Data and Ratings

The information on IQNursingHomes.com is not an endorsement or advertisement for any nursing home. You may want to use a variety of resources when choosing a nursing home. Do not rely only on the nursing home's star rating to make a final decision. Visit the nursing homes you are considering, if possible, or have someone visit for you.

Deficiency Classification Information

Isolated (Few)

This deficiency affects one or the fewest number of residents, staff, or occurences.

Examples:

Health -- 60 of 70 residents in the nursing home are incontinent. The nursing home failed to provide adequate care of services to restore or improve baldder function in 2 of these residents.

Fire -- One resident suffered smoke inhalation as a result of smoking in bed.

Pattern (Some)

This deficiency affects more than a limited number of residents, staff, or occurences.

Examples:

Health -- 60 of 70 residents in the nursing home are incontinent. The nursing home failed to provide adequate care of services to restore or improve baldder function in 10 of these residents.

Fire -- In a 100-bed nursing home, the fire alarm system malfunctioned in only one wing housing 6 residents.

Widespread (Many)

This deficiency is found to be widespread throughout the facility and/or has the potential to affect a large portion or all the residents.

Examples:

Health -- 60 of 70 residents in the nursing home are incontinent. The nursing home failed to provide adequate care of services to restore or improve baldder function in half of these residents.

Fire -- All residents in a 50-bed nursing home were affected by an inoperative sprinkler system.

How Ratings are Calculated

The ratings on IQNursingHomes.com are taken from the Nursing Home Compare tool provided by Medicare.gov. The information below outlines how they calculate the ratings.

The Overall 5-Star rating for nursing homes based on three parts or domains:

  • Health Inspections;
  • Quality Measures (QMs); and
  • Staffing.

Star ratings for each domain and the overall rating range from 1 star to 5 stars, with more stars indicating better quality.

The Overall 5-Star rating is assigned in the following steps:

  • Step 1: Start with the Health Inspections Rating.
  • Step 2: Add 1 star if the Staffing rating is 4 or 5 stars and greater than the Health Inspections Rating. Subtract 1 star if the Staffing rating is 1 star.
  • Step 3: Add 1 star if the Quality Measures rating is 5 stars; subtract 1 star if the Quality Measures rating is 1 star.
  • Step 4: If the Health Inspections rating is 1 star, then the Overall rating cannot be upgraded by more than 1 star based on the Staffing and Quality Measure ratings.
  • Step 5: If a nursing home is a Special Focus Facility, the maximum Overall rating is 3 stars.

Each of the three domains is briefly described below.

  • Health Inspections rating: Health inspection ratings are based on the three most recent comprehensive (annual) inspections, and inspections due to complaints in the last three years. More emphasis is placed on recent inspections.
  • Quality Measures (QM) rating: The values on nine QMs (a subset of the 19 QMs listed on Nursing Home Compare) are combined to create the QM rating. QMs are derived from clinical data reported by the nursing home.
  • Staffing rating: The staffing rating is based on two measures: 1) Registered Nurse (RN) hours per resident day; and 2) total staffing hours per resident day. Total staffing includes: RNs; Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs); and Certified Nurse Aids (CNAs). Staffing data are submitted by the facility and are adjusted for the needs of the nursing home residents.

For more in-depth information of the 5-Star Quality Rating System, please visit the Technical Users' Guide.

Where does this data come from?

IQNursingHomes.com uses information provided to the public by Medicare via their online Nursing Home Compare tool. Their data comes from the CMS's Health Inspection database and a national database known as the Minimum Data Set (MDS). Click here for their overview of the datasources.

Centers for Medicare & Medicaid Services (CMS) have an Online Survey, Certification, and Reporting (OSCAR) database - Includes the nursing home characteristics and health deficiencies issued during the three most recent state inspections and recent complaint investigations.

The survey inspection results are collected by the state survey agencies, who perform onsite visits to nursing homes . The inspections occur at least once during a 15-month period, or any time in between as a result of a complaint received by the state. The inspections ensure that the nursing home residents receive quality care and services in a safe and comfortable environment in accordance with rules established by CMS. Complaints may be reported and inspected during the year (outside of the 9-15 month survey cycle). Inspections about a complaint that result in the citation of a health deficiency are reported to CMS and included in this website. Sometimes the inspection finds a problem that the nursing home identified and corrected before the inspection occurred. The fact and the nature of these prior problems (deficiencies) may be included in this website.

The information on the nursing homes' characteristics derived from OSCAR are prepared by each nursing home at the beginning of the regular State inspection. This information is reported by the nursing homes themselves. It is reviewed by nursing home inspectors, but not formally audited to ensure data accuracy. In addition, this information changes frequently as residents are discharged and admitted, or resident conditions change.

National database known as the Minimum Data Set (MDS) Repository

The data for the quality measures come from the MDS Repository. The MDS is collected on regular intervals for every resident in a Medicare or Medicaid certified nursing home. Information is collected on the resident's health, physical functioning, mental status, and general well-being. These data are used by the nursing home to access the needs and develop a plan of care unique to each resident.

Regulations require that a MDS assessment be performed at admission, quarterly, annually, and whenever the resident experiences a significant change in status. For residents in a Medicare Part A stay, the MDS is also used to determine the Medicare reimbursement rate. These assessments are performed on the 5th, 14th, 30th, 60th and 90th day of admission.

All of this data is reported by the nursing homes themselves. It is reviewed by nursing home inspectors, but not formally audited to ensure that it is accurate. Every attempt is made to assure the accuracy and timeliness of this information. However, this information changes frequently as residents are discharged and admitted, or resident conditions change. We advise interpreting this information cautiously and supplementing it with information from the Ombudsman's office, the State Survey Agency, or other sources.

Some MDS items used to calculate the quality measures consider the resident's condition during previous days prior to the assessment date. The following table provides these "observation" or "look back" time frames.