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The Best and Worst Nursing Homes in America

Each year, U.S. News teams up with Nursing Home Compare, a federal website that collects information from all nursing homes that accept Medicare and Medicaid, to create a database of the nation’s best and worst assisted-living facilities. With an estimated 3.3 million Americans currently residing in nursing homes, collected information of this type is extremely valuable for those already with loved ones in nursing homes or trying to choose the best facility.

Selecting a nursing home for a loved one can be difficult and trying in all aspects, which is why the Centers for Medicare and Medicaid (CMS) rate all nursing homes that accept Medicare on a five-star system (nearly all facilities accept the federal program). The agency’s report also outlines of the nine warning signs of poor or negligent care, and provides information on how to cover the costs and methods on how to choose the ideal facility.

CMS rates nursing homes based on a number of elements, based on state surveys, inspections and investigations, which are conducted at least every 15 months in each individual facility. The three main areas taken into consideration include: health inspection reports, nurse staffing, and quality measures.

Health inspections are conducted by state surveyors, who examine factors such as safety of food preparation, adequacy of infection control, medication management, and resident’s rights. Ratings in this category are based on the number of noted deficiencies, their seriousness, and how many residents could potentially be affected by the deficiencies. This category is extremely important in determining the standard level of care administered at facilities.

Quality measures are based on the percentage of residents who received care such as flu vaccinations, and the percentage of residents who suffered from excessive pain, bedsores, UTIs, and other care-related problems. Nurse staffing rankings are calculated by averaging the number of hours per day residents receive care from nurses at all levels. To receive five stars in this category, a facility must provide its resident with at least four and a half hours of nursing care each day.

Of the 16,000 facilities in the country, only about 3,000 received an overall rating of five stars. Four states, along with the District of Columbia, had fewer than ten top-rated nursing homes: Alaska, New Mexico, Vermont, and Wyoming.

Although CMS ratings of one or two stars are not enough to prove that your loved one is being inadequately cared for, it is certainly a red flag. United Medical Nursing Home in Washington D.C., for example, received one star in all categories except quality measures, in which it received three stars. The report details exactly what elements of all three categories contributed to the poor rankings, the level of harm afflicted by these deficiencies, the number of residents affected, and on what date the deficiencies were fixed.

For example, this particular Washington D.C. facility was noted for failing to make sure that each resident’s medication regimen was free from unnecessary drugs, and failing to manage and monitor each resident’s regimen. Overmedicating and wrongfully medicating residents is a serious form of elder abuse. Too often, understaffed facilities unlawfully medicate residents – using dangerous anti-psychotic drugs – to sedate unruly residents, or to manage residents who need more care. According to the FDA, over 15,000 nursing home residents pass away each year from medication errors.

In another example, Warren Barr Pavilion in Chicago, IL received four stars for quality measures, three for nurse staffing, and one for health inspections, leading to an overall rating of one star. Health inspection records showed that many, if not all residents were negatively impacted by the deficiencies.

Among these deficiencies included failures to: hire dieticians, keep equipment working safely, and have a program that controls infections and keeps them from spreading. Infections that are allowed to fester and spread throughout nursing homes pose immense risk to resident health and safety. In one CDC study, researchers found that patients with open wounds (such as bedsores) and invasive infections had a general mortality rate of 20%. Simple measures like hand sanitation and regular wound care can prevent most if not all of these premature deaths.

Senior abuse and neglect lawyers at Pintas & Mullins encourage anyone with a loved one in a nursing home, or considering nursing home placement, to research the facilities in your area thoroughly. If you notice any warning signs of inadequate care, do not ignore them, and contact an experienced nursing home negligence lawyer as soon as possible.