Consumers now have a simple five-star rating system for judging nursing homes, courtesy of the federal government.

Yesterday, the U.S. Centers for Medicare and Medicaid Services released quality ratings for 15,800 nursing homes, from a low of one star to a high of five stars. Of the 86 nursing homes in Rhode Island, 11 received one star and 12 received five stars. The ratings are available online at http://www.medicare.gov/NHCompare.

Representatives of the nursing home industry yesterday denounced the ratings as skewed and hastily developed. They said some high-quality nursing homes received low ratings only because of inaccuracies or biases in the data.

But everyone –– government regulators, consumer advocates and nursing home owners –– agreed that the star rating should not be the only thing people consider when selecting a nursing home.

“We hope that this new system will make choosing a home even easier,” said Kerry Weems, CMS acting administrator, in a telephone news conference yesterday. “No rating system or Web site can substitute for actually visiting a nursing home.”

The new system synthesizes information that has long been publicly available into a format that Weems called “more user-friendly and more meaningful.”

The ratings are based on three factors: the results of health inspection surveys; staffing levels; and certain quality measures, such as the percentage of residents with bedsores and the number whose mobility worsened after admission. Each nursing home received a star rating in each of those categories, as well as an overall score.

Because of variations in measurement, the scores are intended to compare nursing homes within each state rather than for national or cross-state comparisons. Significantly, the scores will be updated at least four times a year to reflect changes in performance.

Weems said he expected the star ranking to spur efforts at quality improvement among the lower-ranking nursing homes.

But some low-rated nursing homes have been unfairly mislabeled, asserted Virginia M. Burke, president and chief executive officer of the Rhode Island Health Care Association, a trade group of for-profit nursing homes. “There are a few excellent facilities in the state that have one or two stars,” Burke said.

Burke said the biggest flaw in the data is the failure to include patient-satisfaction surveys, because there isn’t a national standard for conducting such surveys.

“Any measure of quality that doesn’t include how happy people are … is missing a vital component of what people need to know in choosing a nursing home,” she said. Rhode Island nursing home residents report high levels of satisfaction in surveys overseen by the state. (Those results can be found at http://www.health.state.ri.us/topics/nursinghomes.php.)

The federal ratings are “a little too simplified to help people with a complex decision,” Burke said.

“We always hear these complaints from providers whenever there’s quality data,” said Raymond Rusin, the state Health Department official who oversees the inspection of nursing homes.

Asked whether he found any surprises among the one-star and the five-star nursing homes in Rhode Island –– any nursing homes he wouldn’t expect to rank so low or so high –– Rusin said there was only one surprise: Steere House, in Providence, which received only one star. “We wouldn’t have thought that was where they belong,” he said.

Julie Richard, Steere House administrator, said that several factors converged to make her home’s ratings paint an inaccurate picture. Staffing data was not included, because of a glitch that Richard said she just learned about. The survey score was dragged down by a negative inspection years ago. And the quality measurements, Richard said, were skewed by the fact that Steere House admits high-risk patients with many needs and also has a unit that focuses on dementia.

“It’s not a happy day when you know how hard your staff works … and you have a very well-intentioned consumer effort that really doesn’t tell the consumer what’s truly out there,” she said.

Janet Wells, a policy director for NCCNHR, formerly the National Citizens Coalition for Nursing Home Reform, has the opposite worry: “We’re concerned that some nursing homes are going to look better than they are because the data are self-reported,” she said. Staffing data are not independently verified. Also, Wells said, studies show that state inspection surveys tend to underreport patient harm.

“We would look just as carefully at a five-star-rated nursing home as one with fewer stars,” she said. “You need to be sure it’s a nursing home that meets your family member’s needs, too.”

Kathleen Heren, acting executive director of the Rhode Island Alliance for Better Long Term Care, called the ratings useful but agreed that people need more. “When you’re choosing a nursing home, you can’t just go by these ratings,” she said. For example, a resident who wants to be among people of her own ethnic group won’t be happy in a home where no one speaks her language –– no matter how many stars it has.

Heren urged people to contact the Alliance for more personalized help in selecting a nursing home. “There’s a nursing home for everyone,” she said.

ffreyer@projo.com