The Mississippi AG along with AG's from 29 other states, has sent a letter to the Center for Medicare and Medicaid Services asking that it suspend its current state by state nursing home rating system.  Under the current rating system, nursing homes within a state are compared against one another for various criteria on a rating scale of 1 to 5.  The AG's have requested that the standards for this rating scale be set on a national scale under the theory that a state by state comparison is confusing to consumers.  What the request fails to recognize, however, is the reality that almost all nursing home searches by families are limited to a single state, due to residency requirements for Medicaid and proximity to family.  A national standard would likely result in a flat-lining of rankings within a given state, making it much more difficult for consumers to tell the best nursing homes within a given state from the worst.  While a nationalized standard for ratings would make it easier for a consumer to compare a facility in Mississippi to a facility in California, the reality is that few consumers have the luxury of actually choosing between homes in different states.  The current system is much better for the overwhelming majority of consumers who are looking within a single state, and it holds nursing homes accountable by comparing them to others within their same market.