What information can you get about nursing homes?
Nursing Home Compare provides details on nursing homes across the country. This includes nursing home inspection results, staffing levels, enforcement actions that the federal government have taken against the nursing homes and how well nursing home residents were treated in specific areas of care.
Get more information about:
expandGeneral information about nursing homes
When you search for nursing homes using Nursing Home Compare, you can find general information on more than 15,000 Medicare- and Medicaid-participating nursing homes, including:
- Nursing home name & address, including street, city, state, and ZIP code, as well as the distance from the ZIP code where you based your search.
- Whether the nursing home participates in Medicare, Medicaid or both. The nursing homes included on Nursing Home Compare are certified by Medicare or Medicaid. Those that aren’t certified nursing homes aren’t included on Nursing Home Compare. For information about nursing homes not on Nursing Home Compare, contact your State Survey Agency.
- Whether the nursing home is within a Continuing Care Retirement Community (CCRC). Continuing Care Retirement Communities (CCRC) offer multiple housing options and levels of care. A nursing home is typically the most service-intensive housing option. Residents may move from one level to another based on their particular needs, while typically still remaining in the CCRC.
- If the nursing home is located within a hospital. Some individuals need a more intensive level of care that can only be provided in a hospital setting. Some Skilled Nursing Facilities (SNF) are located within a hospital, allowing residents to be transferred to an acute care setting more easily if necessary.
- If the nursing home has a resident and family council. Resident and family councils can help communications with staff. Federal law requires nursing homes to allow councils to be set up by residents and families. If a nursing home doesn’t have a resident and family council, ask the administrator why. Ask to talk with a council president to get a sense of how the nursing home has acted on their concerns.
- Type of ownership. Nursing homes can be owned by for-profit or non-profit entities. The entities themselves can range from sole proprietorships to complex multi-facility corporations. Many nursing homes are owned or managed by religious organizations or government agencies.
- Whether the nursing home has submitted staffing data through the Payroll-Based Journal (PBJ) reporting program. The program aims to improve the accuracy of publically reported staffing information for nursing homes. Learn more about the PBJ reporting program here.
expandStar ratings
Nursing Home Compare features a star rating system that gives each facility a rating between 1 and 5 stars. The nursing home star ratings come from:
- Health inspections
- Staffing
- Quality of resident care measures
The Centers for Medicare & Medicaid Services (CMS) calculates a star rating for each of these 3 sources, along with an overall rating.
Why is this information important?
Nursing homes vary in the quality of care and services they provide to their residents. Health inspection results, staffing data, and quality of resident care information are 3 important ways to measure the quality of a nursing homes. This information, combined in the star rating, gives you a "snapshot" of the quality of each nursing home.
Using the star rating with other information
The star rating system can give you important information and help you compare nursing homes by topics you consider most important, but isn’t a substitute for visiting the nursing home. Use the star ratings together with other sources of information, and review the Guide to Choosing a Nursing Home and the Nursing Home Checklist to help you think of questions to ask when you visit the nursing home and determine whether a nursing home fits you or your family members’ needs.
Health & fire safety inspections
Nursing Home Compare collects information on health and fire safety inspections.
Health inspections
Certified nursing homes must meet standards set by the federal government to protect residents. Examples of these standards include:
- Hiring enough quality staff to provide adequate care
- Managing medications properly
- Protecting residents from physical and mental abuse
- Storing and preparing food properly
State survey agencies conduct health inspections about once a year on behalf of the federal government, and may inspect nursing homes more often if the nursing home is performing poorly if there are complaints or facility reported incidents. The health inspection team consists of trained inspectors, including at least one registered nurse.
Using the federal government’s standards, the inspection team looks at many aspects of life in the nursing home including, but not limited to:
- The care of residents and the processes used to give that care
- How the staff and residents interact
- The nursing home environment
Inspectors also review the residents' clinical records, interview residents and family members, as well as caregivers and administrative staff. The health inspection measures listed on the website show the results from the last 3 yearly inspections and the last 3 years of inspections from complaints.
