America's Best Nursing Homes

January 22, 2010
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A recent U.S. News & World Report article provided rankings of America’s Best Nursing Homes. The federal Centers for Medicare and Medicaid Services (CMS) collects data on nursing homes and rates them in its Nursing Home Compare program, with over 15,000 nursing homes ranked. CMS’s information is grouped by performance in health inspections, number of nurses, and quality of care. The agency’s ratings are from one to five stars in each category, and an overall rating from one to five stars. U.S. News & World Report’s rankings are based on an analysis of CMS’s data, and presents the homes within each overall one to five star rating in tiers in an easily searchable format.
Health inspection ratings are based on state survey team inspections, which occur every 12 to 15 months. The visits include a checklist of about 180 items, including infection control and food preparation, as well as medication management, residents’ rights and quality of life. Investigators also review complaints from residents and their families. Ratings depend on how many “deficiencies” are found, how serious the deficiencies are, and how many residents were or could have been affected. CMS wants to know how many nurses a facility employs, and calculates how much time, on average, nurses and nurse’s aides spend with each resident per day. In order to achieve five stars in this category, a facility has to provide at least 33 minutes per patient per day. For the quality of care rating, the medical status of residents is measured in ten areas related to bedsores, pain, and other clinical indicators.
U.S. News & World Report lists several tips that can help in a search for a nursing home:

  • Distance. A nursing home close by makes it easier to monitor care and visit the family member.
  • See if residents’ wishes count. For instance, a married couple might want to room together.
  • How well does the staff know the residents? “Consistent assignment” can make a big difference.
  • Look for a variety of activities for residents. Wii fitness sessions, games, singalongs, classes.
  • Ask about staff turnover. Good facilities provide staff with good benefits and perks to help minimize staff turnover.
  • Look for nursing homes that are moving toward “de-institutionalizing” their facilities by changing from hospital-like qualities such as rooms lined up in corridors to smaller “households” with 10 to 30 resident rooms around a communal kitchen and living room. The Pioneer Network is a leader in advancing this trend.

For more information on the nursing home ratings, including the searchable database, please visit:
The attorneys at Oast & Hook can assist clients with their estate, financial. Insurance, long-term care, veterans’ benefits and special needs planning issues.

Ask Allie

O&H: Allie, we’ve heard that dogs can help people keep fit. Please tell us about it.
Allie: Sure! Researchers in Great Britain surveyed 5,000 people and found that those with dogs exercised up to six hours more per week than those who worked out at a gym or worked out on their own. Those who walked dogs had more than eight hours of physical activity per week, while the average gym goer worked out less than two hours per week. One interesting statistic was that 86% of dog owners said they enjoyed the time with their pets, while only 16% of those surveyed rated going to the gym favorably. Nearly two-thirds of dog owners said they would walk their pets even if pressed for time, while only 46% of gym-goers admitted they have made excuses not to work out. The gym-goers may want to try the dog owners’ secret of breaking up their workouts into smaller bursts of activity – the miles and minutes will add up. Hmmm, all this talk about exercise has made me ready for a nap…. Uh oh, here comes my mom with the laser toy!


Oast & Hook has two corrections to last week’s article on Long-term Care Partnership Program and Medicaid. The 2nd paragraph on page 2 should read “For example, if a couple has $200,000 in countable resources, then the community spouse’s share would equal one-half of this amount, or $100,000. The institutionalized spouse’s share is $2,000, leaving $98,000 in excess resources.” The 3rd paragraph on page 2 should read “The community spouse’s share would be one-half of this total, or $50,000, and the institutionalized spouse’s share would be $2,000, leaving $48,000 in countable resources that would have to be spent down or converted to exempt resources.”


The Alzheimer’s Association will be offering a Family Caregiver Education Series. These programs will be held from 11:00 a.m. to 1:00 p.m. at the Bayside Library, 936 Independence Boulevard, Virginia Beach, Virginia. Brown bag lunches are welcome, and drinks will be provided. These programs are free to family caregivers. The second program is entitled “Personal Care for the Person With Dementia by Family Caregivers,” and it will be held on Wednesday, February 10th. Please register at least two business days before each program by phoning Carol Gurioli at 757-459-2405 or e-mailing her at carol.gurioli@alz.org .
Oast & Hook will hold its quarterly Social Workers and Administrators Breakfast on February 15th at the Virginia Beach Central Library, 4100 Virginia Beach Boulevard, Virginia Beach, Virginia 23452. Registration beings at 9:00 a.m., and the presentation begins at 9:30 a.m. Questions will be answered from 11:00 a.m. to 11:30 a.m. The breakfast is designed to be both a networking opportunity and also an educational opportunity for area professionals who work with seniors, the disabled, and their families. Seats are limited, so please register early. To register for this breakfast, please phone Jennie Dell at 757-967-9704.

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