medicare nursing home compare

By | May 10, 2022

medicare nursing home compare

medicare nursing home compare

medicare nursing home compare

Medicare nursing home compare

The Centers for Medicare and Medicaid Services (CMS) manages Nursing Home Compare, which gives quality ratings for each of the nation’s approximately 16,000 Medicare and/or Medicaid-certified nursing homes. Health inspection results, quality measures, and staffing levels are used to assign a star rating to each facility, which ranges from one to five stars. There is also an overall rating.

  • How do the ratings look?
    The ranking for health inspections is based on the three most recent comprehensive (annual) inspections, as well as inspections prompted by complaints, conducted in the previous three years. Recent inspections are given more weight.
  • The Quality Measures (QM) rating is calculated by adding the values of nine QMs (a subset of the 19 QMs provided on Nursing Home Compare). The nursing home’s clinical data is used to create QMs.
  • The number of registered nurse (RN) hours per resident day and the total staffing hours per resident day is used to determine the staffing rating.
  • RNs, licensed practical nurses or licensed vocational nurses, and certified nurse assistants make up the total staffing. The facility submits staffing data, which is then changed to meet the needs of the facility.

How the CMS determines ratings
The following steps are used by CMS to assign the Overall Five-Star rating:

  • Begin by looking at the Health Inspections Rating.
  • If the “Staffing” rating is four or five stars and exceeds the Health Inspections Rating, add one star. If the “Staffing” rating is one star, deduct one star.
  • If the “Quality Measures” rating is five stars, add one star; if the “Quality Measures” rating is one star, subtract one star.
  • The “Overall” rating cannot be increased by more than one star based on the “Staffing” and “Quality Measure” ratings if the “Health Inspections” rating is one star.
  • The maximum “Overall” rating for a nursing home that is a Special Focus Facility is three stars.

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