Thanks to advances in healthcare, America’s elderly population continues to grow. Currently, there are nearly 58 million people over 65, a 30 percent increase in the last decade. Many of these individuals will be transitioned into nursing homes in the coming years as loved ones struggle to keep up with their medical care.
Medicare is a federal healthcare program available to individuals over 65. It ensures access to health care after retirement, including nursing homes. Finding the right nursing home can be stressful, and Medicare provides a comprehensive list of all certified nursing homes on its website to help you start your search.
This guide breaks down the information found on nursing home reports, exploring how it contributes to their overall rating. By the end, you’ll understand how to read a nursing home report to determine if it’s the right fit for your loved one.
Overall Rating
The first thing you’ll see in the search results or any nursing home’s listing page is their overall rating. This rating is based on the nursing home’s health inspections, staffing, and quality measures.
- Health inspections: This can review the care, nursing home environment, policies, food preparations, medication distribution and storage, and more.
- Staffing: They review the average staffing ratio, turnover, and registered nursing staffing to help see the average number of hours of care each resident receives daily.
- Quality measures: These include the type of care that short-stay and long-stay patients receive, including access to preventative care, regular health screenings, vaccinations, pain medication, proper nutrition, etc.
These big three make up a nursing home’s overall rating. As you consider nursing homes, remember that care varies between nursing homes, even if they are part of a chain.
One big chain in the Pacific Northwest is EmpRes Healthcare Management. It operates more than 58 locations, and while it has the same policies and procedures, EmpRes Healthcare Management ratings vary by location.
The Aspen Meadows Health and Rehabilitation Center in Billings, MT, may have an overall rating of two stars, but the Frontier Rehab & Extended Care in Longview, WA, has an overall rating of five stars. The locations’ overall ratings range from one star to five stars, so it’s important to remember how each facility is run impacts the overall rating rather than who operates it.
COVID-19 Vaccination Rates
CMS provides an overview of the number of residents and staff members who are vaccinated against COVID-19. However, they recently changed how this information is collected, so it may be inaccurate.
Penalties
Nursing homes that violate health and safety policies or fail to address a citation promptly can face Medicare citations and penalties. Their report shows the number of federal fines received in the last three years, how much, and if there were any payment denials in the previous three years. State penalties are recorded in a separate location and are also publicly available.
Basic Details
The report also includes basic details about the nursing home, including:
- Number of certified beds
- If they participate in Medicare and Medicaid
- If they have a resident and family council to improve care
- If it is located in a hospital or continuing care retirement community
- Are there fire safety methods like sprinklers in place
- The legal business name
- Affiliation and affiliated entity ID
- Ownership type
- Location
You can also expand to see a more detailed view of ownership information, including a breakdown of controlling interests, company officers, and more.
This information can help you understand the size and scope of the nursing home. The larger the facility, the more beds it has. If the facility accepts Medicare and Medicaid, it may be harder to get a bed than in private nursing facilities where you have to pay out of pocket.
Why Nursing Home Ratings Matter？
Nursing homes must maintain minimum care requirements to qualify for federal and state funding, and nursing home ratings are one way to hold them accountable to these expectations. If a nursing home consistently ranks low, faces multiple violations, and makes no adjustments, there is a problem.
CMS will create an action plan or impose fines to help them address their issues. Continued violations can result in a loss of certification, meaning the location is no longer eligible for Medicare funding.
These facilities owe their residents a duty of care. They should be able to meet their minimum care requirements, but staffing shortages, budget cuts, overcrowding, and various other factors can significantly impact their care quality.
Conclusion
CMS wants to offer the American people high-quality healthcare, and its rating system is an excellent first step to demystifying the nursing home system. It provides a convenient location for all federal inspection results, including health and safety inspections, staffing levels, and quality of care measures.
The higher the rating, the better the care your loved one will receive at the facility. These ratings are updated annually, so you should check out the nursing home in person to make sure the current conditions match the Medicare rating.