CARMICHAEL, Calif. — The lobby of Rosewood Post-Acute Rehab, a nursing home in this Sacramento suburb, bears all the touches of a luxury hotel, including high ceilings, leather club chairs and paintings of bucolic landscapes. What really sets Rosewood apart, however, is its five-star rating from Medicare, which has been assigning hotel-style ratings to nearly every nursing home in the country for the last five years. Rosewood’s five-star status — the best possible — places it in rarefied company: Only one-fifth of more than 15,000 nursing homes nationwide hold such a distinction. But an examination of the rating system by The New York Times has found that Rosewood and many other top-ranked nursing homes have been given a seal of approval that is based on incomplete information and that can seriously mislead consumers, investors and others about conditions at the homes. The Medicare ratings, which have become the gold standard across the industry, are based in large part on self-reported data by the nursing homes that the government does not verify. Only one of the three criteria used to determine the star ratings — the results of annual health inspections — relies on assessments from independent reviewers. The other measures — staff levels and quality statistics — are reported by the nursing homes and accepted by Medicare, with limited exceptions, at face value. The ratings also do not take into account entire sets of... |
WASHINGTON — Each of the three previous presidents — two Republicans, one Democrat — signed an increase in the federal minimum wage.
Given Mr. Obama’s emphasis on income inequality, and the popularity of an increase in opinion polls, you would think he would. But the story of recent increases underscores the indispensable ingredient he so far lacks: a Republican leader strongly motivated to make a deal over the party’s philosophical objections.
In 1989, it was a new Republican in the White House. President George Bush, while campaigning to succeed Ronald Reagan, had promised “a kinder, gentler America.” The Democrats then controlling both houses of Congress set out to take him up on it.
Mr. Bush drove a hard bargain on the minimum wage. He vetoed the first version Congress sent on grounds that it raised the wage by 30 cents an hour too much. But he eventually accepted a two-stage increase to $4.25 an hour on the condition that lawmakers include a lower “training wage” for teenagers.
In 1996, it was a new Republican Senate leader. Trent Lott took over after Bob Dole, then running for president against the incumbent Democrat, Bill Clinton, resigned his Senate seat.
Mr. Clinton, who had battled fiercely with the House speaker, Newt Gingrich, and Mr. Dole,...