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Medicare’s Nursing Home Ratings Are Vulnerable To Fraud

Everyone has heard nursing home horror stories about abuse and neglect, so it can be incredibly stressful to find the right nursing home for your spouse or parent. It would seem that nursing home ratings from Medicare would be reliable, but many are shocked to learn that the rating system is imperfect, at best.

Medicare’s nursing home ratings are mostly based on self-reported data. If a nursing home wants to manipulate data or submit fraudulent numbers, it may be able to secure itself a five-star rating in misleading fashion. That high rating could go a long way in earning the trust of people who are shopping around for a nursing home.

Further, the Medicare ratings do not factor in enforcement actions that a state takes against a nursing home for abuse or legal violations. If New York uncovers illegal practices at a nursing home and fines it, it will have no effect on the Medicare ratings.

New York State nursing home regulators have too few resources for the job they are asked to do. It is incredibly frustrating that the violations they do uncover are not fully accounted for by the federal government.

If your family member has been victimized by serious nursing home abuse or neglect, speak with an experienced New York personal injury attorney to ensure that your rights are protected.

Source:, “Medicare Ratings Let Nursing Homes Game The System,” Katie Thomas, Aug. 24, 2014


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