Some Caveats to the Nursing Home Compare 5 Star Rating System

We have said in the past that the Nursing Home Compare site even before the 5 Star rating was introduced was just a start in evaluating nursing facilities. I will continue to share a myriad of tips I have accumulated for evaluating care homes. That said when looking at the 5 Star system keep a few things in mind.

Rating are based on three sources of data: health inspections, staffing and quality measures.

The good thing about inspections is that they are done by real people going into the facility. However, since states administer the Medicaid program and many if not most nursing home residents are on Medicaid, state licensing requirements and records of inspections vary greatly from state to state.

Staffing is reported so that you can understand the nurse to resident ratio, in other words there are so many nurses to take care of so many residents. And the numbers reflect the acuity or sickness level of the resident. That is good. However, this number is self-reported by facilities and represents just a two week snapshot in time so a home may just report its best two week period.

There are ten quality measures reported in the data. Of course this does not cover all aspects of care and for many consumers quality data is hard to understand to begin with so consult with your doctor or a nurse to have them tell you more about what it means for example to have a certain score for the number of pressure sores reported in a home.

The system only compares homes to peers statewide not across the country so that is truly not representative of how a home stacks up. And then the top 10 percent of homes in that state automatically are assigned five stars.

If you are in one of the worst of the worst states and you have a facility that has a five star rating, nationwide compared against all 15,000+ facilities you may actually have a home that is two stars.

But again this is a starting point. We’ll share more in future blogs.