Report Finds Hundreds of Nursing Homes Repeatedly Receive Low Ratings

By Warren & Kallianos, PLLC | May 15, 2014

Choosing a nursing home for a vulnerable or elderly loved one can be very difficult. Many families struggle with the decision to use a facility in the first place, and are then disheartened by media reports of nursing home abuse and neglect.

No one wants to discover that their loved ones were placed in a facility that has dirty equipment and bed linens, employs unlicensed caregivers or mistreats its residents. Unfortunately, a recent USA Today report states that over 600 of the nation’s working nursing homes fit this description.

The report focuses on ratings issued by the federal government for each nursing facility. The rating system is implemented through the Centers for Medicare and Medicaid Services (CMS) and is designed to aid patients and their families in the search for the right nursing home. The rating program was developed in 2008 and is designed to follow the goals of the Omnibus Reconciliation Act of 1987 (a nursing home reform law).

How Are the Ratings Calculated?

The ratings system is based on three things:

  • Health inspections
  • Staffing levels
  • Quality measures

Health inspection results are obtained by a “trained team of objective surveyors who visit each nursing home to check on the quality of care, inspect medical records and talk with residents about” the care they receive. This inspection is completed by state officials who are overseen by federal regulators. As a result, ratings may vary from state to state; because of this fluctuation, it is most helpful to compare facilities within the same state to maintain consistency and ensure objectivity.

The second tool used to determine the facility’s rating is a staffing level evaluation. This is calculated by comparing the ratio of residents to staff on site. This determination also takes into consideration what percentage of the staff is licensed according to the standards set forth by each state’s licensing board.

Quality measures, the final tool used in the rating determination, examine how a nursing home performs on ten specific aspects of care. It reviews both clinical and physical measures and can include how well nursing staff help residents self-feed, encourage personal hygiene and prevent and treat skin ulcers. This information is provided by individual nursing homes.

Using these three tools, the federal government rates various nursing home facilities on a scale ranging from one to five stars. The ratings are updated monthly, but the three data sources are reported on different schedules. For example, the inspections are generally conducted on an annual basis while the quality measures are often provided quarterly.

A group of nursing homes throughout the nation has repeatedly received a one star rating. According to CMS, the one-star rating means the facility meets the bare minimum of federal health and safety requirements, but ranks much lower than other nursing homes found in that state. Hundreds of nursing homes – 564 of them, to be exact – have received one-star ratings in every reporting period since 2008. Within that group of low-performing care facilities, two-thirds were for-profit institutions operated by large chains.

Finding a Reputable Nursing Home

Although some nursing care facilities continue to provide questionable care, the number of quality homes is on the rise. The number of four and five-star rated homes throughout the nation increased from 38 percent in 2009 to 43 percent in 2011. In addition, during this same period, a USA Today report notes that the number of one or two-star rated homes fell from 40 percent to 35 percent.

Some facilities have found success and increased their rankings by working to reduce staff turnover and provide consistency of caregivers. Rankings go up when residents see a familiar face every day and the staff members have been around long enough to have knowledge of individual residents’ specific needs.

Although finding a highly rated facility is helpful in the search for a quality nursing home, government officials recommend visiting the sites before making a final decision. Taking the time to talk with nursing home staff and see the facility in person can help you get a better feel for the type of environment it offers, and that sort of personal knowledge cannot always be felt by researching online or speaking with former residents.

Other tips to better provide a quality nursing home experience for loved ones include:

  • Use the Nursing Home Compare tool to search and compare nursing homes.
  • Use a nursing home close to family and friends to increase the likelihood of visits to check in on your loved one.
  • Contact your local nursing home ombudsman.

Even if these tips are followed, nursing home facilities can rapidly change. This shift can be catalyzed by the facility being purchased by a chain with a different outlook on patient care or by the hiring of new management. Any of these changes can have an immediate negative impact on the quality of care provided.

If you suspect that a loved one is being neglected or abused in a nursing home, remedies are available. Contact an experienced nursing home abuse attorney to learn more about your legal rights and options.

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