Inside One Agency’s 5-Star Home Health Rating

A new star rating system for home health agencies made its debut over the summer, with 2.6% of agencies under assessment securing top marks. A Brookdale home health agency in Charlotte, North Carolina is one of these select few, and Kaiser Health News recently delved into what is behind this particular agency’s high ratings.

The federal government began evaluating home health agencies this summer on the quality of patient care they provide based on a five-star scale, but only 239 agencies out of 9,000 rated nationwide earned five stars, according to a Kaiser Health News analysis. They were rated based on nine quality measures of care practices and outcomes, including managing daily activities, treating wounds and staving off unplanned hospital care.

In North Carolina, Brookdale Home Health Charlotte stood out as one of just two agencies out of more than 170 in the state to receive five stars, according to the analysis. This means Brookdale scored well above the national three-star average.


“The key is our philosophy of doing the right thing for our patients,” Shad Morgheim, division president of Brookdale Healthcare Services, tells SHN. “Delivering high-quality care is what’s driving those results.”

Specifically, Brookdale far exceeded the national averages in quickly initiating care and easing pain, according to Medicare data. The home health agency only scored significantly below the national average in improving patients’ ability to correctly take drugs by mouth, receiving a grade of 35.1% as compared to 52.7% across the country.

“These metrics as a whole show home health’s ability to improve somebody’s function and home health’s ability to prevent costly episodes that are negative for the patient, like hospitalization or like a delay in service,” Harrison Brown, of the consulting firm The Advisory Board Company, told Kaiser Health News.


Brown said the new star ratings prove beneficial for consumers as well as the agencies, but others in the industry have cited their limitations.

“The population in home health tends to be fairly aged with multiple chance illnesses, where stabilization may be the goal rather than improvement,” said Bill Dombi, of the National Association for Home Care and Hospice.

Another limitation is that the underlying data bolstering the star ratings are self-reported.

“Some home health agencies are taking this very seriously and are getting really good real-time data and doing in and collecting the data on patients that they see, and others aren’t,” said Dan Mendelson, CEO of consulting firm Avalere Health. “That’s the situation right now.”

Brookdale is one entity collecting real-time data, namely through tablets used to update patient information along the way.

The other five-star agency in North Carolina, Well Care Home Health in Wilmington, primarily serves private homes, according to Kaiser Health News. Meanwhile, Brookdale has teams set up in 22 retirement communities in the Charlotte area alone, and Morgheim says about 80% of Brookdale’s services are administered within retirement communities and 20% to the general population.

Morgheim says those affiliations have the potential to ensure consistency and quality of care, but that it isn’t the end-all be-all for Brookdale’s success.

“For the most part, those [ratings] are independent of whether a patient is seen in a Brookdale community or within the community at large,” Morgheim says.

Written by Kourtney Liepelt

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