One of the most difficult choices family members can make is selecting a nursing home for their loved ones. It is a difficult decision to put a loved one in a long-term care facility but it may be the only option. After an older parent is no longer able to care for themselves, they need the full-time care and medical help that only a nursing home can offer.
How do you know which nursing home is the best option? There are a lot of factors in finding a nursing home, including admissibility, cost, and location. However, you also need to make sure the facility is safe, well-staffed, and your loved one will be treated with dignity and respect. Nursing home ratings can help you make the decision about what nursing home might be best.
Even with nursing home ratings, it does not mean that a loved one will always get the proper level of care. The best nursing homes can still have incidents of medical malpractice, medication errors, or even abuse or neglect. If you have questions about an older family member who is injured while in nursing home care, talk to your experienced medical malpractice team for legal advice.
Types of Nursing Home Ratings Systems
An internet search can show you several options for public and private websites that rate different nursing home centers. Before relying on any website, it is important to understand that some of those sites are sponsored by nursing homes through paid ads or payment to upgrade their rating or listing. The first place you might want to turn is directly to the federal government ratings under Medicare.
Centers for Medicare & Medicaid Services Nursing Home Comparison
The Centers for Medicare & Medicaid (CMS) has a “Care Compare” website where users can find and compare nursing homes, and other health care providers in their area. This has information about the quality of care for nursing homes sorted by location. When you put in your location, it shows a listing with an overall rating, from 1-star to 5-stars.
- 1 Star: much below average
- 2 Star: below average
- 3 Star: average
- 4 Star: above average
- 5 Star: much above average
In addition to the overall rating, there are 5-star-based ratings for other categories, including:
- Health inspections
- Quality measures
Users can also search by the number of beds in a Medicare or Medicaid-certified areas of the facility, locations within a hospital, locations within a continuing care retirement community, and locations that accept Medicare and/or Medicaid.
When selecting a nursing home on the Care Compare site, the listing shows details about COVID-19 vaccination rates among staff members, fire safety inspections and emergency preparedness, and penalties. Medicare can impose penalties where there is a serious health or safety citation or if the nursing home fails to correct the citations. This will show the number and amounts of federal fines in the past 3 years.
What Do Medicare Nursing Home Ratings Mean?
According to Medicare, the overall star rating is a “snapshot” of the quality of each nursing home, based on health inspections, staffing, and other quality measures. Even Medicare cautions that these ratings are not a substitute for visiting the nursing home. When looking for a nursing home, these ratings can act as a starting point to help you evaluate whether a nursing home fits your family member’s needs.
Health Inspections Rating
The health inspections rating is based on outcomes from state health inspections. This includes the number, scope, and seriousness of identified deficiencies during the 3 most recent annual inspections. The rating also includes substantiated findings from the prior 3 years of complaints, investigations, and infection control. Revisits and corrections are also taken into account.
Staffing measures staffing levels and turnover rates. This is based on research that found that there is a “clear association between nursing staffing ratios and nursing home quality of care.” There also appears to be a relationship between resident outcomes and turnover rates, “with high turnover associated with poorer quality of care.”
Quality Measures Rating
The quality measures rating uses 15 quality measures for long-stays and short-stays. This includes measures based on the percentage of residents:
- Whose need for help with daily activities has increased;
- Whose ability to move independently worsened;
- High-risk residents with pressure ulcers;
- Who have or had a catheter inserted and left in their bladder;
- With a urinary tract infection;
- Experiencing one or more falls with major injury; and
- Who got an antipsychotic medication.
5-Star Nursing Homes in Philadelphia
A November 11, 2022, search for 5-star nursing homes within 10 miles of Philadelphia on Medicare.gov showed 9 nursing homes. This means that 9 facilities in Pennsylvania and New Jersey near Philadelphia qualified for Medicare’s overall rating system for 5 stars. These facilities include:
- Abigail House for Nursing & Rehabilitation
- Holy Family Home
- United Methodist Communities and Collingswood
- Little Flower Manor
- Abramson Senior Care at Lankenau Medical Center
- Waverly Heights
- Transitional Care Unit at Nazareth Hospital
- Masonic Village at Lafayette Hill
5-Star Nursing Homes in Chicago
A search of nursing homes in Chicago, within a distance of 10 miles, shows only 9 nursing homes with a 5-star overall rating on the Medicare Care Compare website. These include:
- Terraces at the Clare
- Winston Manor Convalescent & Nursing
- Little Sisters of the Poor
- Presence St. Joseph Hospital – Chicago
- Selfhelp Home of Chicago
- The Admiral at the Lake
- Princeton Rehabilitation & Health Care Center
- Community First Medical Center
- MacNeal Hospital Skilled Nursing Facility
Again, these ratings do not necessarily mean that these are the best facilities, only that they meet the 5-star rating system under CMS measures. Nursing home accidents can happen anywhere, even at the top rated nursing homes in Chicago.
5-Star Nursing Homes in Baltimore
Searching for Baltimore, Maryland on the Medicare website, within a 10-mile radius, shows 7 nursing homes in Maryland with 5-star ratings. These ratings can provide some information about the CMS analysis of staffing levels, quality of care, and health inspections. These facilities include:
- Transitional Care Services at Mercy Medical Center
- Little Sisters of the Poor
- Lochearn Nursing Home
- St. Joseph’s Nursing Home
- Greater Baltimore Medical Center Sub Acute Unit
- Pickersgill Retirement Community
- Chestnut Green Health Center at Blakehurst
5-Star Nursing Homes in Washington, D.C.
