Investigates

Senator calls Nursing Home Compare website ‘almost worthless’ right now

Pennsylvania senator Bob Casey is calling for the Centers for Medicare and Medicaid to provide more accurate information to the public on its Medicare.gov Nursing Home Compare website.

Ratings on the site have remained frozen in time for months and don’t reflect serious problems at facilities during the COVID-19 crisis.

It’s important to note that families depend on ratings from the website to help choose a facility for their loved ones.

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Casey told 11 Investigates in an exclusive interview that having out-of-date information, especially without a disclaimer, is misleading.

"Right now, Nursing Home Compare for a lot of families is almost worthless. It doesn't provide accurate information," Sen. Casey said.

Brighton rehab showing 5 stars

Among the nursing homes with outdated information is Brighton Wellness and Rehabilitation Center in Beaver County — the nursing home with more COVID-19 deaths than any other in the state.

Just one week ago, CMS issued major fines against Brighton for putting residents in “immediate jeopardy” for its handling of the COVID-19 crisis. Yet at the same time, Brighton has a five-star quality of care rating on the Nursing Home Compare website, which is “much above average.” The facility’s overall rating, however, is listed at two stars, or below average.

In response to a question from 11 Investigates, CMS said it suspended updating the website due to the coronavirus pandemic.

“This is because many nursing homes, that would normally be inspected, will not be inspected, thereby overweighting and impacting the ratings of those facilities and could potentially mislead consumers. Therefore, we have temporarily maintained and held constant the health inspection domain of the rating system,” CMS Public Affairs Officer Lorraine Ryan explained in an email.

Brighton already had a troubled record prior to the COVID-19 crisis. It’s been on the federal government’s Special Focus Facility candidate list, identifying the most troubled nursing homes in the country for 25 months. Now, with an overwhelming coronavirus outbreak, the situation has gotten even worse. More than 300 residents and more than 100 staff members have tested positive for COVID-19, and more than 80 residents have died.

Sen. Casey says that makes it even more important to provide the public with accurate and timely information.

“You have this bizarre circumstance where they’ve had all kinds of violations, all kinds of problems, even predating COVID-19, and you look at Nursing Home Compare, and there’s data on there that would mislead you to thinking it’s a facility that has not had problems,” Casey said.

CMS did not answer directly when asked if a five-star quality rating is accurate for Brighton, given the current situation, but indicated other measures on the website do provide information to indicate if there's a problem.

“To be clear, Brighton has an overall star rating of two, a one-star health inspection rating, a two-star staffing rating, and an icon for noncompliance related to preventing abuse. These factors should give the public ample and overwhelming caution about the level of quality this facility provides,” Ryan said.

CMS only doing emergency inspections

During this time of more limited inspections during the coronavirus pandemic, CMS is only sending in federal investigators in emergency situations, like the one at Brighton.

Last month, the National Guard was called in to help stabilize the situation at Brighton. At that same time, federal inspectors conducted a three-day investigation at the facility, which resulted in citations for “immediate jeopardy” and more than $62,000 in fines.

U.S. Health and Human Services Secretary Alex Azar, whose hometown is Johnstown, PA, visited Beaver County at the time and made a point of addressing the investigation at Brighton.

"I wanted to be here, frankly near Brighton, just so the people of Western Pennsylvania know how seriously the national government is taking this issue," Azar said at the time.

But Casey stresses that actions speak louder than words, and says he wants to see more investment in nursing home oversight, especially accurate information provided to the public during this time of crisis and uncertainty.

“I hope that someone from Johnstown, PA (referring to Secretary Azar) would understand that in our state, we need help for nursing homes,” Casey said. “You can’t try to rectify it by just using spin and rhetoric. People want answers. People have suffered enough.”

Complete answers to 11 Investigates questions to CMS:

QUESTION: Why is the Medicare.gov Nursing Home Compare website not being updated? I’m not sure I understand why the reprioritizing of surveys means you don’t update the website. I would think it’s even more important to reflect updated inspections, given they are only under the most serious circumstances.

ANSWER: On April 24, CMS announced that the inspection domain will be held temporarily constant, due to the prioritization and suspension of certain surveys. This is to ensure the rating system reflects fair information for consumers. Due to the March 23 targeted inspection plan, there has been a great shift in the number of nursing homes inspected, and how the inspections are conducted. It was determined that this would disrupt the inspection domain of the Nursing Home five-star quality rating system. This is because many nursing homes that would normally be inspected will not be inspected, thereby overweighting and impacting the ratings of those facilities and could potentially mislead consumers. Therefore, we have temporarily maintained and held constant the health inspection domain of the rating system.

QUESTION: Is it appropriate to have a five-star rating for Brighton’s quality of care given the “immediate jeopardy” citations, more than $62,000 in fines, and at least 80 COVID-19 deaths at the facility? Is this an accurate rating to present to the public?

ANSWER: To be clear, Brighton has an overall star rating of two, a one-star health inspection rating, a two-star staffing rating, and an icon for noncompliance related to preventing abuse. These factors should give the public ample and overwhelming caution about the level of quality this facility provides. Below is a link to the Brighton Rehabilitation and Wellness Center’s information on Nursing Home Compare:

https://www.medicare.gov/nursinghomecompare/results.html#state=PA&lat=0&lng=0&name=BRIGHTON%20REHABILITATION%20AND%20WELLNESS%20CENTER

QUESTION: When will the Brighton ratings be updated to reflect the recent inspection and fines?

ANSWER: Results of health inspections conducted on or after March 4, 2020 will be posted publicly, but will not be used to calculate a nursing home’s health inspection star ratings. The surveys will be posted through a link on the front page of the Nursing Home Compare website in the upcoming months as the survey data is finalized and uploaded. The survey prioritization, including the suspension of standard surveys, will continue until CMS provides notification of any changes, or the Public Health Emergency ends. This memo provide (sic) on how CMS is updating the Nursing Home Compare website with the inspection results: memo 20-33-NH released June 4 explains.