(American Health Care Association: Washington) -- Following the release of a new national report from research firm Holleran Consulting that found little or no connection between a nursing home’s rating under the Centers for Medicare & Medicaid Services' (CMS) controversial Five-Star Quality Rating System and resident and family satisfaction, the American Health Care Association (AHCA) recently said that resident and family satisfaction surveys should be factored into the Five-Star ratings criteria.

CMS created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily and to help identify areas about which they might want to ask questions.

“The significant Holleran findings are just one more example whereby the methodology and accuracy of the existing Five-Star Rating System has been legitimately called into question, and it is reasonable to expect CMS to reevaluate its scoring and ratings criteria,” says Bruce Yarwood, president and CEO of AHCA. “We intend to continue working with CMS to perfect the Five-Star System, and we are pleased that our concerns are being corroborated independently.”

The Holleran analysis of satisfaction data from more than 12,000 residents and family members found little to no association with CMS' one (“much below average”)  through five (“much above average”) ratings.

“We did find some similarities between the one and two ratings given by CMS, but what the CMS rating system fails to do is accurately capture any clear differences between a two and a three, a three and a four, and so on,” says Lisa Scott Lehman, Holleran’s managing partner, quoted in McKnights Long Term Care News. The study, she notes, actually found cases where facilities rated a one or two by CMS received extremely high satisfaction scores.

While Yarwood acknowledges Holleran primarily studied the not-for-profit sector, he says the overall construct of the research and analysis is directly applicable to all long-term care providers.

“Quality improvement is a dynamic, ongoing process and its quantification must reflect the many variants that go into the delivery of care," says Yarwood.  "Today’s survey system, for example, does not specifically measure quality; it assesses compliance with federal and state regulations. We believe customer satisfaction—and how a resident and family members judge the actual care being provided in a particular facility—is a key indicator of the quality of care and quality of life experienced by residents, and should be integrated into the Five-Star System.”