How Do Nursing Homes Get Rated?

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The U.S. News has ranked the best nursing homes in the country for this year, but the search for a good home tends to be a subjective one. What works for one person may be totally off base for another, while a third senior yet may be looking for something entirely different. To that extent, the U.S. News has written an extensive article detailing how they arrived at their rankings, going hand-in-hand with a checklist of questions you should be asking when looking at nursing homes.

Health and Safety

These are two of the most important criteria to look at when selecting a nursing home, as being without one or both can not only be unpleasant, but downright dangerous. U.S. News looks at health and safety with a fairly broad lens, encompassing everything from medication to quality of life.

They’ve looked at data collected from surveys performed by the Centers for Medicare and Medicaid Services (CMS), done every 12 to 15 months (most nursing homes accept Medicare/Medicaid patients, and are federally regulated). U.S. News then assigns a ranking score based on how many violations or deficiencies a nursing home has received, as well as a comprehensive listing of health and fire inspection results.


The amount of attention your senior will receive—the the level/skill of care—is another important factor to consider. For a nursing home to get the maximum 5-star rating, they need to have almost 270 minutes of nursing care per resident each day, with 43 of those minutes coming from a registered nurse. The only thing that doesn’t count in CMS rankings is time devoted by agency temporary workers.

Quality and Other Intangibles

It’s fairly difficult to assign a quantitative, numerical ranking to something as subjective as “quality”, which may be why the CMS expanded its points to 18 indicators for Medicare/Medicaid residents. Some of the things they looked at included:


  • Percentage of residents with urinary tract infections (something that can be a sign of poor attention or care, and easily preventable)
  • Percentage of physically restrained residents to prevent them from falling off beds or chairs
  • Bedsores
  • Pain
  • Mobility


U.S. News also notes that ratings differ for long- and short-term patients, with more indicators being looked at for the former and fewer for the latter.

Questions to Ask

Along with their article detailing how they ranked each nursing home on their list, U.S. News also published a checklist of questions to ask. Some of the more important ones are centered on the following topics:


  • Problems or special needs
  • Toileting
  • Nutrition and nourishment
  • Falls
  • Health inspections
  • Medical care and medication management
  • Staffing (and nursing staff) and workload)
  • Worrisome or missing data
  • Safety
  • Overall direction
  • Employee feedback and ratings
  • Quality of life
  • Visitor accessibility
  • Resident engagement


Choosing a nursing home can be a daunting prospect, which is why U.S. News has broken down the characteristics that make a nursing home a good one, this way you can find the most supported independent living Melbourne services, and in all 50 states, too.