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Five reasons five-star falls short as an effective network development and discharge tool

Becker’s Health IT & CIO Review — February 10, 2017
Written by Steven Littlehale, EVP & Chief Clinical Officer, PointRight

For many years, hospital social workers and discharge planners have had few tools at their disposal to determine the relative quality of skilled nursing facilities (SNFs) when seeking to assist a patient or their family with a placement.

Yes, hospital staff are plugged into their communities and hear a lot about local providers of choice. And, like any citizen, they can review inspection reports, but most often the determinants of placement are based on factors like location and proximity to family, quality of food, building aesthetics, word of mouth or personal relationships.

Publicly available data, specifically the Centers for Medicare and Medicaid Services’ Five-Star Quality Rating System, help to put information to work in a way that not only benefits consumers but also other providers. At its core, Five-Star is simple and easy to use, designed to enable comparisons between nearby facilities so that the “best” placement can be made.

But does Five-Star really capture the “best” – and isn’t the “best” SNF different for each individual? While it’s certainly a useful tool for learning about facilities and making comparisons, it has significant limitations that can stymie efforts to find truly the “best” placement for meeting the medical and functional needs of the individual. It falls short of being an indispensable discharge planning tool for hospitals, and in today’s value-based environment, placement in a facility where the patient can have good outcomes and avoid unnecessary re-hospitalizations is more important than ever before.

As we look toward data-driven systems, processes and solutions to better integrate as a means of improving patient outcomes and safety, we need to demand from tools like public rating systems the same quality: the ability to transcend provider types and provide precise, actionable information.

Here are five reasons why Five-Star falls short of that standard:

1. Within Five-Star, results from state inspections (called surveys) is the tail wagging the dog. Survey results do not necessarily align with the true indicators of quality, or at least the indicators of quality that might be relevant to a patient’s particular needs. For instance, where there is so much focus currently on reducing hospital readmission, Five-Star does not correlate in any way to re-hospitalization data.

Continue reading Steven Littlehale’s column on www.beckershospitalreview.com