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NURSING HOME OVERSIGHT

When you look for a nursing home make sure you read the State and Federal Government Reports.  All nursing homes in the United States that receive Medicare or Medicaid funding are subject to federal regulations.  Surveyors may inspect for compliance with State regulations and/or Medicare and Medicaid regulations.

Skilled Nursing Facilities (SNFs) are subject to federal regulations as well as strict state regulations. The nursing home industry is considered one of the two most heavily regulated industries in the United States (the other being the nuclear power industry).

NURSING HOME COMPARE

The Nursing Home Compare tool on the website for the Centers for Medicare and Medicaid Services (CMS) has detailed information about every Medicare and Medicaid-certified nursing home in the country.  Nursing homes are rated overall and on health inspections, nursing home staffing and quality measures.  The tool uses a 5-star quality rating to make overall evaluations, with five stars indicating “much above average”, and one star indicating “much below average”.  CMS also publishes a list of Special Focus Facilities – nursing homes with “a history of serious quality issues.

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Nursing Home Compare is an appropriate first step when you are researching nursing homes, however, the systems does have flaws.  The US Government Accountability Office (GAO) found that state nursing home inspections understate the number of serious nursing home problems that present a danger to residents. The GAO concluded that while CMS oversight has improved, there are still weaknesses in its oversight of nursing homes.

READ REPORTS IN DETAIL

When you review each nursing home report, do not stop after you find the “Overall Rating” and the “General Nursing Home Characteristics”.  Specific data may be more important to you depending on your particular needs.

The “Health Inspections Section” identifies the number of Health Deficiencies and how that score compares to the rest of the state.  The” Nursing Home Staffing” section covers number of residents and the ratio of nursing staff to residents.  This is one of the most important measurements for you to understand. The Quality Measures Section covers a number topics that are evaluated in percentage points.  Topics covered include vaccinations, ADLs, pain, pressure sores, use of restraints, depression, anxiety, incontinence, abiliyy to move about,  and weight changes.

Finally there is information about  “Fire Safety Inspections”, “Penalties and Denials of Payment Against the Nursing Home,” and ” Complaints”.

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The information provided in the reports becomes even more valuable when you compare several candidate homes using the same criteria.  Patterns emerge that help separate the quality facilities from the inadequate ones.  On the other hand, don’t be put off from digging further if a home you really like has a few less stars.  Find out the reason (s) why and if the problem (s) have been corrected.

EXPAND YOUR RESEARCH

There are alternatives to skilled nursing care and you should research them all.  Official reports offer good pointers, but word-of-mouth may uncover more accurate information.  You should talk to all of the following before you make a final decision.

• Healthcare practitioner (s) and doctor (s)
• Family
• Friends
• Nursing home residents
• The families of nursing home residents
• Long-Term Care Ombudsman
• State Survey Agency