HHS Secretary Kathleen Sebelius Acknowledges "Inherent Flaws" in Five-Star NH Rating System

VHCA (3/19/2010)

Health and Human Services (HHS) Secretary Kathleen Sebelius acknowledges “inherent flaws” in the Five-Star Quality Rating System for nursing homes this week.

Secretary Sebelius expressed her concerns with the Five-Star program when speaking to the National Council on Aging and the American Society on Aging.  According to media reports, she said, “The suggestion that it's a flawed snapshot because it forces the reviewers at the outset to make decisions that may or may not be accurate… I think that's serious criticism that needs to be looked at; the last thing we want to do is have an arbitrary bell curve just for the sake of having a system.”

Upon its introduction in December 2008, AHCA maintained Five-Star’s ratings criteria was “highly problematic” in large part due to the use of a forced bell curve which required each state to have 20 percent of its facilities ranked as the poorest and only 10 percent ranked as the best.  Echoing that belief, 31 State Attorneys General wrote a letter to Secretary Sebelius in August 2009 advocating for Five-Star’s “temporary suspension.”   Secretary Sebelius made it clear that improvements will be made to the system. “Absolutely. I think we need to make sure it isn't flawed inherently. But should we have a rating system? You bet.”