Fire safety inspections
Fire safety specialists inspect nursing homes to measure if a nursing home meets Life Safety Code (LSC) standards set by CMS, based on codes established by the National Fire Protection Association (NFPA). The fire safety inspection covers building design and construction and operational features designed to provide safety from fire, smoke, electrical failures, and gas leaks.
Emergency preparedness inspections
Starting November 17, 2017, health and life safety code surveyors began to inspect facilities for emergency preparedness. The Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule requires facilities to implement an emergency preparedness program based off an all-hazards risk approach. There are 4 required core elements: 1) risk assessment; 2) policies and procedures; 3) communication plan and 4) training and testing program. The core elements are designed so that the facilities can adequately plan for emergencies, staff are aware of the procedures, and the safety and welfare of residents are protected during disasters.
Why is health & fire safety inspection information important?
To be part of the Medicare and Medicaid programs, nursing homes must meet certain requirements set by the federal government to protect residents, including those about fire safety. If a nursing home has no citations, it means that it met federal standards at time of its inspections.
While reading these reports, keep in mind that the quality of a nursing home may get much better or much worse in a short period of time. These changes can occur when a nursing home's administrator or ownership changes, or when a nursing home's finances suddenly change.
Each nursing home that provides services to people with Medicare or Medicaid must make the results of its last full inspection available at the nursing home for anyone to review. Nursing Home Compare shows all reports from the last 3 years.
For the most current information on nursing homes, or to find out more about inspections, contact your Long Term Care Ombudsman's office or the State Survey Agency in your area. External Link icon
What are citations?
If an inspection team finds that a nursing home doesn't meet a specific federal standard, it issues a citation. The federal government may impose penalties on nursing homes for serious citations or for citations that the nursing home doesn’t correct for a long time. See more information on this in the Penalties section below. State governments may also impose penalties on nursing homes. Nursing Home Compare doesn’t report penalties that states assess against nursing homes. Information about them may be available on state websites.
What are complaints?
Inspectors also may visit a nursing home when a complaint is registered about a nursing home. Nursing Home Compare includes health citations that result from inspections about a complaint.
You may file a complaint with your state if you have a concern about the quality of care you or your family member gets from a nursing home, and you don't get a satisfactory resolution from your nursing home. Get more information about how to file a complaint.
expandStaffing
Each nursing home annually reports its staffing hours to the Centers for Medicare & Medicaid Services (CMS). CMS calculates a ratio of staffing hours per resident day and reports those ratios on Nursing Home Compare.
These types of staff are included in the nursing home staffing information that is collected by CMS:
- Registered Nurse (RN)
- Licensed Practical Nurse (LPN) and Licensed Vocational Nurse (LVN)
- Certified Nursing Assistant (CNA)
- Physical Therapist (PT)
Staffing hours per resident per day is the total number of hours worked by the staff member(s) divided by the total number of residents. It doesn't necessarily show the number of nursing staff present at any given time, or reflect the amount of care given to any one resident.
What are the differences between the types of staff?
Registered nurses and licensed practical and vocational nurses
Registered nurses (RNs) are responsible for the overall delivery of care to the residents. Licensed practical and vocational nurses (LPNs/LVNs) provide care under the direction of an RN. Together, RNs and LPNs/LVNs make sure each resident’s plan of care is being followed and their needs are being met. Nursing homes must have at least one RN for at least 8 straight hours a day, 7 days a week, and either an RN or LPN/LVN on duty 24 hours per day. Certain states may have additional staffing requirements. Nurses must be licensed in the state where they practice.
Certified nursing assistants
Certified nursing assistants (CNAs) work under the direction of a licensed nurse to assist residents with activities of daily living like eating, bathing, grooming, dressing, transferring, and toileting. All full time CNAs must have completed a competency evaluation program or nurse assistant training within 4 months of their permanent employment. They must also pursue continuing education each year. CNAs provide care to nursing home residents 24 hours per day, 7 days a week.
Physical therapists
Physical therapists (PTs) help residents improve their movement and manage their pain. PTs test muscle strength, the amount of flexibility in joints, and the resident’s ability to walk or move. PTs often work with other providers, like doctors, nurses, and occupational therapists to create individualized therapy plans to address and restore the resident’s physical function and well-being. All states license PTs. The amount of physical therapy service hours depends on the needs of the resident.
