Nursing Home Rating System Gets an Upgrade

Nursing Home Rating System Gets an Upgrade | Pintas & Mullins Law Firm

Nursing homes around the country have received new ratings from The Centers for Medicare & Medicaid Services (CMS), the federal agency which administers Medicare and works in partnership with state governments to administer Medicaid.

Last month, CMS changed its inspection process and the Five-Star Quality Rating System for nursing homes nationwide. The revisions, which now provide improved staffing details and new quality metrics, are designed to provide more transparent and meaningful information about the quality of care that residents receive.

CMS originally created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily and identify areas about which you may want to ask questions.

How the Rating System Works

The Rating System gives each nursing home a rating between one and five stars. Nursing homes with five stars are considered to have a great deal of above-average quality, while nursing homes with one star are considered to have quality that is much below average.  There is one overall five-star rating for each nursing home, and a separate rating for each of the following:

  • Health Inspections contains the three most recent health inspections and investigations due to complaints. This information is gathered by trained, objective inspectors who go onsite to the nursing home and follow a specific process to determine the extent to which a nursing home has met Medicaid and Medicare’s minimum quality requirements. The most recent survey findings are given more weight than the prior year.
  • Staffing has information about the number of hours of care provided on average to each resident daily by nursing staff. This rating considers differences in the levels of residents' needs in each nursing home. For example, a nursing home with residents who have more severe needs would be expected to have more nursing staff than a nursing home where the resident needs were not as high.
  • Quality Measures has information on 17 different physical and clinical measures for nursing home residents. These measures offer information about how well nursing homes are caring for their residents’ physical and clinical needs.

Deciding on a Nursing Home

It’s important to recognize that no rating system can address all of the considerations that go into a decision about which nursing home may be best for your loved one. Still, visiting the Medicare.gov Nursing Home Compare search tool is a good place to start. You should also talk to your doctor or other healthcare providers about the nursing homes you are considering. And be sure to pay a visit to the nursing home to see for yourself how residents are being cared for.

If you ever run into a problem with a nursing home in which a loved one resides, be sure to contact our experienced nursing home attorneys. We have worked with clients who have encountered a wide range of nursing home issues. All of our services are free, and you pay nothing unless we win a settlement or verdict on your behalf. You can reach us online or at 800-794-0444.

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