some of the most troublednursing homes in its public database, which already has someinformation on staffing and quality measures. Many consumers havecomplained that the information isn't easy to understand, and statessuch as Wisconsin and California have established their own databasesto evaluate nursing homes.

Sen. Charles Grassley (R., Iowa), and Sen. Herb Kohl(D., Wis.), have introduced legislation to allow consumers to lodgecomplaints about nursing-home neglect. The lawmakers welcomedMedicare's move, but stressed that to make a difference, the MedicareWeb site will have to be easy for consumers to use.

Mr. Weems said the agency is aiming for easy use, andis accepting public comments in July and August on the site and itscontents.

Mr. Weems said that requiring all nursing homes to install sprinklers by 2013 is also an important step toward safety.

Only new nursing homes and those under renovationcurrently are required to have sprinklers. The Medicare agency said 80%of nursing homes now have sprinklers. Renovation costs to meet the newsprinkler requirement are expected to total $846.7 million over fiveyears, the agency said. The lack of sprinklers has been blamed for 31deaths in nursing-home fires in Hartford, Conn., and Nashville, Tenn.

In March 2005, Medicare required all nursing homeswithout sprinklers to have battery-operated smoke alarms in patientrooms and public areas.

Larry Minnix, president and chief executive ofAmerican Association of Homes and Services for the Aging, a tradegroup, said the new rating system must be based on "reliable, validatedinformation for the public to trust not only nursing homes but therating system itself." He said the public oversight, as part of thesystem, will be most controversial, because it is subjective,inconsistent and not timely, among other things.

Toby S. Edelman, senior policy attorney with theCenter for Medicare Advocacy, an advocacy group, said two of the threecriteria that CMS plans to include "are self-reported by nursingfacilities and are inaccurate."

"Too often, nursing facilities report that residentsare doing much better than they really are and that they have morestaff than they really have," he said. "Relying on nursing homes todescribe accurately how well they are doing -- and reporting thatinformation as fact -- just doesn't make sense."

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