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National Long Term Care Leader Praises Sebelius Acknowledgement of “Inherent Flaws” in Five-Star Nursing Home Rating System  
National Long Term Care Leader Praises Sebelius Acknowledgement of “Inherent Flaws” in Five-Star Nursing Home Rating System
HHS Secretary’s New Comment “A Key Step Forward in Effort to Better Empower Consumers With Reliable Information”

Katherine Lehman

Washington, DC – The American Health Care Association (AHCA) today strongly praised Health and Human Services (HHS) Secretary Kathleen Sebelius for acknowledging “inherent flaws” in the Five-Star Quality Rating System for nursing homes and pledged to continue working with HHS to ensure consumers receive the most accurate, objective and useful information when seeking a nursing home for oneself or a family member.
Yesterday, Secretary Sebelius expressed her concerns with the Five-Star program when speaking to the National Council on Aging and the American Society on Aging. According to media reports, she said, “The suggestion that it's a flawed snapshot because it forces the reviewers at the outset to make decisions that may or may not be accurate… I think that's serious criticism that needs to be looked at; the last thing we want to do is have an arbitrary bell curve just for the sake of having a system.”

“Secretary Sebelius’s new comments about ongoing concerns with the Five-Star rating system is a very positive step forward in ultimately being able to ensure consumers have the very best, most accurate, and useful information when making the very important decision about a nursing home,” stated Bruce Yarwood, President and CEO of AHCA.
Upon its introduction in December 2008, AHCA maintained Five-Star’s ratings criteria was “highly problematic” in large part due to the use of a forced bell curve which required each state to have 20 percent of its facilities ranked as the poorest and only 10 percent ranked as the best. Echoing that belief, 31 State Attorneys General wrote a letter to Secretary Sebelius in August 2009 advocating for Five-Star’s “temporary suspension.”

“AHCA agrees with Secretary Sebelius’ remark that every facility should have the ability to be excellent or fail rather than be subject to an “arbitrary bell curve,” stated Yarwood. “We support a rating system that accurately reflects the quality of care provided in our nation’s nursing homes and which can assist consumers in choosing the best facility to meet their needs.”

“There is and always will be a direct correlation between funding adequacy and quality patient care – and this is a vital part of this week’s health care reform debate,” Yarwood concluded. “We look forward to working with Secretary Sebelius and all stakeholders to ensure consumers have direct and ready access to the most accurate and complete data they need and deserve.”

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represent more than 13,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and developmental disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit or