Nursing Home Grading System Upgraded by CMS

Federal regulators are strengthening the system used to grade nursing homes, factoring in the tendency of the facility to use chemical restraints, as well as refining how staffing levels are judged and raising the bar for facilities to receive a top rating. 

The U.S. Centers for Medicare & Medicaid Services (CMS) recently announced changes to its “Five Star Quality Rating System” for nursing homes.

The agency’s Nursing Home Compare website allows family members to quickly get a summary of the quality of nursing homes when looking for a possible facility, with a grade or rating provided to each nursing home.

Since late last month, the rating system has included the use of antipsychotic medications on residents when calculating nursing home ratings, indicating use during both short-term and long-term stays. In addition, the site has improved calculations for staffing levels and increased requirements for a facility to earn the five-star quality grade.

“CMS is committed to improving Nursing Home Compare and the Five Star Quality Rating System to ensure they are the most trusted and easy-to-use resources we can provide,” Patrick Conway, CMS’s Chief Medical Officer and the deputy administrator of Innovation and Quality, said in a press release. “Consumers can feel confident that Nursing Home Compare’s star ratings include measures that matter most to nursing home residents and their families and challenge nursing homes to continuously improve care.”

Antipsychotic Chemical Restraints on Elderly

Antipsychotics like Risperdal and Seroquel are often used in U.S. nursing homes as a form of chemical restraint to drug elderly patients into an easily controllable state. In many cases, these patients suffer from dementia, and studies have shown that not only do antipsychotics provide no benefits for dementia patients, but could increase their chance of dying.

Atypically antipsychotic medications have been identified often as a common form of chemical restraint, which is often considered a form of elder abuse.

The FDA has warned that use of atypical antipsychotic drugs among dementia patients may pose serious health risks, increasing the risk of death without providing any substantial benefit for the patient.

The Department of Justice (DOJ) has previously accused Johnson & Johnson of engaging in kickback schemes designed to convince doctors to prescribe their antipsychotic medication Risperdal to elderly nursing home patients, knowing that the drug was being used abusively and potentially placing patients’ at risk of death.

In November 2013, Johnson & Johnson agreed to pay $2.2 billion to the federal government to settle its Risperdal illegal marketing claims.

Amid the increasing efforts to eliminate use of antipsychotic medications as a form of chemical restraint, factoring in the prescription of the medications is designed to help families select facilities that provide better quality of care.