When it comes to choosing a nursing home for yourself or for your loved ones, it is so important to take the time to really research a potential first before seriously considering it. A new assisted living facility is a home, a social community and a place where seniors can get the care and attention they need to live safely and comfortably. This is why it is so important to take the time and research any nursing home or assisted living facility first to gain insight into what others have experienced with a particular nursing home.
One of the best ways to gain insight into a potential assisted living facility is to look at the Medicare ratings of a particular community. Not all nursing homes are Medicare-certified. This doesn't mean that they aren't quality homes, it simply means that they do not fall under the Medicare and Medicaid program. There are approximately 15,000 or more nursing homes that participate in this program and all of the licensing is done by state. Those interested in detailed information about a nursing home's rating under the Medicare program can visit Medicare.gov's Nursing Home Compare site, or they can contact their State Survey Agency.
The first and most important thing to remember with Medicare-rated nursing homes is that these certifications are only for nursing care facilities that fall under the "skilled" care category. Skilled care is a type of care given where nursing or rehabilitation staff members must be there to observe, manage or evaluate the care. Typically, this includes care such as physical therapy or IV injections. Facilities that do not offer this type of care will not fall under the Medicare licensing umbrella.
After finding the rating and information on a particular facility, it is important that potential future residents and their families know about the system, what it entails and how to read these ratings properly.
The Medicare Star Rating System
The Centers for Medicare and Medicaid Services (CMS) has developed a system to help make reading Medicare reviews easier for potential residents to research Medicare-licensed facilities. The organization's Nursing Home Compare site features a quality rating system that helps provide a general overview of the "grade" of Medicare-approved nursing homes. The ratings vary between one and five stars, with five-star facilities being much higher than the average nursing home and one star facilities, much lower than average.
The system utilizes the following information to create their rating:
- Health inspection ratings from three years of onsite inspections. The information is gathered from objective inspectors to see how a facility has med Medicare and Medicaid’s minimum quality standards.
- Staffing ratings that include information about the number of hours each resident receives by a staff member. This rating takes the type of nursing homes into account, noting that some residents may require less care than others depending on what type of facility they are in.
- Quality Measures, which is a rating based on 11 different physical and clinical measures. This is information collected by the nursing home for all of its residents in an attempt to see how well nursing homes are caring for their residents' clinical and physical needs.
One of the first things that potential residents typically see when it comes to a Medicare rating is the star rating. Typically, there is an overall "star" rating out of five for a facility, which is the most referenced number. There is also a star rating for Health Rating, Quality Rating, Staff Rating and RN/Nurse Rating, such as the ratings detailed in Inspira Transitional Care Unit Woodbury or the Tanbark Health and Rehabilitation Center in Kentucky.
Beyond the Stars- What Medicare Ratings Can Really Show
Medicare ratings do more than just provide a star-rating. While a facility that has a five out of five Medicare rating is one worth considering, it is important to take a look at all of their star ratings. Facilities such as the Forest Hills Care Center in Cincinnati, not only have an overall five out of five star rating, but they also have five-star ratings on all other areas of their care as well. In addition to star-ratings, there are other important pieces of information that can be illuminated by a Medicare report. Other features to look for in a Medicare rating include:
- How long the facility has been licensed by Medicare
- Number of Complaints Reported
- Fines Issued
- Payment Denials
- Deficiencies Recorded
- Total Penalties Issued
For example, facilities such as Brighton Gardens of Tampa has information on all of these areas, providing potential residents with an in-depth look at how this facility stacks up by Medicare standards. The facility has been licensed by Medicare since 1999, has a 5 out of 5 star rating, has one reported complained, 0 fines issued, 0 payment denials, 6 deficiencies recorded and 0 total penalties in the last year.
It is important to remember, that just because a facility has a violation or a deficiency, it doesn't mean that it is necessarily a bad facility. For example, Lake Orion Nursing Center in Lake Orion, Michigan has two total deficiencies reported, which are two health standard deficiencies. However, the facility has no health complaint deficiencies, incidents, complaints, fines or penalties on their records. They also still have an overall five out of five-star rating.
A violation doesn't necessarily mean something earth-shattering either. It can be something as small as a cobweb in a storage closet. Interested potential residents should take the time to visit the official Medicare site for their state to research a potential facility first hand. This can provide potential residents with more insight on the reports conducted and how a Medicare rating got to where it is.
These nursing home rating are a great way to find out more information about a particular nursing home, its performance levels and how it ranks with other facilities in the country. However, while this information is valuable, it is important to also include other tips for choosing the right nursing home and to visit the nursing home in person before making a final decision. This rating shouldn't be the only factor considered when it comes to choosing a nursing home, but they can play an important role when it comes to deciding which nursing home has the best overall history of quality and care for its patients.