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Understanding How Nursing Homes are Rated

Legally Reviewed and Edited by: Terry Cochran

There are two major ways consumers can view how nursing homes are rated in the United States. One is run by the U.S. government through Medicare and is known as Nursing Home Compare, and the second is YELP which is a popular online directory for finding out information about businesses in a particular area.

There is a lot of disagreement as to the actual value of the two rating systems, and some confusion as to whether they are rating systems or marketing platforms. If a case evolves where a patient in the nursing home is mistreated and files a medical malpractice suit, a nursing home neglect lawyer at Cochran, Kroll & Associates, P.C. will look at both these ratings to gain an overall view of the nursing home facility.

Both rating systems have three major components and a five-star rating scale. The information gained from each system is different, and it has been suggested that the overall approach for rating nursing homes would be better if they combined for a standardized rating system.

Know what to expect from each system

The Medicare system, Nursing Home Compare, is a qualitative based approach to rating the nursing homes. The nursing homes are rated according to Health Inspections, Staffing, and Quality Measures. Nursing Home Compare has been described as a quantitative tool giving facts and information about a nursing home, but not providing a lot of information about the level of personal care.

YELP, on the other hand, is a consumer-based approach that provides feedback from patients and their families as to the care given in the nursing home. Professionals describe this rating as one that provides an understanding of what happens in the nursing home on a daily basis.

These results are gathered from surveys and personal reports. A drawback to the YELP approach is that within a family there may or may not be an agreement as to the qualities of the nursing home since most of it is based on personal opinion.

View the systems as working together

The Medicare Nursing Home Compare system gets its information from a national base of resident clinical data, Medicare Claims Data, and the federal government’s health inspections base. YELP gathers its information from reviews that members post.

Medicare Nursing Home Compare system

Many experts are frustrated with the fact that the Medicare model has no consumer voice in its rating system, and that is why some lean toward the YELP model. However, there is value in the qualitative data available through Medicare that tells the story of how the nursing home operates.

If you get a Medicare rating that says the nursing home is high in quality care but ranks lower in health inspection and staffing then it is a clear message that the quality is not where they think. It is wise to understand how the two systems support each other rather than try to define how they are different.

What you should do when researching nursing homes?

These nursing home rating systems have only been in place since 2009, and the experts in the nursing business do not agree on which approach gives the most accurate picture of the quality of the nursing home being evaluated. They recommend that anyone considering a nursing home should review the ratings in connection with a planned visit.

Before scheduling a visit determine what is important to you and your loved one. Does your family member need nursing care, physical therapy, handicap access, a special care unit for dementia patients, or a religious connection? Do you want the nursing home to be close to relatives and friends so they can visit?

When visiting an assisted living facility or nursing home for your family member or a loved one, look for a warm interaction between staff and nursing home residents, but also look for signs of abuse or neglect.

Pay attention to any odors. Good ones may mean the home is hiding something and bad smells like urine, might indicate neglect. Also ask how long each head of department has worked there. A high staff turnover may be an indication of problems.

Before making a decision visit the facility again announced, preferably during meal time. Does the food look appetizing? Are the residents who need help provided with special utensils or getting the assistance they need? Look for warning signs of elder abuse or neglect such as a poor standard of care.

Contact Cochran, Kroll & Associates, P.C.

If you have placed a loved one in long-term care and suspect nursing home negligence, personal injury, physical abuse or even sexual abuse by a staff member, contact a nursing home abuse lawyer at our law firm. We also handle wrongful deaths on behalf of next-of-kin and beneficiaries.

You can contact us at or call us at 866-MICH-LAW for a free consultation to discuss your abuse case in an elder care facility.

Disclaimer : The information provided is general and not for legal advice. The blogs are not intended to provide legal counsel and no attorney-client relationship is created nor intended.

Sebastian graduated from a liberal arts ivy league college with a major in history and minors in economics and classical studies. While in college he worked as a medical trainer and has a special interest in sports injuries and their impact on student-athletes. In his spare time, he enjoys playing soccer and ice hockey and visiting museums.



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