Note: Each state may have its own specific education and training requirements for nursing home staff.
Why is staffing information important?
Federal law requires all nursing homes to provide enough staff to safely care for residents. However, there is no current federal standard for the best nursing home staffing levels. The staffing rating takes into account differences in the levels of residents' care needs in each nursing home. For example, a nursing home with residents that have more health problems would be expected to have more nursing staff than a nursing home where the residents need less health care. Refer to the Nursing Home Checklist to help answer questions about specific nursing homes you’re interested in or plan to visit.
expandQuality of resident care
The nursing homes that the Centers for Medicare & Medicaid Services (CMS) certifies regularly report clinical information about each of their residents. CMS uses this information to measure parts of nursing home care quality, like if residents have gotten their flu shots, are in pain, or are losing weight. These measures are often called the "quality of resident care", and Medicare posts each nursing home's scores for these measures on Nursing Home Compare. By comparing scores, you can see how nursing homes may be different from each other.
Nursing Home Compare has two different types of quality of resident care measures: short- and long-stay resident quality measures.
Short-stay quality of resident care measures
Short-stay resident quality measures show the average quality of resident care in a nursing home for those who stayed in a nursing home for less than 101 days. Short-stay residents often are those recovering from surgery or being discharged from a hospital stay. Many short-stay residents get care in a nursing home until they’re able to go back home or to the community.
|
Quality Measure |
What does this show you & why is it important? |
|---|---|
| Percentage of short-stay residents who improved in their ability to move around on their own |
What does this show you?
This shows you the percentage of short-stay nursing home residents of all ages who got better at moving around during their stay. This shows improvements in:
Higher percentages are better. Why is it important?Nursing homes can help residents make their physical functioning better. Short-stay residents admitted to a nursing home often have limited physical functioning because of illness, hospitalization, or surgery. For many short-stay residents, being able to go back to the community or home is most important. Residents who get better at moving independently are more likely to be able to go back home or the community. |
| Percentage of short-stay residents who were re-hospitalized after a nursing home admission |
What does this show you?
This shows you the percentage of short-stay residents who went to the nursing home from a hospital and then were readmitted to a hospital within 30 days for an unplanned stay. Planned readmissions aren’t included. Lower percentages are better. Why is it important?Nursing homes help residents recover after being in the hospital and keep from going back to the hospital. Sometimes residents have to go back to the hospital. If nursing homes send many residents back to the hospital, it may be because the nursing homes aren’t assessing or taking care of their residents well. |
| Percentage of short-stay residents who had an outpatient emergency department visit |
What does this show you?
This shows you the percentage of short-stay residents who:
Lower percentages are better. Why is it important?Emergency departments give necessary care for many residents of nursing homes. When nursing homes send many residents to the emergency room, it might be because the nursing homes aren’t taking good care of their residents so they need emergency treatment. |
| Percentage of short-stay residents who were successfully discharged to the community |
What does this show you?
This shows you the percentage of all new admissions to a nursing home from a hospital where the resident:
Higher percentages are better. Why is it important?High rates of successful discharge, where a resident is able to stay in the community and out of a nursing home for at least a month, shows the nursing home may be helping to make a resident’s function better so that he or she can successfully go back to the community. |
| Percentage of short-stay residents who report moderate to severe pain |
What does this show you?
This shows you the percentage of short-stay residents who say they have pain that's either almost constant or happens often:
This percentage may include some residents who are getting or have been prescribed treatment for their pain, but either don’t take the pain medicine or choose to take less. Some residents may choose to be in some pain so they can take less pain medicine and stay more alert. Lower percentages are better. Why is it important?Nursing home staff should check often to see if residents are in pain. Residents (or someone on their behalf) should let staff know if they’re in pain so staff can find the cause of the pain and make the resident more comfortable. If pain isn't treated, a resident may:
|
| Percentage of short-stay residents with pressure ulcers that are new or worsened |
What does this show you?
