Winning at All Costs: Analysis of Inflation in Nursing Homes’ Rating System

The Nursing Home Compare system, administered by the Centers for Medicare & Medicaid Services (CMS), is used by consumers over 1.4 million times per year. Consumers depend heavily on this website in choosing a nursing home for a loved one. However, a recent study demonstrates that nursing homes are guilty of inflating their ratings in order to obtain a higher ranking on the CMS system. Of the 3 domains reported on the CMS rating system, 2 of the elements (Staffing and Quality Measures), are self-reported by nursing homes, and only one element (Health Inspection) is independent. The study, conducted by Florida Atlantic University and University of Connecticut researchers, shows no correlation between inspection and self-reported results, and further demonstrates significant financial incentive for facilities to inflate their self-reported numbers. A key component used by the researchers in their analysis, resident complaints, is not used by CMS in its Compare System. The study specifically finds that the existing CMS rating system is prone to inflation by nursing home operators, which leads to biased and misleading ratings.