Ohioans Pleased With Skilled Nursing Facilities

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Ohio's skilled nursing facilities scored, on average, 88.23 on a 100-point scale in family satisfaction, according to data released today by the Ohio Department of Aging (ODA). The Ohio Health Care Association (OHCA), the state's largest long-term care organization, applauded the agency for again seeking out the opinions of real consumers, pointing out that the survey results are a much more useful tool to evaluate the care provided by the state's skilled nursing facilities than the federal government's hastily released "Five-Star" rating system.

"We believe these surveys of families of actual patients present a clear picture of the quality services actually delivered in Ohio's skilled nursing facilities," said Peter Van Runkle, OHCA's Executive Director. "By listening to the opinions of the people in the best position to judge the services our facilities provide, these independent surveys are a better measure of quality than a misleading 'star' system based on an arbitrary and convoluted formula."

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Ohio's Family Satisfaction Survey asks family members about their satisfaction with over 60 aspects of a facility's services. The 2008 survey shows improved satisfaction compared to 2006 (88.23 versus 86.6). The 2008 survey was conducted between July and December by the Scripps Gerontology Center of Miami University, under contract with ODA. In 2007, ODA contracted for interviews of skilled nursing facility patients, which also showed high levels of satisfaction. The satisfaction questionnaires were developed by impartial researchers and tested to ensure their validity. The ratings are based on two key questions selected by the researchers: "Overall, do you like this facility?" and "Would you recommend this facility to a family member or friend?"

The satisfaction survey results show the inaccuracy of the Five-Star rating system rushed into public view last week by the federal Centers for Medicare and Medicaid Services (CMS). "CMS arbitrarily put their thumb on the scale by dictating that twice as many skilled nursing facilities have to be one-star as five-star," said Van Runkle. "Then they distorted the formula even further by saying a facility can be rated two stars higher than another facility with the exact same inspection and clinical results just because it has higher staffing, and without considering what patients and families think of the care provided." This caused such erroneous results as half or more of the skilled nursing facilities in certain Ohio counties being at the bottom of CMS's five-star scale." CMS did not wait to include customer satisfaction data, even though the agency has plans to collect it, and did not verify staffing data, despite its importance in the Five-Star formula.

"To sum it up, Five-Star tries to come up with a single star measure and then claims this one measure accurately describes each facility's quality," Van Runkle said. "This might sound like it would be helpful to consumers, but the results are extremely misleading." He noted that Five-Star gives the state's skilled nursing facilities more "one-star" ratings than other states, but the satisfaction survey shows families at these supposedly "poor" facilities are generally happy with the care delivered: a third of the one-star facilities even beat the 88.23 statewide satisfaction average.

"We recommend Ohio's long-term care consumers use the Department of Aging's online 'Consumer Guide,' which gives detailed data on survey results, quality measures, and most importantly, the opinions of actual consumers, and does it in a usable fashion," Van Runkle continued. "Visits to the facility are indispensible, and talking to residents, their families, and staff is more important than rating systems. Even CMS says the Five-Star system should not be used to rule out facilities when conducting a search."

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