The rating is based on three criteria:
- Staffing. This is the ratio of RNs and LPNs to residents, as well as the number of care hours provided per resident. It also takes into consideration the care levels of residents — if there are more residents with higher care needs, then there would be an expectation of higher staffing levels, as well.
- Quality Measures (QMs). These are 11 different criteria for how residents are cared for in terms of their physical and clinical needs.
- Health Inspections. This is a compilation of the prior three years of onsite health inspections that are carried out by trained inspectors who follow a specific process. That process determines how well the organization is meeting Medicare and Medicaid standards.
How Important is the Five-Star Rating When Making a Decision?
“The consumer population is more educated in deciding what they want for their services and what they’re trying to accomplish,” according to Stephine, Regional Health Services Director for The Goodman Group.
Yet the rating isn’t just for family members. Hospital discharge planners also look at the rating while helping families make placement decisions. It’s to the hospital’s advantage to make good recommendations.
As Stephine explains, “Hospitals get penalized for re-admission rates. So if a resident is readmitted because they didn’t get good care, the hospital suffers.” Not only is that a clear incentive for the hospital, but it’s reassuring for the family.
You can search CMS ratings for communities by name or ZIP code by clicking here.