Subscribe for 17¢ / day
Keystone Elder Law logo 2016

The month of May has several designations that are significant for older adults, including Older Americans Month, Elder Law Month and National Nursing Home Week (May 14-20). These “celebrations” offer the opportunity for folks to share gratitude for the availability of aging services and learn more about the benefits and function of these services.

A frequent question that arises regarding nursing homes is how to choose one. The website,, offers a starting point on its Nursing Home Compare page by sharing information about nursing facilities that participate in Medicare and Medicaid programs.

Medicare has attempted to simplify some of the technical information about how facilities operate and the quality of their services by assigning star ratings in three areas: health inspections/fire safety, quality measures and staffing. A composite rating based on a combination of these individual scores is also available.

Unannounced health and fire safety inspections of all nursing homes are conducted annually by the state. These inspections cover facility policies and procedures for aspects of care, including residents’ rights, quality of life, medication management, skin care, resident assessment, food service, building environment and administration.

When a facility doesn’t meet a certain standard during an inspection, a deficiency is assigned, and the facility is given the opportunity to make improvements. The star rating accounts for the number, type and severity of deficiencies received during the previous three annual inspections, as well as the number of additional visits required to ascertain that the necessary corrections have been made.

Also included are the results of intermittent investigations that occur as a result of complaints. Only the investigations that lead to verification of a complaint are used.

Quality measures scores are calculated through a review of clinical data, which is submitted to the state by each facility. Some of the areas that are evaluated include the presence of skin breakdown due to pressure; the use of physical restraints, urinary catheters and antipsychotic medications; pain management; and the occurrence of falls.

For those residents who are admitted for a short-term stay, additional areas of evaluation include re-hospitalizations, the percentage discharged to the community and the percentage of those who demonstrate functional improvements or declines.

Scores based on staffing evaluate the total staffing hours per resident per day of nurses, physical therapists and nursing assistants. This value is combined with the number of registered nurse hours per resident per day. These numbers are self-reported to the state by each facility.

Specific scoring techniques and technical adjustments that are made to the scores are beyond the scope of this article, but facilities receive a score of one to five stars in each area noted above. While the star rating system for nursing homes is valuable, families who are researching care options for a loved one should use this information in conjunction with a personal visit or visits to a facility and the experiences of current and previous residents when making their decision.

Learn more about searching for nursing home care and the admission process at a free seminar on Tuesday, May 2. Evaluating Admission is the first in a series of Nursing Home Know-How seminars sponsored by Keystone Elder Law in recognition of Elder Law Month and National Nursing Home Week. Please call 697-3223 for additional details and to register, or visit the events page of our website at

Learn more about the article’s author, and other community education opportunities, at Check out the book, “Long Term Care Guide: Essential Tools for Solving the Elder Care Puzzle,” at the Whistlestop Bookshop or Amazon, and see Keystone’s free directory of services for older adults at Keystone Elder Law has offices in Mechanicsburg and Carlisle. Call 717-697-3223 for a free telephone consultation.