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The Centers for Medicare and Medicaid Services launched the five-star rating system Thursday, saying it will give consumers new information to help compare homes.
Some administrators say they don't understand how the ranking system works. Others say the system is flawed, inaccurate and incapable of measuring the kind of complex services that occur in nursing homes.
In fact, the director of one of the local homes that received a high score said the rating that the low-scoring home received doesn't tell the whole story.
Consumers can view the ratings on the federal Web site, cms.gov. The data has been collected but never compared with a star rating system until now.
Locally, TidePointe's Broad Creek Care Center and the Preston Health Center at the Cypress of Hilton Head Island received five stars. The Seabrook's Fraser Health Center earned four stars. The Life Care Center of Hilton Head had one star.
Five stars means the home is "much above average," while four stars means "above average" and a one-star rating means "much below average."
Medicare spokeswoman Mary Kahn said the ranking is based on three years of health inspection reports and a nine-month review of nursing home staff levels and quality of care. Those quality measures include statistics, such as the percentage of residents with bed sores or the percentage of residents who lose too much weight during their stay.
Life Care Center is listed on the federal Web site with eight deficiencies from October 2007 to September 2008. They include not giving residents care and services that would give them the highest quality of life possible, not providing the kinds of food that meets residents' needs, not having necessary medicine and pharmacy products available and not having a medical director.
Jim Hardy, the facility's executive director, said Life Care does have a medical director. Dr. Gaston Perez of Bluffton has served in that role since 2005. Hardy would not comment further on any other deficiencies listed on the Web site.
Instead, he faxed a written response from the corporate Life Care Centers of America, which owns the local facility.
Corporate president Beecher Hunter calls the rating system "premature and problematic due to the fact that it is premised upon a flawed survey system that does not measure quality, lacks the inclusion of other important quality elements that help consumers make informed decisions and includes inaccurate data."
Hardy said the Life Care Centers were accredited by the Joint Commission of Accreditation of Health Care in 2005. Customers also have about 89 percent overall satisfaction with the care provided there, he said.
Rob Lee, executive director of the Seabrook, said he does not understand what all the ratings mean or how the data were compiled. However, he said historically the three retirement communities that participate in Medicare generally have earned "good" inspection reports.
Life Care is at a disadvantage, he said, because although it participates in Medicare, it also accepts Medicaid patients. Medicaid, which is a national medical insurance program for low-income and disabled people, might not cover all the expenses needed for resident care, he said.
"Some people just look at a rating system and don't look at everything that goes into that," Lee said. "A lot of those people aren't paying anything to stay there. The government is covering a lot of that cost, yet it may not cover all the costs it takes to live there."
The National Consumer Voice for Quality Long-Term Care, which has the support of the state's Area Councils on Aging, said the nursing home industry has tried to put political pressure on the federal government to eliminate the ratings plan.
"We believe this is part of a concerted industry attack against CMS's efforts to make quality information available to consumers, and against the survey and certification system itself," the advocacy group wrote in a letter to local aging councils.
S.C. Lt. Gov. Andre Bauer's Office on Aging stands behind the ratings, saying they are a valuable tool for consumers. Still, Office on Aging agency spokesman John Legare said families always should check out a facility in person.
"Going by a rating system should not be a final decision in where you will put your loved one," he said. "However, it can give people ideas of what they should be looking for."
