Industry Under Scrutiny

Quality of Care

A bipartisan group on the Senate Finance Committee conducted hearings on the nursing home industry’s deadly incompetence. Approximately 185,000 residents and caregivers in nursing homes died because of poor infection control throughout the pandemic.

The hearing noted significant deficiencies in nursing home safety and emergency preparedness standards. Here is a link to the hearing that was held by the US Senate Finance Committee on nursing homes and COVID: Hearing | Hearings | The United States Senate Committee on Finance

Quality Measures

The New York Times recently published an investigative report explaining how CMS incorrectly measure nursing home performance. Operators have many non-care-related incentives to boost star ratings. However, the information is not reliable.

Despite years of warnings, the system provided a badly distorted picture of the quality of care at the nation’s nursing homes. Many relied on sleight-of-hand maneuvers to improve their ratings and hide shortcomings that contributed to the damage when the pandemic struck.

Self-reported staffing data was inaccurate and inflated. Abuse and neglect are hidden or undisclosed, and occur in low and high-ranked facilities. The Times’s analysis found that people at five-star facilities were roughly as likely to die of the disease as those at one-star homes.

Advocates argue that enforcement is too lax and fines aren’t high enough. The current punishments certainly don’t work to improve infection control and safe staffing.


CMS must require the nursing home chains to be transparent. Each facility should provide information about nurse turnover, rentetion rates, wages, and tenure as well as staffing hours. Experts, advocates, and regulators recommend these easy fixes. CMS must develop a series of qualitative metrics (i.e call bell response time, cleanliness, food quality).  Each facility could rely on Resident Council meeting minutes for consumer and family input.