Rating Nursing Homes

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Q: Is the government now rating nursing homes?

A: Yes. The federal government has an updated site on the internet that rates 16,000 nursing homes much like hotel ratings – with Five Stars being the best. But don’t expect hot towels and gourmet meals. The updated website is sponsored by the federal Center for Medicare & Medicaid Services, and it’s designed to give consumers more information upon which to make a decision about nursing home care. Only nursing homes that participate in Medicare and Medicaid are included in the rankings – but that covers most homes.

The data on the “Medicare Compare” website describes nursing home characteristics, inspection results, staffing information, and quality measures. The information presented may be too detailed for many consumers, but the Five Star Rating system will remind them of picking a fine hotel. But any similarity with Five Star Hotels ends there.

The data from nursing home inspections is gathered in Massachusetts by the Department of Public Health. Inspections are done usually once a year, and look at the care of residents, the process of care, staff and resident interaction, and the nursing home environment.

The federal ratings also contain quality measures about the resident’s health, physical functioning, mental status, and general well-being. From these reports, you can find out what percentage of people in a given nursing home, over time, lost too much weight, spent most of their time in bed, became more depressed, and so on. You can search this database by state, county, city or zip code.

Each home’s overall rating is a combination of scores for health inspections, staffing capacity, and quality measures. You can see at a glance how many health inspection deficiencies or quality care deficiencies a facility had—and even what was the level of harm to which the residents were exposed. Was food being stored in a clean and safe way? Were residents properly assessed when admitted to the home? Did a licensed pharmacist check their medications?

But some measures, such as the level of nursing home staffing, are not that useful in isolation. The fact that a facility has 42 minutes of RN time per resident per day doesn’t tell you if that nursing was excellent or poor.

Statistical analysis can help give you an overall sense of how a nursing home performs—but to get a real sense of a facility, you must visit it, talk to residents and family visitors, sample a meal being served, inspect the rooms for cleanliness and smell, and ask for a copy of the home’s most recent DPH survey.

But before you make any decision about a nursing home, find out if there are home care alternatives that could meet your needs. Call 1-800-Age-Info and press ‘1’ for home care information. As the Medicare Compare website says: “A nursing home may not be your only choice.” To find the new Five Star website, go to www.medicare.gov/NHCompare.