This shows you the percentage of residents with pressure ulcers. Pressure ulcers are areas of skin damaged by staying in one position for too long. Residents most likely to get pressure ulcers have at least one of these problems:
Lower percentages are better. Why is it important?There are many ways nursing homes can help prevent or treat pressure ulcers:
|
| Percentage of short-stay residents who needed and got a flu shot for the current flu season |
What does this show you?
This shows you the percentage of residents who received a vaccine to prevent the flu. The "flu" (also called influenza) is a very contagious infection that affects the lungs. Flu is spread very easily from person to person. People are usually infected when a person coughs or sneezes. Higher percentages are better Why is it important?People who are 65 and older are at higher risk for developing serious life-threatening medical complications from the flu. If you're 65 or older, you should get the flu shot once every year. Nursing home residents should be given a flu shot during the flu season (October through March). You shouldn't get another flu shot if you have already gotten a flu shot at another place, or if there's a medical reason why you shouldn't get it. Learn more about flu shots and the elderly. |
| Percentage of short-stay residents who needed and got a vaccine to prevent pneumonia |
What does this show you?
This shows you the percentage of residents who received a vaccine to prevent pneumonia. The pneumococcal shot (pneumococcal vaccination) may help prevent or lower the risk of becoming seriously ill from pneumonia caused by bacteria. It may also help prevent future infections. Higher percentages are better. Why is it important?Residents should be asked if they’ve been vaccinated for pneumonia, and if not, should be given the pneumococcal shot unless there's a medical reason why they shouldn't get it. |
| Percentage of short-stay residents that got antipsychotic medication for the first time |
What does this show you?
This shows you the percentage of residents who got an antipsychotic medication. Antipsychotic drugs are an important treatment for patients with certain mental health conditions. However, the FDA has warned that antipsychotic medications are associated with an increased risk of death when used in elderly patients with dementia. Also, the medications have side effects. This means these medications must be used in the right ways. Lower Percentages are better Why is it important?If possible, nursing homes should try to manage behavior without medications first. If antipsychotic medications have to be used, the resident should be watched carefully. You should ask nursing homes how they manage behavior. Managing behavior without using medications, like higher staffing ratios, many and varied activities, and regular assignment of nursing staff, have lowered the use of medications in many cases. |
Long-stay quality of resident care measures
Long-stay resident quality measures show the average quality of care for certain care areas in a nursing home for those who stayed in a nursing home for 101 days or more. Residents in a nursing home for a long-stay are usually not healthy enough to leave a nursing home and can’t live at home or in a community setting. These residents may be older and have more serious health issues.
| Quality measure | What does this show you & why is it important? |
|---|---|
| Percentage of long-stay residents experiencing one or more falls with major injury |
What does this show you?
This shows you the percentage of residents who had at least one fall with a major injury. Lower percentages are better. Why is this important?When nursing home residents fall, they can get moderate or severe injuries like:
Every year, 1 in every 3 adults 65 and older falls. One third of falls among nursing home residents results in an injury. There are many things nursing homes can do to prevent falls and fall-related injuries. Learn more about fall prevention. |
| Percentage of long-stay residents with a urinary tract infection |
What does this show you?
This shows you the percentage of residents with a urinary tract infection (UTI). Bladder infections are the most common type of UTI, but any part of your urinary tract can become infected—the urethra, bladder, ureters, and kidneys. Lower percentages are better. Why is it important?Most UTIs can be prevented by:
To help avoid UTIs, nursing home staff should make sure residents have good hygiene. Finding the cause and getting early treatment for a UTI can keep the infection from spreading and becoming more serious or causing complications like delirium. It's important to find out whether a UTI is caused by a physical problem, like an enlarged prostate, so the right medical treatment can be given. |
| Percentage of long-stay residents who report moderate to severe pain |
What does this show you?
This shows you the percentage of long-stay residents who say they have pain that’s either almost constant or happens often:
This percentage may include some residents who are getting or have been prescribed treatment for their pain, but either don’t take the pain medicine or choose to take less. Some residents may choose to take less pain medicine so they can stay more alert. Lower percentages are better. Why is it important?Nursing home staff should check often to see if residents are in pain. Residents (or someone on their behalf) should let staff know if they’re in pain so the staff can find the cause of the pain and make the resident more comfortable. If pain isn't treated, a resident may:
|
| Percentage of long-stay high-risk residents with pressure ulcers |
What does this show you?
