Best Nursing Homes Definitions
Posted March 11, 2009
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| Key terms | |
|---|---|
| Nursing home | A residential facility that provides skilled nursing or rehabilitation and participates in Medicare and/or Medicaid. May be integrated into a continuing-care retirement community or a hospital. Assisted-living facilities and private-pay nursing homes are not included in this evaluation. |
| Honor Roll | Nursing homes with overall rating of 5 stars and 5 stars in all three categories that make up the overall rating. Ordered alphabetically. |
| Overall rating | Combines data from health inspections, staffing, and quality measures. The highest rating is 5 stars and the lowest is 1 star. |
| Health inspections | Indicates compliance in regular inspections with Medicare and Medicaid standards concerning food safety, hiring practices, and other aspects of healthcare. Conducted by state inspectors at least every 15 months. Stars are based on the latest three inspections and on complaint-related inspections in the past three years. 5 stars are best, 1 star is worst. |
| Nurse staffing | Indicates adequacy of time spent caring for residents by registered nurses, licensed practical nurses, licensed vocational nurses, and certified nursing assistants. Reflects hours worked during two-week period before regular health inspection divided by number of residents. Adjusted according to residents' needs and health status. 5 stars are best, 1 star is worst. |
| Quality measures | Indicates adequacy of care, such as percentages of residents with pain, bedsores, or urinary tract infections. From data nursing homes are required to collect and report for each resident. Of the 19 measures in which performance is displayed, 10 were used to arrive at the star rating. 5 stars are best, 1 star is worst. |
| Individual nursing home details | |
| Medicare/Medicaid participation | Most nursing homes accept Medicare, which pays all or part of the cost of a stay following hospitalization of at least three days; coverage is limited to 100 days per hospitalization. Medicaid covers a stay of any length for individuals who meet income requirements and are ineligible for or have exhausted their Medicare benefits. |
| Number of beds | Indicates how many beds are certified for Medicare and/or Medicaid residents. There may be private beds in addition. |
| Owner | Nursing homes can be owned by for-profit corporations, nonprofit groups, religious bodies, and other types of organizations. |
| Initial certification | The date a home was certified as meeting Medicare or Medicaid requirements. The date the home was licensed by the state to operate is different. |
| Continuing-care retirement community | Provides care geared to residents' changing needs over time, from independent apartment living to assisted living to full-time nursing home care. Generally costly, with large upfront payment required in addition to monthly fee. |
| Part of a chain | A chain is defined as two or more homes under one owner or operator. |
| Special Focus Facility (SFF) | A nursing home with a persistant history of poor care. It will be monitored and reinspected until it either has improved enough to be taken off the SFF list or it loses its Medicare or Medicaid certification. |
| Health inspection details | |
| Health inspections | Indicates compliance in regular inspections with Medicare and Medicaid standards concerning food safety, hiring practices, and other aspects of healthcare. Conducted by state inspectors at least every 15 months. Stars are based on the latest three inspections and on complaint-related inspections in the past three years. 5 stars are best, 1 star is worst. |
| Health deficiencies | Indicates health or safety requirements that the nursing home failed to meet in an inspection. |
| Complaint investigations | Indicates an investigation conducted independently from the standard inspection. If a deficiency is found, it is assigned to a specific reporting period. Family, friends, or anyone else can initiate a complaint investigation by contacting the state survey agency. |
| Inspection date | Date of standard health inspection or complaint investigation. |
| Severity of health deficiency | Indicates a deficiency's degree of seriousness. 1=did not harm but posed a threat of minor harm. 2=did not harm but posed a threat of more than minor harm. 3=caused harm but did not immediately put residents in jeopardy. 4=immediately threatened health or safety. |
| Scope of health deficiency | Indicates how many residents were or could have been affected by a deficiency. 1 means few or none; 2 means some; 3 means many. |
| Nurse staffing details | |
| Nurse staffing | Indicates adequacy of time spent caring for residents by registered nurses, licensed practical nurses, licensed vocational nurses, and certified nursing assistants. Reflects hours worked during two-week period before regular health inspection divided by number of residents. Adjusted according to residents' needs and health status. 5 stars are best, 1 star is worst. |
| Hours per resident (all nurses) | Average caregiving time per resident per day from registered nurses, licensed practical nurses, and licensed vocational nurses. Based on hours worked in the two weeks before last regular health inspection. Adjusted by residents' health status and condition. |
| Hours per resident (RNs only) | Average caregiving time per resident per day from registered nurses. Based on hours worked in the two weeks before last regular health inspection. Adjusted by residents' health status and condition. |
| Hours per resident (LPNs, LVNs) | Average caregiving time per resident per day from licensed practical nurses and licensed vocational nurses. Based on hours worked in the two weeks before last regular health inspection. Adjusted by residents' health status and condition. |
| Hours per resident (CNAs) | Average caregiving time per resident per day from certified nurse assistants. Based on hours worked in the two weeks before last regular health inspection. Adjusted by residents' health status and condition. |
| Quality measure details | |
| Quality measures | Indicates adequacy of care such as percentages of residents with pain, bedsores, or urinary tract infections. From data nursing homes are required to collect and report for each resident. The star rating is based on 10 of the 19 measures shown. 5 stars are best, 1 star is worst. |
| Long-stay measures | Indicates quality of care of residents in a home longer than a few days or weeks, according to data supplied by nursing home for each individual. |
| Short-stay measures | Indicates quality of care of residents in a home for a few days or weeks, according to data supplied by nursing home for each individual. |
| Fire safety details | |
| Fire safety | Medicare- and Medicaid-certified nursing homes must meet safety standards set by the National Fire Protection Agency. |
| Fire safety deficiencies | Indicates that a nursing home failed one or more NFPA standards. |
| Severity of fire deficiency | Indicates seriousness. 1 means did not harm but posed a threat of minor harm; 2 means did not harm but posed a threat of more than minor harm; 3 means caused harm but did not immediately put residents in jeopardy; 4 means immediately jeopardized health or safety. |
| Scope of fire deficiency | Indicates how many residents were or could have been affected. 1 means few or none; 2 means some; 3 means many. |
| NA | Not available, not applicable, insufficient data, or did not report. |
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