Understanding CMS Five Star Rating, other sources for choosing nursing home care

Choosing a skilled nursing care facility (SNF), commonly known as nursing homes, is a daunting task and tough to navigate for families looking for care for a loved one. Often, these decisions are made under difficult circumstances as a loved one may still be in the hospital recovering from a medical event such as a hip fracture or stroke. Hospitals often need bed availability and will want to work with a discharge planner or social worker to find placement.

In other words, families must make life changing decisions very quickly and need information on SNFs within close proximity so the resident will be close to family, friends, and other support systems.

So how do families get the relevant information they need to find the right care for their loved one? There are many ways people can quickly learn about local SNFs or even care facilities across the United States.

This blog will explore different ways people can learn more, specifically the Centers for Medicare & Medicaid’s (CMS) Five Star Rating system.

The CMS Star Rating System:
The Five Star Rating System was introduced by CMS in 2008 to help consumers, families, and caregivers compare nursing homes easily and assist in identifying areas they may have questions about before choosing care.

Through the Nursing Home Compare website, nursing homes receive a rating between one and five stars. Nursing homes with five stars are considered to have higher than above average quality and those with one star are considered to have quality below average. Each nursing home has an overall star rating and three separate domain ratings for health inspections, staffing and quality measures.

Each of these domains receive star ratings, which are utilized to produce the overall star rating. The health inspections rating is based on the outcomes from the individual state inspections or surveys. All nursing homes that participate in the Medicaid or Medicare program have unannounced onsite comprehensive inspections. Based on those inspections, CMS bases a rating on the number and scope of severity of deficiencies identified over the three most recent survey cycle.

The surveys are supposed to happen annually and no longer than 15 months apart. The star ratings also consider complaint surveys, which are triggered when CMS receives specific complaints about facility services.
The next measurement is a staffing ratio for resident care services. CMS bases the facility staffing rating on six areas of staffing- registered nurse (RN) hours per resident day, total staffing hours per resident per day, total nursing on the weekends, total nursing turnover, RN turnover and administrator departures. The staffing measures are adjusted for the different care needs of residents across nursing homes.

The final category is quality measures which addresses a wide range of services in multiple care areas. There are 15 quality measures utilized for five star. Nine of the metrics look at long stay residents, and six focus on short stay residents. Points are assigned to each measure based on the facilities performance. All the QMs are given equal weight, and the points are added up to create a total QM score.

Other Resources:
Almost all SNFs have a website that can provide families with a lot of information on the facility, its culture, contact information, and an idea of what that location has to offer in terms of care, rehabilitation, and activities for their loved one. To get an idea of the activities and day-to-day events at a SNF, check to see if the center being considered have social media pages.

There are many resources for consumers when choosing care for a loved one in a SNF. It is important to consider all sources to make the decision for your family. From the Five Star Rating to a SNF’s social media pages, they all come together to provide a clearer picture of the right decision. Also, calling the center and personally talking with employees, residents, other families, and touring is highly recommended.

Author: Brandon S. Totten
Digital Media Coordinator, Kissito Healthcare