Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public

The pandemic has exposed the shortcomings in the state’s rating system.

State health inspections do little to punish homes with poor records of preventing and controlling infection. According to The Times, from 2017 to 2019 inspectors cited nearly 60 percent – more than 2,000 – of the country’s five-star facilities for failing to follow basic safety precautions such as regular hand washing. Nevertheless, they received top marks.

In San Bernardino, California, inspectors have written to Del Rosa Villa about four different infection control violations. It kept its five stars. Ninety residents at the 104-bed facility contracted the coronavirus and 13 have died.

Del Rosa Villa officials did not respond to requests for comment.

The Life Care Centers of Kirkland, Washington, the first nursing home in the United States to document coronavirus cases, reported poor infection control despite its five stars in 2019. State inspectors wrote it down because they “failed to consistently implement an effective infection control program”.

Thirty-nine residents of the facility have died from Covid-19. The house has 190 beds.

Leigh Atherton, a spokeswoman for Life Care, said the citation was the only infection control flaw that inspectors had found on more than 32 previous visits. She said the house quickly fixed the problem.

If the rating system had worked as intended, it would have provided indications of which houses were most likely to get out of hand and which houses would be likely to get messed up.

That didn’t happen.

The Times noted that there was little correlation between star ratings and the condition of homes during the pandemic. In five-star facilities, the death rate from Covid-19 was only half a percentage point lower than in facilities with lower ratings. And the death rate was slightly lower in two-star facilities than in four-star homes.

The location of a facility, the infection rate in the surrounding community, and the race of nursing home residents were all predictors of whether a nursing home would have an outbreak. The star rating didn’t matter.

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