What do "Choosing a Nursing Home" and "Buying a Toaster" Have in Common?

To most people, choosing a nursing home and buying a toaster would appear to have very little in common. But apparently to the "brilliant minds" at the Center for Medicare and Medicaid (CMS), not so.


Now I must admit, whenever I am in the market for a new appliance, I always check out the Consumer Reports online prior to buying. I figure I don't buy a toaster or washer and dryer very often, so what do I know about which brand is best. Should I go with Brand X, Brand Y or Brand Z?

Appliances can be tricky you know. Fortunately, it can all be "dummied" down to a few basic elements: Features, Performance Ratings, Energy Efficiency & Cost. And then, to make it even easier for us, the Consumer Guides will assign a nifty little "star system" so all we need to do is choose the appliance with the most stars and voila, our work is done!

I'm guessing a lot of people choose appliances this way and why not. It's not very personal and rather subjective based on a series of statistical reviews and results that are formulated by some unknown technicians using data, formulas and processes totally foreign to you and me. But come on, it's only a toaster for crying out loud! If you like the color and the price is within your range, go with the 5 star toaster and don't sweat the decision.

So if this process works so well with appliances, why not use it for other purchasing decisions?Well, many of us do. But not every decision in life can or should be "dummied" down to a simple 5 Star process.

I would put choosing a nursing home in this category, but CMS doesn't agree.

CMS has come out with its own version of a 5 Star system that takes this very personal and emotional decision and makes it all very "simple". Finally, choosing a nursing home for your loved one is as easy as buying a toaster! Simply look for the home with the 5 Star rating and voila, don't sweat the decision. It's only your mother's quality of care and life for crying out loud!

Thanks a lot CMS, but wait....................could there be a flaw or two in this simple process?

For starters, the data used is not current. It is also just a snapshot of the homes data at a given time and not necessarily representative of the on-going operation. Its formula penalizes homes that have Special Care units or who care for sicker residents. The survey and clinical data is totally subjective and inconsistent. At Kirkhaven, we have greatly improved on the documentation that drives the acuity rating of our residents and ensures we are receiving the appropriate reimbursement rate for the level of care we provide. According to the CMS 5 Star rating system, this increased acuity erroneously translates to "poor performance outcomes".

The bottom line is that you can't take an important decision like choosing a nursing home and make it fit into a simple 5 Star scoring system. Consumers need to study the data that is available and use it to ask good questions. Visit the homes you are considering and talk to the staff, residents and family members. Use your senses to observe and take adequate time to review and make your decision. References from friends and professionals in the field are much more reliable and accurate than anything CMS can conjure up from their limited data and real knowledge of the home.

So, what do choosing a nursing home and buying a toaster have in common? Absolutely nothing.................unless of course you're CMS.

Happy Holidays everybody!