U.S. News Best Nursing Homes aims to make one of life's most difficult decisions a little easier. For the 3.3 million Americans who move into a nursing home each year, and for their caregivers and loved ones, the realization that a move is inevitable can be just the beginning of an agonizing process: figuring out where to go. Everyone deserves a home that will take care of their health needs and treat them with dignity. But only some nursing homes consistently deliver.
The 39 nursing homes listed alphabetically below make up the 2012 Honor Roll. They were the only homes, out of more than 15,500 that U.S. News reviewed, to receive four straight quarters of perfect five-star ratings from the federal Centers for Medicare and Medicaid Services in all three areas—health inspections, nurse staffing, and quality of care—in which CMS evaluates these facilities. While that's no guarantee a home is free of shortcomings or that it's ideal for a specific person, it can provide some peace of mind.
A crucial challenge, for many people, is finding a good nursing home that's close to home. Many states have no homes on the 2012 Honor Roll, but all have nursing homes that have earned an overall rating of five stars. Start by consulting the list of Best Nursing Homes in your state, or conducting a geographical search. Then explore the most promising options, using all your senses, from sight to smell, to build a profile of each home. Here are three tactics to help you select a good nursing home and avoid the bad ones:
Use research to narrow your list. Best Nursing Homes highlights meaningful data, like what proportion of residents have bedsores or are in pain. If a facility's performance in a particular area seems questionable, ask the administrators how they got those marks and what they've done to improve. You're entitled to see any home's most recent inspection findings, reported on federal form 2567, which describes violations ranging from staff neglect that contributed to a resident falling and getting hurt, to nurses failing to wash their hands as they move from one resident to another. If the report isn't available on your state website, ask to see it when you visit. It's also smart to be leery of nursing homes that the government has labeled Special Focus Facilities. In Best Nursing Homes, facilities in this category are flagged with an icon that indicates they've been singled out by the state where they operate and by CMS as nursing homes with long histories of subpar or inconsistent health inspections. If a SFF is on your candidate list, ask administrators tough questions about what they're doing to get off (and stay off) the list.
Visit multiple times. Ideally, show up at different times of day and on different days of the week. Does staffing seem lighter on weekends? If so, residents' care could be compromised. Pay attention to mealtimes: the routine, the quality of the food, and how attentive staffers are to residents who need help feeding themselves. Notice whether the parking lot is full with visitors' cars, and if grandkids, other relatives, and visiting friends dot the halls. To get a sense of quality-of-life issues, notice if residents are out of their rooms and actively engaging with one another and with staff—or if they're just slouched in bed and unaware of their surroundings.
Observe and talk. Bring along printouts of Best Nursing Homes data, and quiz administrators in a friendly, non-confrontational way. Tailor questions to your loved one's needs: How would the home deal with your father's dementia, or your mother's difficulty maintaining weight, for example? Observe how nurses and aides relate with residents and one another. Are they standing around gossiping, or are they joking with and tending to residents? Insight can come from current residents and their families, too. But rather than asking a generic question like "Are you happy here?" inquire about things that matter to your loved one. Do the residents have friends in the home, are many outside activities arranged, and do they like the nurses and aides? And have their family members been satisfied with the level of care?
The 2012 Honor Roll of Best Nursing Homes (in alphabetical order):
Learn more about how U.S. News selected the nursing homes above: Best Nursing Homes: Behind the Rankings