Reviewing a Nursing Home Rating

Making the decision to move an elderly loved one to a nursing home facility can be one of the most difficult ones a family can make. Before choosing a facility, it is crucial that families do all they can do learn all they can about the home they are entrusting their loved one’s care to. There are many websites available that actually break down the ratings of the home you may be considering. This is especially critical given the recent rise in nursing home abuse and neglect cases across the country

When making your list for the nursing home facilities you are considering, you want to keep in mind that there are certain issues that you should check out for each home. For example, how do staff treat residents, what is the staff to resident ration, and how often are residents transferred from the home to a hospital. Certain online websites can provide you that info. Medicare provides a nursing home rating section and you can also find rating information on Yelp. The state you live in may also have a website dedicated to nursing home ratings, as well. Other locations where you may be able to find ratings and reviews include:

•                  The facility’s website

•                  The facility’s social media pages (Facebook, LinkedIn, etc.)

•                  Reviews on Google

•                  Local media sites

•                  Friends and associates who loved ones residing at the home

Medicare Rating

If a nursing home is certified by Medicaid or Medicare, they will receive a Medicare rating. Medicare uses a five-star rating system using data obtained from four different sources:

•                  Centers for Medicare & Medicaid Services’ health inspections

•                  Medicare claims data

•                  Minimum Data Set (MDS) national database

•                  Payroll-Based Journal (PBJ) system

The criteria that the Medicare rating system addresses includes quality, staffing, health inspections, and an overall rating. Under the quality measures criteria, the system looks at the following:

•                  What percentage of residents who had the ability to move on their own had worsening conditions?

•                  How many residents receive antipsychotic drugs to manage behavior?

•                  How may residents have bedsores (pressure ulcers)?

•                  What is the percentage of patients who are suddenly admitted or readmitted to hospitals?

The staff to resident ratio is also rated. The Medicare system looks at how many registered nurses are there for each resident at the home. The system also rates how many hours of nursing care a resident receives each day. This includes nursing care from registered nurses, licensed practice nurses, and certified nurses aides.

Health inspections also play a critical role in Medicare’s evaluation. The system looks at certain factors of health inspection results, such as how good the staff is at managing resident medications, is there enough staff to meet all the residents’ needs, how are the interactions between staff and residents, and is the food for residents prepared and stored correctly.

When it comes to calculating the final overall rating for the facility, Medicare uses the following formula:

•                  The rating from the health inspection section is used as a starting point.

•                  If the rating from the staff section has a four- or five-star rating and higher than the health inspection rating, the facility is given another star. If the staff rating received only a one-star rating, then one star is removed from the overall rating.

•                  If the quality section received a five-star rating, then the facility receives another star for their overall rating. If the quality section received only a one-star rating, then one star is removed from the overall rating.

If your loved one has been abused or neglected while living in a nursing home, speak with a lawyer, like a nursing home lawyer from Brown Kiely, LLP, right away about your legal options. Call a law firm today.