AAHSA On the Centers for Medicare and Medicaid Systems (CMS) Proposed Rating System for Nursing Homes

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“AAHSA believes there should be two types of nursing homes: the excellent and the non-existent. Through Quality First, we have for many years supported a consumer-friendly nursing home rating system based on reliable quality information that the public can understand. A rating system that helps consumers identify both high and low performing nursing homes is essential. Consumers deserve nothing less than a reliable seal of approval for the best nursing homes in America .

“Such a rating system should be based on four essential pillars: resident and family satisfaction, staffing based on resident needs and staff satisfaction, clinical quality outcomes and public oversight. Each of these pillars needs to be based on up-to-date and valid data.

“The construction of these four pillars is at various levels of development. Satisfaction tools are available and need to be more widely utilized. Clinical measures are now the norm and need constant updating. Staff levels and satisfaction need to be crisply defined and reported. The public oversight process is broken and needs extensive repair.

“The public oversight process will be the most controversial because that pillar is the most developed, yet has the largest cracks in its foundation. Numerous expert opinions and reports speak to its inconsistency, subjectivity, lack of timeliness and unintelligibility to the public.

“We will continue to work aggressively with CMS on these four pillars, which must be based on reliable, validated information for the public to trust not only nursing homes but the rating system itself.

“AAHSA is already working with CMS and other stakeholders on the Advancing Excellence in America’s Nursing Homes campaign to strengthen all four of these pillars, enhance quality in nursing homes and increase the public’s trust. We hope CMS will leverage this coalition to develop a rating system based on science and sense so consumers can trust it to find excellent nursing home care.”



The members of the American Association of Homes and Services for the Aging (www.aahsa.org) help millions of individuals and their families every day through mission-driven, not-for-profit organizations dedicated to providing the services that people need, when they need them, in the place they call home. Our 5,800 member organizations, many of which have served their communities for generations, offer the continuum of aging services: adult day services, home health, community services, senior housing, assisted living residences, continuing care retirement communities and nursing homes. AAHSA’s commitment is to create the future of aging services through quality people can trust.

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