Finding a nursing home or similar type of residential facility for a loved one can be challenging. There are a lot of emotions attached to the decision to seek residential care for an older family member, especially a parent. But the choice can also be made logically, by weighing the benefits and the problems with keeping a loved one at home versus moving them to a nursing home.

Once the decision to seek out a nursing home has been made, there are still more important choices, most importantly the choice facility. There are plenty of nursing homes available, and you need to consider level of care, quality of care, types of care, the staff, amenities, and so much more. One way in which you can get help evaluating these facilities is with the federal government’s Nursing Home Compare program and its Five-Star Quality Rating System.

What is a Nursing Home?

A nursing home is a type of residential facility that is designed for patients and residents who need 24-hour care. They cannot live alone at home without a nurse and other types of assistance, but they also do not need to be hospitalized. A nursing home offers an alternative to these other options. Nursing homes are staffed by aides and registered nurses who can provide round-the-clock care as needed. Examples of the kind of skilled care residents get in these facilities are physical therapy, administration of medication and IVs, wound care, and more.

Nursing homes are most often for elderly people, but they can become homes for anyone who needs constant care. Some facilities are designed like hospitals while others are more residential. Most facilities offer some type of recreation, or even outings, as well as social opportunities. Some may give residents degrees of independence such as access to the kitchen to make meals. Older couples are often allowed to live together in a small apartment in a nursing home.

The Five-Star Quality Rating System for Nursing Homes

The U.S. government, through the Centers for Medicare and Medicaid Services (CMS), offers citizens the five-star rating on over 15,000 nursing homes across the country. The system includes data on all of these nursing homes, as well as a rating of between one and five stars for each so that you can get a quick view of the best facilities.

A five-star rating is given when a nursing home is found to provide care that is well above average quality. A one-star rating means that the facility’s care is below average in quality. In addition to the overall star rating, CMS gives each facility a separate rating for three important areas:

  • Staffing. The rating for staffing describes how many hours of care per day residents receive from staff on average. It takes into account the fact that some patients need more care than others.
  • Health Inspections. Nursing homes undergo regular inspections and the health inspections score collects the resulting information from the previous three years. The rating also includes information from surveys and complaints.
  • Quality Measures. There are eleven separate clinical and physical measures that are used to come up with the quality measures score for a nursing home. It gives a measurement of the quality of care that residents receive in a facility.

Recent Additions to the Five-Star Quality Rating System

In 2016, several changes to the system were put into effect in order to create even better and more informative ratings for nursing homes. The changes are supported by the American Health Care Association, an advocacy group for quality health care. The support comes because the changes enhance the use of metric-based measurements, but the group also believes even more changes are needed to best communicate the level of quality of nursing homes with the public.

Some of the changes include the addition of five new measures that are used in coming up with a nursing home’s rating. These include:

  • The percentage of residents staying for shorter periods of time who were later successfully discharged from the facility.
  • The percentage of these short-term residents who had an emergency room visit.
  • The percentage of the short-term residents who were hospitalized again after being admitted to a nursing home.
  • The percentage of short-term residents who had improvements in functioning.
  • The percentage of long-term nursing home residents whose mobility deteriorated.

Other changes that were made to the rating system include expanding the time for making a quality rating from three to four quarters. The Activities of Daily Living Measure was also changed. It went from being ranked at the state level to the national level.

How to Use the Five-Star System

CMS encourages the public to use the rating system as one tool in selecting a nursing home. It offers information and comparisons regarding how individual nursing homes care for residents, how they are staffed, and how their inspections have gone. This is important information that people can access through the CMS website.

That website acts like a search tool that is easy to use. You can put in a zip code or other geographical information and then limit the search by distance. You will then see a list of nursing homes and the one to five-star rating for the overall score and the three specific measures. You can also filter the results so that you only see those with four- or five-star ratings. You can then select a few nursing homes from the list to compare with more detailed information about their ratings. Click on any facility on the list to get more information, like number of beds and ownership.

Visiting Nursing Homes

The CMS provides this important information about nursing homes through the rating system, but it is not a substitute for actually visiting facilities. People seeking out nursing homes are encouraged to select a few facilities and then to use the rating system and visits to the facilities to make a final decision. Go to the visit with a checklist of important factors or requirements as well as a list of questions to ask.

Making a choice of nursing home for a loved one is a big decision with a lot of factors to consider, from location to cost to quality. Of course, you want the best quality you can afford, and the rating system through CMS can help you get that. Use the comparison tool to find out how each nursing home in your desired location compares and then be sure to visit each facility to see care in action and to have any questions you have answered.