America's Best Nursing Homes

March 4, 2011
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U.S. News & World Report recently 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.
The U.S. News & World Report website 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, like Wii fitness sessions, games, sing-alongs, and 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, investment, long-term care, life care, veterans benefits, and special needs planning issues.

Ask Allie

O&H: Allie, we’ve heard about a program that helps elderly people keep their pets. Please tell us about it.
Allie: Sure! Veterinary students at Colorado State University can take a class called Pets Forever. This class pairs social work and pre-veterinary students with seniors and persons with disabilities who need help to be able to keep their pets at home. If homebound owners need help, then the students can take the pets to the vet; they also help by walking dogs and cleaning litter boxes. The class provides the pre-vet students with the opportunity to care for animals in a home setting; it also helps the seniors and persons with disabilities keep their companion animals. Studies show that companion animals can help prevent depression and even lower hospital admission rates. Lori Kogan, a university psychologist who works with the College of Veterinary Medicine, created the program in 2008. Ms. Kogan has to cap the enrollment at 35 students, although many more want to take the class. She said, “I would hear these really sad stories about people who had to give up their pets because they couldn’t walk the dog anymore, couldn’t clean the litter box. And there are cases where the relationships people have with their pets are sometimes the only relationships they have left, because everyone else is gone.” She hopes to see the program replicated at other universities. What a great idea! I hope that other schools decide to take on this program as well. Time to go and play. See you next week!


Oast & Hook is co-sponsoring a presentation with Churchland House on Wednesday, March 9th, at Churchland House, 4916 West Norfolk Road, Portsmouth, Virginia, 23703. This informational seminar will cover veterans benefits, assisted living services, and retirement living. If you have any questions about this seminar or if you would like to register for it, then please phone Shelly Ruckman or Starr Caulder at 757-483-1780.

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