A search for 5-star nursing homes within 5 miles of Washington, D.C. on the Medicare Care Compare site shows 5 nursing homes. These 5 nursing homes that qualify with an overall score of 5 stars according to CMS include:
- Stoddard Baptist Nursing Home
- Jeanne Jugan Residence
- The Jefferson
- The Hospital for Sick Children Pediatric Skilled Nursing Facility
- Sibley Memorial Hospital Renaissance
ProPublica Nursing Home Inspect Database
ProPublica is an independent, nonprofit journalism site that provides a Nursing Home Inspect listing to search a database for deficiencies and penalties imposed on a nursing home in the past 3 years. The database is based on data from CMS. A search based on location, severity of violation, or nursing home name can show a nursing home’s deficiencies. Severity is ranked from A to L with L being the most serious, for “immediate jeopardy to resident health or safety. Deficiency is widespread.”
U.S. News and World Report Nursing Home Ratings
U.S. News and World Report was started as a magazine but is now more known for itsrankings guides. U.S. News ranks everything from the best colleges, best towns for quality of life, best hospitals, and best nursing homes. The U.S. News rates nursing homes from High Performing to Below Average for long-term and short-term care.
According to U.S. News, the long-term care rating is based on an “assessment of nine quality measures focusing on staffing, medical outcomes, resident complaints and processes of care such as vaccinations and appropriate use of some medications.”
Data for the ratings comes from a variety of sources, including the CMS Nursing Homes Data Archive, COVID-19 data, and information about the use of antipsychotic medications. The analysis includes consideration of:
- Registered nurse staffing
- Physical therapist staffing
- Nurse staffing consistency
- Rate of substantiated complaints
- Resident-centered rehabilitation therapy
- Staff COVID-19 vaccination
- Use of antipsychotic drugs
- Falls with major injury
- Ability to self care
- Short term residents able to return home
- Emergency-room visits
There are other measures that are taken into consideration. For example, beginning in 2021-22, the score included continuous ownership of a facility, whether a facility maintained or changed ownership within the last year. According to U.S. News, “the measure was added because changes in ownership can lead to staff turnover and a discontinuity in care. Studies demonstrate that ownership change is associated with lower nursing home quality and lower consumer ratings of nursing home resident experience.”
Like other hospital and nursing home guides, the best rated may not represent the best nursing home for your needs. For example, the high ratings of a short-term care facility may not be helpful if you are looking for a long-term care facility.
What Should I Look For When Visiting a Nursing Home?
You may use the Medicare search tool or get recommendations from a friend, doctor, or others about which nursing homes might be best. However, it is important to actually visit the nursing home before signing a contract. Some things to consider when you check out a nursing home include:
- Is transportation provided?
- Are there community activities?
- Can the nursing home help you participate in social or recreational activities?
- What types of meals does the center provide? Will they be able to meet your dietary needs and preferences?
- What are the visitor policies?
- Who are the doctors that provide services in the nursing home?
- Do you have the same nurse or staff members or are they changing every day?
- How many nurses are available overnight and on the weekends?
- Will you have transportation to see your personal doctor?
- Is there phone, computer, and TV access?
- Is there preventative care, like eye care, dentists, or podiatrists that are available?
- Are there screening or vaccination programs for the flu?
- Is there mental health care available?
- Is there care for people with Alzheimer’s or other types of dementia?
- Is the nursing home Medicare certified?
- Does the nursing home have a bed available?
- How did the nursing home handle the COVID-19 pandemic?
Nursing home residents may also be at risk of elder abuse or neglect because they are in a restricted environment. They also have to rely on the nursing home for their daily needs, including food, medicine, healthcare, and shelter. To consider the risk of abuse, you may want to look at the following during a nursing home visit:
- Is there a warm and respectful relationship between residents and staff?
- What does the facility do to make sure they don’t hire staff members with a history of abuse or criminal offenses?
- What are the policies for reporting abuse and neglect?
- Has the nursing home been cited for abuse on Medicare.gov?
- Is the nursing home clean?
- Are residents clean and appropriately dressed?
What If My Loved One Died in a Nursing Home?
If a family member died in a nursing home, it is not always due to natural causes. Medical accidents can happen in a nursing home and may be caused by caregiver negligence. A doctor, nurse, or even nursing home employee could be responsible for causing injury or death in a residential care facility.
Unfortunately, it can be difficult to know if a death in a nursing home was caused by malpractice or not. The nursing home may not be very forthcoming about what happened or how it could have been prevented. Instead, you can contact a nursing home negligence attorney for advice. Your attorney may be able to help you determine whether the death was caused by a medical error or elder abuse and how you can recover compensation in a wrongful death lawsuit.
Contact experienced trial attorneys who have successfully represented nursing home injury victims and their families to recover financial compensation from nursing homes. Taking the first step in getting answers begins by calling a malpractice lawyer to find out more about your case and what kind of damages you can recover. For a free consultation, contact Gilman & Bedigian online or at 800-529-6162.