Nursing Home Ratings Medicare

Nursing Home Ratings Medicare

Medicare has a way to rate nursing homes. Here are the key factors that Medicare uses to determine their ratings.

Overall Rating

The Medicare Overall rating is based on 3 components:

  • Health Inspection
  • Staffing
  • Quality Measures

Each is scored from 1 to 5, with 5 being the best and 1 being the worst (5 = “much above average,” 4 = “above average,” 3 = “average,” 2 = “below average,” 1= “much below average”). The total score for each nursing home is calculated by averaging these scores across all three categories; if a nursing home has no health inspection or staffing data, it won’t be included in its overall rating calculation.

Health Inspections

The nursing home industry is under constant scrutiny, and the best way to find out whether your loved one’s nursing home has been inspected is through Medicare. The facility must be inspected by the state health department at least every 15 months, but many facilities are inspected more often than that. Inspections generally take place during a 1-2 day stay at the nursing home, and nurses will examine each resident to ensure they’re receiving adequate care. Any violations found during an inspection are noted in an official report called a deficiency notice or deficiency plan of correction, which can be accessed online by anyone through Medicare’s Nursing Home Compare page (https://www1.cms.gov/medicare/medicare-fee-for-service-providers/quality-and-performance/nhsqp).

Staffing

  • Staffing Levels
  • Staffing Mix
  • Staffing Hours
  • Turnover Rate of RNs and LPNs
  • Qualifications of Nursing Home Staff

Quality Measures

The Quality Measures section is based on data from the Centers for Medicare & Medicaid Services (CMS). CMS collects quality measures from all nursing homes in the country and uses this information to determine how well nursing homes perform compared with national averages. The calculations are made using two years of data, one year before and one after the date that each facility is inspected.

The quality measures used in our rating system include staffing levels, quality of care, health inspections, and resident health improvement.

Staffing Levels: This refers to the number of people who work at a nursing home; it includes registered nurses (RNs), licensed practical/vocational nurses (LPN/LVNs), certified nurse assistants (CNAs), therapists, physical therapists aides and others who work directly with residents on a daily basis. If you compare this figure against state averages for your area you’ll be able to see if there are more or fewer staff members than average at that particular facility.

Quality Measures: These refer to specific aspects of care like how often incontinence products were changed or whether residents had pressure sores while living in this specific facility during its last inspection period by Medicare inspectors

Medicare has developed a way to rate nursing homes

Medicare has developed a way to rate nursing homes. These ratings are based on quality measures, health inspections, staffing and an overall rating.

Quality measures are things that the nursing home should be doing but is not. Health inspections are things that the nursing home did not do correctly when inspected by Medicare inspectors.

Staffing is how much time nurses spend with patients every day—the lower this number is, the better it is for your loved one as more attention can be given to them when there are fewer patients per nurse working in their unit at any given time.

The overall rating ranges from 1-5 stars with 5 being the best possible score (in other words: The best!)

Medicare has developed a way to rate nursing homes. This rating system is based on the most recent routine health inspections, staffing levels, quality measures and other factors.

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