Adult Care Home Star Rating Certificate Program

Adult Care Home Star Rating Certificate Program

If no current Star Rating appears, it only means the community has not been surveyed in 2009. (See below for further explanation.)

The following are links to the NC DHHS DHSR Web pages that deal with Star Ratings, etc:

During the 2007 session of the North Carolina General Assembly, Senate Bill 56 (SB 56) was ratified, implementing a rating system for Adult Care Homes. SB 56 mandated the Medical Care Commission to adopt rules for issuance of rated certificates to Adult Care Homes. These certificates will contain a rating based, at a minimum, on the following:

  1. Inspections and substantiated complaint investigations conducted by the Department of Health and Human Services (DHHS) to determine compliance with licensing rules.
  2. The initial ratings awarded to a facility pursuant to this rule will be based on inspections, penalties imposed, and investigations of substantiated complaints that revealed non-compliance with statutes and rules.

Adult care homes will be required to display the rating certificate in a location visible to the public. (You can visit the NC DHSR ACLS Star Rating Certificate Program Web site for NC General Statute references.)

Since the passage of the bill, draft rules were developed by the Medical Care Commission and proceed through a public hearing process. During this process, provider groups never spoke against the provision of access to information about all services available to all seniors: we support efforts to disclose information about adult care homes to seniors and their families, so that informed decisions can be made. It is our belief that the Star Rating system does not accomplish this goal. Would it not be more helpful to have access to current monitoring and survey data? Issues with the Star Rating system have been debated at length, and it still appears flawed based on the following:

  1. The system is based on a 0–4 Star Rating (see Star Rating Scale). For the first year (starting January 2009), by law, there will be no 4-Star communities in North Carolina. Achieving the 4th star requires two consecutive rating surveys scoring 100% or better (and the soonest any adult care home will receive their second rating survey is January 2010). Ratings will be assigned after a community receives its 2009 annual Department of Health Service Regulation (DHSR) Survey. If no current Star Rating appears, it only means the community has not been surveyed in 2009. These DHSR surveys are unnanounced and occur throughout the year.
  2. Once a rating is received, it will remain in place for one year. Circumstances often change—for the better or the worse—during a year, meaning that a rating can become obsolete and therefore meaningless before the next survey is conducted.
  3. Even if a community requests a reinspection prior to the next annual survey, it can only be accomplished based on “availability of state staff” to provide the re-inspection.
  4. Instead of rewarding rapid correction of problems and quality improvement for the benefit of existing and future residents and families, the rating system provides only a one-day-in-time snapshot of the actual care provided by a community.

All of this being said, the Star Rating Certificate Program has become a reality, and initial ratings are being assigned now (in 2009). It is our hope that consumers will educate themselves about adult care homes using more than this single data point. It is imperative that visits and observations be made, questions asked, and decisions be made based on an overall impression of an adult care home. NCALA recommends that consumers use the ALFA checklist to get an overall and current perspective of any adult care home they may be considering.