The Method
An estimated 3.3 million Americans will live in the nation’s nearly 16,000 nursing homes during 2013. That number translates to 1 in 7 people ages 65 and up, and more than 1 in 5 of those 85 and older. The data behind ranking the best nursing homes come from Nursing Home Compare, a website run by the federal Centers for Medicare & Medicaid Services. CMS sets and enforces standards for nursing homes enrolled in Medicare or Medicaid, as most are. The agency also collects information from states and individual homes and assigns each home (other than a few too new to have built up enough months of data) a rating of one to five stars in each of three categories: state-conducted health inspections, nursing and physical therapy staffing, and quality of medical care. The ratings are combined to produce an overall rating of one to five stars.
Health inspections
Because almost all nursing homes accept Medicare or Medicaid residents, they are regulated by the federal government as well as by the states in which they operate. State survey teams conduct health inspections on behalf of CMS about every 12 to 15 months. They also investigate health-related complaints from residents, their families, and other members of the public. “Health” is broadly defined. Besides such matters as safety of food preparation and adequacy of infection control, the list covers such issues as medication management, residents’ rights and quality of life, and proper skin care. A nursing home’s rating is based on the number of deficiencies and their seriousness and scope, meaning relatively how many residents were or could have been affected. Deficiencies are included if they were identified during the three latest health inspections and in investigations of public complaints in that time frame.
Nurse staffing
CMS determines the amount of time per day patients receive from the nursing staff, because even first-rate nurses and nurse aides can’t deliver quality care if there aren’t enough of them. Homes report the average number of registered nurses, licensed practical nurses, licensed vocational nurses, and certified nurse aides and assistants on the payroll during the two-week period before the latest health inspection. The number of hours they worked is also reported. Agency temporary employees do not not count toward a home’s totals. That information is compared with the average number of residents during the same period and crunched to determine the average number of daily minutes of nursing time. To receive five stars in the latest CMS ratings, the nursing staff had to provide nearly 4½ hours of care a day to each resident, including about 43 minutes from registered nurses. The time for each home is shown in the ratings. Last year CMS also began displaying the number of hours residents receive from physical therapists.
Quality measures
CMS requires nursing homes to submit clinical data for the latest three calendar quarters detailing the status of each individual Medicare and Medicaid resident in 18 indicators, such as the percentage of residents who had urinary tract infections or who were physically restrained to keep from falling from a bed or a chair. The ratings are based on nine—seven for long-term and two for short-term residents—that are considered the most valid and reliable, such as the two above and other measures related to pain, bedsores, and mobility.
Source: To see the full list of best nursing homes in 2013 please visit – http://health.usnews.com/best-nursing-homes