Over a year ago, the Centers for Medicare and Medicaid Services (CMS) implemented their new "five star rating system" as a way to assist consumers in compare nursing homes and identify the strong and weak points of each facility. (www.medicare.gov/NHCompare)
The Nursing Home Compare Website features a rating system that gives each nursing home a rating of between 1 and 5 stars. Nursing homes with 5 stars are supposed to have above average quality and nursing homes with 1 star are supposed to have quality “below average”. There is one overall rating for each nursing home, and a separate rating for each of the following:
. Health Inspections – This rating uses information from the last 3 years of onsite inspections, including both standard surveys and any complaint surveys. Onsite visits help to determine the extent each facility meets Medicare's minimum quality requirements. More recent survey findings are weighted more heavily than those in prior years.
. Staffing – The staffing rating has information about the number of hours of care on average provided to each resident each day by nursing staff. This rating does take into consideration the level of need of residents ("Acuity"). For example, a mix of patients requiring a higher level of care means that nursing home should have more staff per patient, compared to another facility where the level of patient care based on need is not as high.
. Quality Measures – The quality measure rating has information on 10 different physical and clinical measures for nursing home residents - for example, the prevalence of pressure sores or changes to resident's mobility (ability to move about), or percent of residents with moderate to severe pain. This information is collected by the nursing home for all residents. The quality measures offer the consumer information about how well, in general, a nursing home is caring for its residents' physical and clinical needs.
Although the rating system is one way for consumers to get an idea of how nursing homes measure up, no rating system can address all of a family’s considerations that go into a decision about which nursing home may be best for their loved one. There is no substitute for making your own visit to a nursing home, talking with administration and staff, and making sure your loved one will be comfortable there. Remember also, the nursing home rating system cannot take into account factors like whether the nursing home is close to family so visits to their loved one can be more frequent, compared to a facility further away.
The rating system should be used as a tool, and keep in mind it is a "lagging indicator". You are viewing a measure of the nursing home over the last couple years, and when employee turnover ranges at close to 100% at the majority of nursing homes, quality can change quickly.
