There are approximately 17,000 nursing homes
in the country and – of course – they are not all alike. So how do you compare them? Medicare has made understanding how to look for quality care in a nursing home a bit easier through its Five Star Quality Rating system Nursing Home Compare program
. This online tool will give you a better perspective on how each home measures up to its competitors.
The Nursing Home Compare program
The program reports on ten basic measures of quality, as well as compares the quality measures for each home to state and national averages. The quality measures are derived from data nursing homes routinely collect about all residents at specified intervals during their stay at the facility, and the measures are based upon the care that is provided to the total population of residents in a facility.
Here is a description of each measure:
- Help with daily activities: Percentage of residents who need more help eating, moving from one chair to another, going to the bathroom alone, or changing positions in bed than when they were last assessed.
- Infections: Percentage of residents who have infections (e.g., pneumonia, bladder, urinary tract).
- Pain: Percentage of residents who had very bad or moderate pain over the previous week.
- Bedsores: Percentage of residents with skin wounds caused by constant pressure on one part of the skin (usually bony parts of body, e.g., tailbone, heel, hip).
- Lost too much weight: Percentage of residents who lost too much weight (can indicate malnutrition, not receiving enough help eating).
- Physical restraints: Percentage of residents who are physically restrained daily with any device, equipment or material that prevents them from moving freely.
- Improved walking: Percentage of residents who were admitted for a short stay (e.g., stroke rehab) whose walking improved.
- Short-stay residents in pain: Percentage of residents who have had very bad or moderate pain at any time over the previous week.
- Short-stay residents with delirium: Percentage of residents who have problems focusing, or are confused and unaware of their surroundings. (This condition can appear suddenly, but can be reversible.) Delirium is not senility or dementia – these are memory and learning impairments.
- Number of nursing staff per resident per day: Nursing Home Compare also reports the number of hours that a registered nurse, licensed practical nurse and nurse aide spends daily with each resident.
Learning more about a nursing home
The Nursing Home Compare website also reports on the number of nursing hours that are spent on each resident at a facility. This is very important to know: The more time nursing staff spends directly with your parent, the more likely he or she is receiving quality care. Be sure to ask what percentage of the nursing staff is from a “temp agency.” It’s better to have permanent, stable staff providing care since continuity of care is a good quality predictor. Having your parent exposed to new staff every day increases the chances that care plans or routines are being disrupted.
Of course, you don’t want to rely only on this one report to decide whether or not a nursing home is good for your loved one. You must visit the facility–once during a weekday and once during a weekend or night when staffing is lighter. But keep in mind that surprise visits are not a good idea – privacy and security reasons prevent you from roaming through a facility, so make sure you set up an appointment.
To get a report, go to medicare.gov
and scroll to the section titled Resource Locator. Click on Nursing Homes and follow the prompts. Or call Medicare at 1.800.MEDICARE (1.800.633.4227) and ask a customer representative to read to you the ratings of a particular nursing home.