Senior Care Selection: Using the Centers for Medicare and Medicaid Services (CMS) Ratings

A nurse in a senior care community helps a senior with a walker.

As you begin the task of selecting an senior care for your loved one, you may find the experience overwhelming.  You are looking for a “new home” that is clean, safe, friendly, with access to medical personnel, and skilled, well-trained staff.  The Centers for Medicare and Medicaid Services (CMS) offers important Skilled Nursing Ratings specifically related to the information you are seeking. 

CMS Compare is a website to help consumers, their families, and caregivers compare skilled nursing communities and nursing homes to help identify areas of concern.   

The CMS website features a quality rating system that gives each nursing home and skilled nursing community a rating of between 1 and 5 stars.  Communities with an overall rating of 5-Stars are considered to have an above-average quality rating, and those with 1-Star are considered much below average. They also give one overall Star-Rating for each community and a separate rating for each of the following areas: 

Health inspections – The health inspection rating contains the three most recent health inspections and investigations that came from complaints. This information is gathered by trained, objective inspectors who go to each community, on-site, and follow a specific process to determine the extent to which the nursing home and skilled nursing community has met Medicaid and Medicare’s minimum quality requirements.  The most recent survey findings are weighted more than the prior years.

Staffing – The staffing rating has information about the number of hours of care provided, on average, to each resident each day by nursing staff.  This rating considers differences in the levels of residents’ care needs in each community.  For example, a nursing home with residents who have more severe needs would be expected to have a greater nursing staff to resident ratio than others. 

Quality Measures (QMs) – The quality measure rating has information on 15 different physical and clinical measures for nursing home and skilled nursing residents. The QMs offer information about how well nursing homes are caring for their residents’ physical and clinical needs.

If your loved one has enrolled in Medicare Part A, they can qualify for some coverage of their skilled nursing stay. However, Part A only covers temporary stays in a skilled nursing facility before the patient or family acquires costs. 

There are other programs that can assist in these costs, such as Medicaid, Medicare Savings Program, Long Term Insurance, Veterans Aid and Attendance, and Program of All-Inclusive Care for the Elderly (PACE). Since most patients residing in a skilled nursing community are covered under Medicare, it is in the facility’s best interest to remain compliant and Medicare certified.  It is also in the patient’s best interest to choose a community that has high ratings and is compliant with Medicare standards. This ensures that Medicare Part A will cover at least part of their stay. 

Find a New Home for Senior Care

You want to assure that your loved ones will receive optimal care when they transition to a skilled nursing community.  Dimensions Living Appleton and Dimensions Living Stevens Point are two skilled nursing communities with 5-Star Overall Ratings by CMS. They both offer assisted living, memory care, and skilled nursing so residents can age in place with the confidence they will receive the best of care.

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