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Health & Wellness, Skilled Nursing

What Is the CMS 5-Star Rating for Nursing Homes and Why Does it Matter?

As you begin researching senior care communities, you should know they’re not all created equally. The Centers for Medicare & Medicaid Services (CMS) developed a rating system to help compare the quality of senior health services across skilled nursing centers. A CMS 5-Star rating is the highest “grade” a skilled nursing community can earn. While the overall system is certainly a convenient way for seniors and their families to quickly evaluate senior health services, it’s important to know the individual factors on which skilled nursing providers are evaluated. Here, we’ll examine the deeper implications behind a CMS rating.

CMS Rating System

Only senior health services care centers that qualify as “skilled” are eligible for CMS certification. That means senior care must be provided by licensed health professionals such as registered nurses (RNs) and physical, occupational and speech therapists. Physical and occupational therapy, catheter care, IV injections, and wound care are all examples of skilled care.

The CMS simplified nursing home 5-Star rating system is actually intensively created from close inspection of key sources:

    • Health Inspections
      • Reports from the three most recent annual state inspections and complaint investigations that may have occurred within the last three years. These include health inspections, fire safety inspections and health code penalties.
    • Staffing
      • The number of hours each resident receives care by a skilled nursing staff member and the total amount of hours staff members work directly with individual residents.
    • Quality Measures (QMs)
      • Quality of care for each individual resident assessed by the skilled care provider based on 17 different physical and clinical measures for each resident’s needs.

Each of the health inspection, staffing, quality of care and claims are assessed and given an individual star rating. These individual ratings are then combined to produce the overall star rating, which is typically one of the first reference points for seniors researching Medicare nursing services.

a senior woman speaking to a nurse at her senior living community

Beyond the Rating

A CMS 5-Star rating for nursing homes means that community is a reliable, high-quality community in the minds of potential residents. And while that’s an accomplishment within itself, there’s more to CMS ratings than the stars on the surface. It can be more helpful to make an informed decision about a senior living community to look at each factor’s rating and the reasons behind it. For example, when looking at a nursing home 5-Star rating for the Staffing category, how many registered nurses (RNs) are on staff compared to how many nurse aides? How many hours does a nurse aid spend with a resident compared to an RN? These questions could help you choose which community or nursing home is right for you. 

CMS rates Quality Measures on 17 values to create three Quality of Resident Care ratings: short-stay, long-stay, and overall quality measure ratings. Depending on the level of care you or your loved one might need, reviewing these three Quality of Resident Care ratings could be vastly more important than the overall rating. How to determine a nursing home 5-Star rating and more information can be found on the Nursing Home Compare website from Medicare.gov, which includes important information from more than 15,000 nursing homes and senior living communities in the country.

5-Star Care at Querencia 

Of all Texas nursing home ratings from CMS, Querencia at Barton Creek is one of only three to earn a 5-Star overall rating. In fact, we’ve earned a CMS 5-Star rating in all of the Health Inspections, Staffing, and Quality of Resident Care categories. Plus we’ve earned a CMS 5-Star rating in short-stay, long-stay, and overall quality measure ratings in the Quality of Resident Care category. And Querencia has zero penalties issued by CMS. This rating has only strengthened our resolve for delivering the highest-quality care to residents in any level of our full continuum of care. Our independent living, assisted living, memory care, skilled nursing and rehabilitation services are designed to deliver a comprehensive spectrum of care other communities can’t provide. You can learn more about our exceptional-level care and the value Querencia offers now on our Health Services page.

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