Heart Health Articles

15,800 American Nursing Homes Rated By Centers For Medicare & Medicaid Services

September 11, 2017

The CMS (Centers for Medicare & Medicaid Services) has issued quality ratings for 15,800 nursing homes throughout the USA that participate in Medicare or Medicaid. Each nursing home is assigned a star rating, from one to five - with five being the best. The ratings are based on health inspection surveys, staffing information, and quality of care measures.

CMS Acting Administrator Kerry Weems said "Our goal in developing this unprecedented quality rating system is to provide families a straightforward assessment of nursing home quality, with meaningful distinctions between high and low performing homes. The new information will also help consumers and families identify important questions to ask nursing homes and challenge nursing homes to improve their quality of care."

Sen. Herb Kohl (D-WI), chairman of the Senate Special Committee on Aging, said "With this new rating system, CMS is improving the ability of consumers to readily obtain critical information which should be used in conjunction with in-person visits to a facility. Transparency is key when it comes to nursing home quality," said Sen. Kohl. "I commend Acting Administrator Weems today and, as always, appreciate the opportunity to work together to improve our nation's nursing homes."

Along with consultations with a panel of experts from academia, patient advocacy, and nursing home provider groups, CMS created the rating system based on each nursing home's performance in three key areas:

Health inspection surveys
State and federal surveyors conduct approximately 15,800 annual on-site assessments of each nursing home. The comprehensive assessments look at how each nursing home service complies with federal and state rules. The surveys are aimed at protecting the health and safety of residents, including residents' rights and general quality of life. 50,000 complaint investigations are carried out each year. To devise the new rating system information was gathered from the most recent three years of survey findings.

Quality measures
10 key quality measure out of the 19 that are found in the Nursing Home Compare website were used, including the percent of at-risk residents who have bed sores (pressure ulcers) after their first three months in the nursing home, the number of residents whose mobility deteriorated after admission, as well as whether residents received appropriate medical care.

Staffing information
Evidence indicates that low staffing levels can significantly undermine the level of patient care in nursing homes. Consequently, staffing levels are considered an important indicator of quality. This measure reports the total number of hours of nursing and other staff care per resident per day. Adjustments are made for the residents' levels of illness and services required.

Members of the public can clearly see the quality rating for each of the three areas mentioned above, as well as a composite or total score.

What do the stars mean?

5 Star Rating
Much above average
4 Star Rating
Above average
3 Star Rating
About average
2 Star Rating
Below average
1 Star Rating
Much below average

All the ranking will be updated monthly.

Weems said "Because quality and conditions within a nursing home can change at any time, this system is not intended to be the only tool families use in selecting the right nursing facility for a loved one. Nursing homes can make dramatic improvements between rating periods, just as a previously highly-rated home could see its quality of care deteriorate. And nothing can substitute for visiting a nursing home."

Initially 12% of all nursing homes got a 5-star rating, and 22% scored with just one star. The other 66% were fairly evenly distributed among the two to four star rankings.

Thomas Hamilton, director of the CMS Survey and Certification Group, who helped develop the new system said" "Choosing a nursing home or community-based care is one of the most difficult and sometimes confusing decisions families have to make. The new Web site improvements also include links to information for community-based alternatives to nursing homes that may be of great interest to families. Regardless of the type of support a family chooses," he said, "It is vital that families and caregivers use the Web site as just one of many important sources of information they should consult. Families should also consult with their physician, talk to the state's nursing home ombudsman or the state's survey and certification office and, most importantly, visit the nursing home or community-based program for themselves."

Weems added "Around three million Americans depend on nursing homes at some point during each year to provide life-saving care. Most of those individuals are enrolled in Medicaid or Medicare and we all bear a special responsibility to protect their health and welfare. Adding this new quality rating system to our Web site is a huge step toward giving our beneficiaries and their loved ones meaningful information to compare nursing homes more easily."

Below is a list of States with percentages of nursing homes with 1-star ranking and 5-star ranking

Alabama
16.4% of all nursing homes have a 1-star ranking
19.8% of all nursing homes have a 5-star ranking

Alaska
0.0% of all nursing homes have a 1-star ranking
26.7% of all nursing homes have a 5-star ranking

Arizona
21.8% of all nursing homes have a 1-star ranking
14.3% of all nursing homes have a 5-star ranking

Arkansas
21.8% of all nursing homes have a 1-star ranking
12.0% of all nursing homes have a 5-star ranking

California
21.7% of all nursing homes have a 1-star ranking
11.8% of all nursing homes have a 5-star ranking

Colorado
15.6% of all nursing homes have a 1-star ranking
12.3% of all nursing homes have a 5-star ranking

Connecticut
10.0% of all nursing homes have a 1-star ranking
18.3% of all nursing homes have a 5-star ranking

Delaware
15.6% of all nursing homes have a 1-star ranking
28.9% of all nursing homes have a 5-star ranking

District of Columbia
11.1% of all nursing homes have a 1-star ranking
16.7% of all nursing homes have a 5-star ranking

