By Charles Ornstein, ProPublica
www.medicare.gov/NHCompare/home.asp
WHAT YOU CAN FIND
Data on the quality of care provided to nursing home residents, deficiencies identified during nursing home inspections, the amount of nursing care provided to residents, and the characteristics of the home and its residents. In addition, the government assigns star ratings to homes (one to five stars) to help in comparisons.
STRENGTHS AND WEAKNESSES
CMS offers strengths and weaknesses of the three main types of information provided on the site.
Inspection results
Strengths: Inspectors examine all major aspects of care in a nursing home (about 180 different items); findings made by a trained team of surveyors who visit each home, inspect records and talk to residents; state surveyors overseen by the federal government.
Limitations: Variation among state inspectors; differences in state licensing rules; length of time between inspections.
CMS Tip: The best comparisons are made by looking at nursing homes within the same state. You should be careful if you are trying to compare a nursing home in one state with a nursing home in another state.
Staffing
Strengths: Adjust for differences in sickness of residents; review overall staffing patterns.
Limitations: Data are self-reported by the nursing home, rather than collected and reported by an independent agency; staffing data are reported just once a year and reflect staffing over a two-week period of time.
CMS Tip: Quality is generally better in nursing homes that have more staff who work directly with residents.
Quality measures
Strengths: Measures show how well a nursing home helps residents keep their ability to dress and eat, or how well the home prevents and treats skin ulcers; used in all nursing homes.
Limitations: Data are self-reported by the nursing home, rather than collected and reported by an independent agency; cover just a few of the many aspects of care.
WHAT’S MISSING
While CMS provides an overview of the deficiencies cited by inspectors, it does not post the actual reports detailing what happened. This information can only be found by reading the 2567 reports. Nursing Home Compare also does not allow users to easily compare a nursing home over time to see if it has improved or gotten worse.
THE WORST HOMES
CMS now publicizes a list of “special-focus facilities” (PDF) that have longstanding quality issues.
ONLY NURSING HOMES
CMS currently does not provide any quality information on assisted living centers or independent living centers because they do not accept Medicare or Medicaid as payment. Those centers may be regulated by states.
OTHER SOURCES OF INFORMATION
Consumer Reports has long offered useful information on nursing homes. AARP offers a host of information. And there are long-term care ombudsmen in every state, as well as advocacy groups for nursing home residents. The nursing home industry also has trade groups that can offer its perspective.
WORKING WITH THE DATA YOURSELF
You can download the raw data from Medicare’s Web site. But be advised, the data is in Microsoft Access and has not been assembled for easy use/analysis by novices.
