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Nursing Home Ratings: What does it mean?

Nursing Home Word Cloud ConceptChoosing a nursing home to provide care for a loved one is an agonizing decision for the family. How can you be sure that the nursing home you choose is the right place? We know that a nursing home can never provide the same level of loving care that a family member can, but how do you find a nursing home that is dedicated to caring for its residents with an acceptable level of dignity and respect while providing competent medical care?

Those of us who have consulted the website have been led to believe that a facility with a five-star rating would provide superior care. A recent New York Times article has raised serious concerns about relying on that rating system which is easily manipulable by the facilities being rated.

In the article, reference is made to a letter from Rep. Elijah Cummings, Ranking Member of the House Committee on Oversight and Government Reform, to the Center for Medicare and Medicaid Services (CMS) which raises significant questions about the validity of the rating system.

Rep. Cummings points out that, while the rating system awards a score of up to five stars based on health inspections, staffing levels, and quality indicators, only one of these indicators – health inspections – is actually based on data that has been collected by trained inspectors from the state government survey agency. Scores for staffing levels and quality indicators are self-reported by the nursing homes. How reliable can that information be when, under the current scoring system, nursing homes receive one extra star if they self-report staffing levels of four or five stars and they receive another star if they self-report quality measures of four or five stars? That means that a five-star rating can be attained by facilities with only a three-star rating based on state inspection data simply by reporting data which will likely not be checked or challenged.

In fact, Medicare’s own website ( states, “All of these data are reported by the nursing homes themselves. Nursing home inspectors review it, but don’t formally check it to ensure accuracy.” Can we really trust the nursing homes to be on an “honor system” when reporting information that can significantly impact heir bottom line?

Until changes are made in the current rating system, families cannot rely solely on the Medicare rating system to determine a “good” facility for a loved one. What was represented to be a valuable tool to assist with making this decision may not provide much help at all.

Rosen & Spears advocate that it is always best to visit the nursing home you are considering for your loved one if at all possible to do so, perhaps more than once.  Some questions you may want to ask include: frequency of staff turnover, what is the availability of doctors and nursing staff, and whether there is an active Family and Friends Council.

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About the author

Rosen & Spears is a plaintiff law firm which seeks to protect the rights of healthcare consumers and their loved ones through medical malpractice, nursing home neglect, financial abuse of seniors, and other types of claims. For more information, please contact us