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home-healthIn this day and age, everybody’s a critic. With sites like Trip Advisor, Yelp, and the movie site Rotten Tomatoes, there is virtually an unlimited serving of critical commentary…often served with a side of stupid. Now the CMS (Center for Medicare Services) – after developing rankings for nursing homes and hospitals – is extending its 5 Star Rating System to Home Health Agencies. This development has been long overdue as the baby boomers age with relentless speed. In addition, continuing regulations and coverage standards can create confusion for those wanting to make informed decisions on long term care. While knowing the quality of croutons in a Caesar salad and deciding what flick to stream on a weekend Netflix binge is of critical importance to us as Americans (I especially have a weakness for Rotten Tomatoes), these CMS ratings register at a vastly different level of importance.


Before the ratings system, CMS established the Home Health Compare website on as a critical tool for consumers looking to make intelligent decisions regarding home health agency selection. While the information was plentiful, it could often leave consumers feeling confused and overwhelmed. The Star Rating System is a way to strip down much of the data without diminishing its impact. CMS has given agencies and stakeholders a valuable role in the process and is aiming for constant improvement with high standards of transparency. The system currently has 2 types of ratings: one for quality of patient care and one for direct patient surveys. In the patient care ratings, CMS incorporates 9 of the 27 standards of care and outcome measurements in use:


  1. Timely Initiation of Care
  2. Drug Education on all Medications Provided to Patient/Caregiver
  3. Influenza Immunization Received for Current Flu Season
  4. Improvement in Ambulation
  5. Improvement in Bed Transferring
  6. Improvement in Bathing
  7. Improvement in Pain Interfering With Activity
  8. Improvement in Shortness of Breath
  9. Acute Care Hospitalization


For a more detailed look at the methodology I recommend consulting the website.


CMS has also held a number of open door forums for affected parties to give constructive suggestions and proposed change to the methodology in use. CMS has stressed that this is an ongoing process that will see significant changes as more data is collected and weighted. The direct patient surveys are targeted for publication in January of 2016 while the quality measurements are now fully accessible. Florida and Rhode Island fared strongly on quality of patient care measures as both states had the highest percentage of agencies in the 4/5 star category. On the flip side, Texas, Wyoming, and Arkansas had the highest percentages of agencies scoring under a 3 star rating. The ratings were drawn from assessments ranging from Fall 2013 to the end of 2014. Moving forward, CMS will update these rankings quarterly.  You can get the full rankings here. Until next time…