Florida
17.7% of all nursing homes have a 1-star ranking
12.7% of all nursing homes have a 5-star ranking

Georgia
32.4% of all nursing homes have a 1-star ranking
5.0% of all nursing homes have a 5-star ranking

Hawaii
12.5% of all nursing homes have a 1-star ranking
22.9% of all nursing homes have a 5-star ranking

Idaho
14.3% of all nursing homes have a 1-star ranking
13.0% of all nursing homes have a 5-star ranking

Illinois
26.1% of all nursing homes have a 1-star ranking
10.4% of all nursing homes have a 5-star ranking

Indiana
27.9% of all nursing homes have a 1-star ranking
9.8% of all nursing homes have a 5-star ranking

Iowa
18.9% of all nursing homes have a 1-star ranking
13.1% of all nursing homes have a 5-star ranking

Kansas
14.7% of all nursing homes have a 1-star ranking
14.2% of all nursing homes have a 5-star ranking

Kentucky
22.7% of all nursing homes have a 1-star ranking
9.8% of all nursing homes have a 5-star ranking

Louisiana
39.3% of all nursing homes have a 1-star ranking
2.8% of all nursing homes have a 5-star ranking

Maine
8.0% of all nursing homes have a 1-star ranking
23.2% of all nursing homes have a 5-star ranking

Maryland
20.4% of all nursing homes have a 1-star ranking
13.0% of all nursing homes have a 5-star ranking

Massachusetts
14.3% of all nursing homes have a 1-star ranking
16.6% of all nursing homes have a 5-star ranking

Michigan
20.5% of all nursing homes have a 1-star ranking
12.5% of all nursing homes have a 5-star ranking

Minnesota
13.3% of all nursing homes have a 1-star ranking
16.2% of all nursing homes have a 5-star ranking

Mississippi
23.2% of all nursing homes have a 1-star ranking
13.3% of all nursing homes have a 5-star ranking

Missouri
24.2% of all nursing homes have a 1-star ranking
9.1% of all nursing homes have a 5-star ranking

Montana
12.1% of all nursing homes have a 1-star ranking
15.4% of all nursing homes have a 5-star ranking

Nebraska
13.8% of all nursing homes have a 1-star ranking
14.7% of all nursing homes have a 5-star ranking

Nevada
20.8% of all nursing homes have a 1-star ranking
14.6% of all nursing homes have a 5-star ranking

New Hampshire
8.8% of all nursing homes have a 1-star ranking
23.8% of all nursing homes have a 5-star ranking

New Jersey
22.2% of all nursing homes have a 1-star ranking
12.7% of all nursing homes have a 5-star ranking

New Mexico
26.8% of all nursing homes have a 1-star ranking
9.9% of all nursing homes have a 5-star ranking

New York
20.3% of all nursing homes have a 1-star ranking
13.5% of all nursing homes have a 5-star ranking

North Carolina
28.4% of all nursing homes have a 1-star ranking
13.5% of all nursing homes have a 5-star ranking

North Dakota
6.0% of all nursing homes have a 1-star ranking
19.3% of all nursing homes have a 5-star ranking

Ohio
29.2% of all nursing homes have a 1-star ranking
9.4% of all nursing homes have a 5-star ranking

Oklahoma
26.3% of all nursing homes have a 1-star ranking
7.1% of all nursing homes have a 5-star ranking

Oregon
18.8% of all nursing homes have a 1-star ranking
14.5% of all nursing homes have a 5-star ranking

Pennsylvania
25.5% of all nursing homes have a 1-star ranking
11.1% of all nursing homes have a 5-star ranking

Rhode Island
12.8% of all nursing homes have a 1-star ranking
14.0% of all nursing homes have a 5-star ranking

South Carolina
26.3% of all nursing homes have a 1-star ranking
13.7% of all nursing homes have a 5-star ranking

South Dakota
14.6% of all nursing homes have a 1-star ranking
15.5% of all nursing homes have a 5-star ranking

Tennessee
30.7% of all nursing homes have a 1-star ranking
6.9% of all nursing homes have a 5-star ranking

Texas
26.8% of all nursing homes have a 1-star ranking
9.6% of all nursing homes have a 5-star ranking

Utah
18.3% of all nursing homes have a 1-star ranking
7.5% of all nursing homes have a 5-star ranking

Vermont
20.0% of all nursing homes have a 1-star ranking
17.5% of all nursing homes have a 5-star ranking

Virginia
31.8% of all nursing homes have a 1-star ranking
11.4% of all nursing homes have a 5-star ranking

Washington
23.5% of all nursing homes have a 1-star ranking
13.5% of all nursing homes have a 5-star ranking

West Virginia
26.2% of all nursing homes have a 1-star ranking
9.2% of all nursing homes have a 5-star ranking

Wisconsin
17.3% of all nursing homes have a 1-star ranking
14.8% of all nursing homes have a 5-star ranking

Wyoming
23.1% of all nursing homes have a 1-star ranking
15.4% of all nursing homes have a 5-star ranking

Nursing Home Compare

Source - CMS (Centers for Medicare & Medicaid Services)