This shows you the percentage of residents with pressure ulcers. Pressure ulcers are areas of skin damaged by staying in 1 position for too long. Residents most likely to get pressure ulcers have at least 1 of these problems:
Lower percentages are better. Why is it important?There are many ways nursing homes can help prevent or treat pressure ulcers:
Some residents may get pressure ulcers even when the nursing home takes good care to prevent them |
| Percentage of long-stay low-risk residents who lose control of their bowels or bladder |
What does this show you?
This shows you the percentage of residents who, even though they don't have conditions that make it likely, still can’t control their bowels or bladder. Lower percentages are better. Why is it important?Having bowel and bladder control can prevent infections and pressure ulcers. When residents get treatment to help them have bowel and bladder control, it can help their well-being by giving them dignity and helping them be more social. Loss of bowel or bladder control isn't a normal sign of aging and can often be successfully treated. Loss of bowel and bladder control can be caused by:
Usually with the right treatment and help from nursing home staff, residents who are low-risk can control their bowels or bladder. |
| Percentage of long-stay residents who have or had a catheter inserted and left in their bladder |
What does this show you?
This shows you the percentage of residents who have a catheter left in their bladder. A catheter is a tube placed in the body to drain and collect urine from the bladder. A catheter should only be used when it's medically necessary. It's used by residents who:
Lower percentages are better. Why is it important?A catheter shouldn't be used to make care easier for the nursing home staff. There may be complications from using a catheter:
Some studies have shown that using indwelling catheters for many years may increase the rates of bladder cancer in some patients. |
| Percentage of long-stay residents who were physically restrained |
What does this show you?
This shows you the percentage of long-stay residents who were physically restrained during either the day or night using different devices. Lower percentages are better. Why is it important?Restraints should only be used when they're necessary as part of the treatment of a resident's medical condition. Only a doctor can order a restraint. Restraints should never be used to punish a resident or to make care easier for the staff. Facilities aren't allowed to use restraints based solely on a family's request, unless there's a documented medical need and a doctor's order. A resident who's restrained daily can:
|
| Percentage of long-stay residents whose ability to move independently worsened |
What does this show you?
This shows you the percentage of long-stay residents who have a harder time getting around on their own. This is measured by a decrease in how well residents are able to move around their rooms and in hallways on the same floor. For residents in a wheelchair, this measure shows if they became less independent once they started using the chair. Lower percentages are better. Why is it important?It’s important that nursing homes keep residents moving on their own as much as possible. When residents become less able to move, they’re more likely to:
Residents who are less able to move independently also need more staff time than those who are more independent. |
| Percentage of long-stay residents whose need for help with daily activities has increased |
What does this show you?
The percentage of residents who need help with activities like:
Lower percentages are better. Why is it important?It's important that nursing home staff have residents do as much as they can for themselves. Residents’ ability to perform daily functions helps to maintain health status and quality of life. Some residents will lose function in their basic daily activities even though the nursing home gives good care. |
| Percentage of long-stay residents who lose too much weight |
What does this show you?
This shows you the percentage of residents who had a weight loss of 5% or more in the last month, or 10% in the last 6 months, but weren’t on a prescribed weight-loss plan. Lower percentages are better. Why is it important?A loss of 5% or more of body weight in 1 month is usually considered unhealthy (for example, a 140 pound person shouldn't lose more than 7 pounds in one month). Too much weight loss can:
Too much weight loss may also mean that the resident:
To help prevent unhealthy weight loss, it's important that the residents’ diets are balanced and nutritious, and that staff spend enough time feeding people who can't feed themselves. |
| Percentage of long-stay residents who have symptoms of depression |
What does this show you?
This shows you the percentage of patients with signs of depression. Depression is a medical problem of the brain that can affect how you think, feel, and behave. Signs of depression may be:
Lower percentages are better. Why is it important?Feeling depressed can lessen your quality of life and lead to other health problems. Nursing home residents are at a high risk for developing depression and anxiety for many reasons:
Identifying depression in residents can be hard because the signs may be confused with the normal aging process, a side effect of medication, or the result of a medical condition. Proper treatment may include medication, therapy, or an increase in social support. |
| Percentage of long-stay residents who got an antianxiety or hypnotic medication |
What does this show you?
