CMS created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily and to help identify areas about which you may want to ask questions. The Nursing Home Care Compare web site features a quality rating system that gives each nursing home a rating of between 1 and 5 stars. Nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average. There is one Overall 5-star rating for each nursing home, and separate ratings for health inspections, staffing and quality measures.
Caution: No rating system can address all of the important considerations that go into a decision about which nursing home may be best for a particular person. Examples include the extent to which specialty care is provided (such as specialized rehabilitation or dementia care) or how easy it will be for family members to visit. Visits can improve both the residents' quality of life and quality of care, it may be better to select a nursing home that is very close over one that may be, rated higher but far away. Consumers should therefore use the Web site together with other sources of information for the nursing homes (including a visit to the nursing home) and State or local organizations (such as local advocacy groups and the State Ombudsman program).
state inspection iowa nursing home ratings
December 4, 2020QSOG Memo QSO-21-06-NH, Updates to the Nursing Home Compare website and Five Star Quality Rating System, has been posted. This memo describes changes to the Rating System to be implemented in January 2021. Specifically CMS will resume calculating nursing homes Health Inspection and Quality Measure ratings on January 27, 2021.
Grassley has been an advocate for seniors throughout his time in Congress, particularly through his oversight work. In 2017, Grassley pressed CMS for answers on why it failed to ensure that nursing home abuse and neglect cases are reported to law enforcement as required, as well as its lack of urgency in responding to an early alert from the agency watchdog on the problem. Grassley also called on social media companies to explore how they could stop users from posting humiliating and demeaning photos of vulnerable individuals after reports surfaced of nursing home workers in at least 18 facilities taking unauthorized photos of elderly residents.
The Division of Health Facilities Licensure and Certification is the Mississippi regulatory agency responsible for regulating and licensing hospitals, nursing homes, hospices, and other specialized care facilities.
COVID-19 exposed many vulnerabilities in assisted living and nursing homes, causing some seniors to reconsider moving in. This guide explores the federal and state regulations in place for these communities, especially regarding cost, health and safety. It also discusses enforcement and how to get data on how closely a facility follows regulations. These regulations are current as of 2023.
If you have second thoughts about entering a nursing home, chances are you mean assisted living and not skilled nursing. (Because you have the time to consider living options, you're probably not dealing with a current health emergency that led to hospitalization.) Check out the table below for a refresher on the differences.
Check your state's licensure agency for assisted living (more on this in Table 2). In some states, detailed breakdowns of surveys or the reports themselves are available. Always pay attention to the date of the inspection. The further off it was, the less reliable or relevant the data might be.Decision to Live There and Living Situations
Medicare does not pay for assisted living but sometimes pays for medical/skilled nursing care services received in assisted living.More on comparisons: If the facility you're considering is part of a CCRC, check both the Medicare comparison tool and your state's assisted living inspection reports (if accessible). Do this even if it's just the skilled nursing aspect or the assisted living aspect you care about.
A third tool to use is ProPublica's Nursing Home Inspect. It draws from the same CMS data that goes into the Medicare comparison tool but is organized differently. For example, there are state pages such as Michigan's that enable comparisons among all nursing homes in the state. At a glance, you get total deficiencies, serious deficiencies, fines and even COVID-19 cases (as of September 2020). Unfortunately, there's no similar tool for assisted living since it is state regulated.
Care cutoffs: These cutoffs address the sometimes fine line between assisted living and nursing care. To give a basic example, some assisted living facilities assist in diabetes management, performing glucose monitoring, toenail clipping and other services for a fee. However, intensive, ongoing medical care needs are more likely to be the purview of skilled nursing homes.
Florida has three special license types for assisted living: extended congregate care for more intensive care, including nursing services to frail residents; a limited nursing services license; and a limited mental health license. Assisted living administrators must have a high school diploma or GED and must complete core training. (In some other states, the requirements are higher-level.)
Important: All states are required to have a long-term care ombudsman. Your local or state ombudsman office should be able to help with FOI requests and background information on assisted living facilities and nursing homes. To find offices, check out this map.
Some assisted living homes are unlicensed. That is, they haven't submitted the necessary forms for state approval. They haven't undergone fire safety inspections and other required inspections. It's anybody's guess if they're properly staffed and whether staffers are vetted.
Another intriguing program, although it's not SSI-specific, is Alaska's Pioneer Homes. These homes are state-owned and state-operated assisted living communities. They keep costs lower than private facilities would and offer various types of financial assistance.
If you're married, Medicaid spousal protection rules can help a healthy spouse continue to live at home instead of becoming impoverished to pay for the other spouse's assisted living or nursing home care. More commonly, it's nursing home care but applies to some assisted living situations. Here are Wisconsin's spousal impoverishment regulations as an example.
Nursing homes must keep a lot of federal rules, regulations and recommendations in mind (plus some states add their own). Oversight to some extent is necessary, although it's debatable to what extent. At some point, do regulations become more of a burden than a help, burying nursing homes under growing mounds of paperwork and taking away from time with residents?
Whatever your thoughts, there's no question that before regulation, which began in the late 1960s, care quality was poor. The 1987 Nursing Home Reform Act established requirements in three main areas: service provision, residents' rights, and administration and other matters. Further reforms followed with the 2010 Affordable Care Act and with the rollout of even more regulations in 2016. The 2016 requirements in particular were supposed to strengthen infection controls, emergency preparedness and facility assessment. Unfortunately, COVID-19 still hit many nursing homes hard.
Regulations require that you have a care plan prepared by you (if possible), your family or someone you designate, along with nursing home staff. You undergo regular health assessments to determine the personal and health care services you need, how often, who should administer them, necessary equipment and supplies, the best diet for you and goals for returning to the community, among other things.6
Prior to the COVID-19 pandemic, we found that most nursing homes were cited for infection prevention and control deficiencies (82% of those surveyed from 2013-2017). About half of these homes had persistent problems and were cited across multiple years. 7
This is troubling on multiple fronts, for example, the problem itself and then the high number of repeated failures to correct it. So, what happens when a nursing home is out of compliance? What penalties, if any, prod the facility to do better? The following section touches on these issues.
If a survey finds that nursing homes are out of compliance, what happens depends on how serious the non-compliance is. An immediate jeopardy finding means that temporary management could be appointed while the nursing home remedies its deficiencies. Otherwise, the facility is terminated from the Medicare and Medicaid programs and the residents moved elsewhere.
In short, seemingly strict regulations are in place, but they are not always effective, nor is enforcement. It's important to research the facilities in your area and visit them in person (if possible) to make sure you're comfortable with how they do things. Talk with current and former residents and their families for different perspectives. Many nursing homes do provide good care that is equal to or better than what non-medical family members and friends might provide at home.
It's great to be knowledgeable about the assisted living and nursing home rules in your state. However, just because these rules exist doesn't mean they offer 100% protection. Some issues include these:
A standard survey evaluates a sample of the nursing home's residents. The sample should closely represent the nursing home's population regarding severity and type of illness/injury/medical condition.
Medicare covers some skilled nursing facility costs in specific situations. It doesn't cover custodial nursing home care (one way to look at assisted living). From the Medicare website on skilled nursing facilities:9 2ff7e9595c
Comments