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California nursing homes to post five-star ratings

Contemporary Long-Term Care Weekly, October 15, 2009

Governor Schwarzenegger signed legislation October 11 requiring California nursing homes certified by Medicare or Medicaid to post their rating determined by CMS’ Five-Star Quality Rating System. The bill, known as Assembly Bill 215, will go into effect January 1, 2011.

The Five-Star Quality Rating System, which was launched in December 2008, uses data from nursing home surveys, staffing rates, and 10 quality measures to calculate star ratings, ranging from one to five.

The new legislation requires Medicare or Medicaid certified nursing homes in the state of California to post their overall star rating information in at least the following locations:

• An area accessible and visible to the public
• An area used for employee breaks
• An area used by residents for communal functions and activities

The information, which should be posted on white or light-colored piece paper, must include the following, in the following order:

• The full name of the facility, in a clear and easy to read font of at least 28 point.
• The full address of the facility, in a clear and easy to read font of at least 20 point.
• The facility’s most recent overall rating determined by CMS’ Five-Star Quality Rating System. This information should be in the center of the page, in the form of the number reflecting the rating, and in a clear and easy to read font of at least two inches. A facility will have seven business days from the day it receives a new rating to post it.
• Below the star rating should be “The above number is out of 5 stars” in a clear and easy to read font of at least 28 point.

Although Assembly Bill 215 is an effort to educate consumers about facilities’ quality of care ratings, many providers, associations, and other professionals in the long-term care industry are not thrilled that this legislation has passed.

According to a representative from the American Health Care Association (AHCA), “AHCA believes that reliably and accurately measuring quality, and publicly disclosing the results, will help to inform consumers’ health care choices, especially in identifying care facilities that best meet individual needs. Since we believe that CMS’ Five-Star Rating System fails to provide the tools necessary to evaluate quality care and may do more to confuse and even mislead consumers than to enlighten them, we oppose the notion that facilities should post these ratings.”

The legislation also requires nursing homes to provide consumers with a detailed explanation of their rating as well as how to access this information on the Nursing Home Compare Web site. Failure to comply with the provisions of this legislation will result in a class B violation, the fines from which will be deposited into the State Health Facilities Citation Penalties Account.

To read Assemble Bill 215, visit the Resources page on MDSCentral.

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