The percentage of residents who received antianxiety and hypnotic medication. These medications treat certain mental health conditions. Lower percentages are better. Why is it important?High rates of use of these medications may mean that resident assessments have been done poorly and there is over-use of medications. When thinking about choosing a nursing home, ask nursing homes how they manage behavior. Nursing homes that have higher staffing ratios, many and varied activities, and regular assignment of nursing staff, have been successful at lowering the use of medications. |
| Percentage of long-stay residents who needed and got a flu shot for the current flu season |
What does this show you?
This shows you the percentage of residents who received a vaccine to prevent the flu. The "flu" (also called influenza) is a very contagious infection that affects the lungs. Flu is spread very easily from person to person. People are usually infected when a person coughs or sneezes. Higher percentages are better. Why is it important?People who are 65 and older are at higher risk for developing serious life-threatening medical complications from the flu. If you're 65 or older, you should get the flu shot once every year. Residents should be given a flu shot during the flu season (October through March). You shouldn't get another flu shot if you have already gotten a flu shot at another place, or if there's a medical reason why you shouldn't get it. Learn more about flu shots and the elderly. |
| Percentage of long-stay residents who needed and got a vaccine to prevent pneumonia |
What does this show you?
This shows you the percentage of residents who received a vaccine to prevent pneumonia. The pneumococcal shot (pneumococcal vaccination) may help prevent or lower the risk of becoming seriously ill from pneumonia caused by bacteria. It may also help prevent future infections. Higher percentages are better. Why is it important?Residents should be asked if they’ve been vaccinated for pneumonia, and if not, should be given the pneumococcal shot unless there's a medical reason why they shouldn't get it. |
| Percentage of long-stay residents who got an antipsychotic medication |
What does this show you?
This shows you the percentage of residents who got an antipsychotic medication. Antipsychotic drugs are an important treatment for patients with certain mental health conditions. However, the FDA has warned that antipsychotic medications are associated with an increased risk of death when used in elderly patients with dementia. Also, the medications have side effects. This means these medications must be used in the right ways. Lower percentages are better. Why is it important?If possible, nursing homes should try to manage behavior without medications first. If antipsychotics have to be used, the resident should be watched carefully. You should ask nursing homes how they manage behavior. Managing behavior without using medications, like higher staffing ratios, many and varied activities, and regular assignment of nursing staff, have lowered the use of medications in many cases. |
What to keep in mind when using quality of resident care measures
The quality of resident care measures on Nursing Home Compare aren’t benchmarks, thresholds, guidelines, or standards of care, and aren't appropriate for use in a lawsuit. They are based on the average quality of care given to all the residents in a nursing home and don’t detail a single resident’s experience.
Most of these quality measures show residents’ health in the 7 days before the assessment was done. This means that the quality measures may not show the residents' health during the entire time between assessments.
Call your State Survey Agency or Long-Term Care Ombudsman for additional information. External Link icon
expandPenalties
Centers for Medicare & Medicaid Services (CMS) may impose penalties on a nursing home when there’s a serious health or fire safety citation or if the nursing home fails to correct a citation for a long period of time. For example, Medicare may issue a fine, deny payment to the nursing home, assign a temporary manager, or install a state monitor. Nursing Home Compare only lists penalties that have been imposed in the last 3 years.
What are the types of penalties on Nursing Home Compare?
There are 2 types of penalties reported on Nursing Home Compare:
- Fines: Fines may be imposed once per citation or each day until the nursing home corrects the citation.
- Payment denials: During a payment denial, the government stops Medicare or Medicaid payments to the nursing home for new residents until the nursing home corrects the citation.
Why is this information important?
If the nursing home doesn't correct these problems, Medicare will end its agreement with the nursing home. This means the nursing home is no longer certified to provide and be paid for care to people with Medicare or Medicaid. Residents with Medicare or Medicaid who are living in the home at the time of the termination will be moved to a different nursing home that is still certified by CMS.