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What Our CMS 5-Star Rating Means for Your Care

A health care worker walks side by side with an older man who is using a cane to walk

As a culture, we love ratings. They make it easier to evaluate everything from cars, restaurants and movies to senior care. Of course, the rating is only as good as the reviewer. For something as complicated as a skilled nursing facility, the most important reviews are from the Centers for Medicare & Medicaid Services (CMS).

Nursing homes are given a quality rating between 1- and 5-stars. Communities with 5-stars are considered to have much above average in quality, and those that receive 1-star are considered to be below average quality. Only the top 10% of nursing homes with the best health inspection scores in each state get a rating of 5-stars.

At Freedom Village at Brandywine, we received a CMS 5-star rating for staffing which means our residents have greater access to RNs and nursing care compared to other communities. To truly appreciate a CMS 5-star rating, it helps to understand how it’s determined.

How Is a 5-Star Rating Calculated?

Determining the CMS nursing home star rating is a complicated process, but the way you think about it can be broken down into three distinct components: health inspections, quality measures and staffing standards.

Health Inspections

To find this portion of the rating, scores from state-conducted health inspections are combined with a deficiency rating and the number of substantiated complaints. The reports of ADL decline and mobility decline are the most heavily weighted in the score (1.667 times the others). The scores of all senior care facilities in the state are then graded on a curve. The top 10% receive 5-star ratings. The bottom 20% receive 1-star ratings. The middle 70% are divided into three sections of 23.33% and awarded 2-star, 3-star and 4-star ratings based on their scores.

Quality Measures

CMS uses ten quality measures to rate this portion of their overall score. These quality measures include seven long-term (chronic) categories and three short-term (post-acute) categories.

Long-Term Care Quality Measures:

  • Activities of Daily Living (ADL) Decline (Is a long-term care resident’s ability to conduct fundamental self-care tasks worsening?)
  • Mobility Decline (To what extent is a long-term care resident less active and mobile than when they started their stay?)
  • Catheter (What percentage of long-term care residents require the use of a catheter?)
  • High-Risk Pressure Ulcers (How many long-term care residents have experienced this type of injury?)
  • Physical Restraints (Has the community had to confine long-term care residents?)
  • Urinary Tract Infections (How many long-term care residents have experienced UTIs during their care at the community?)
  • Moderate to severe pain (Have long-term care residents reported high levels of pain?)

Short-Term Care Quality Measures:

  • Pressure Ulcers (How many short-term care residents have experienced this type of injury?)
  • Moderate to Severe Pain (Have short-term care residents reported high levels of pain?)
  • Delirium (To what extent have short-term care residents experienced an acutely disturbed state of mind?)

Staffing Standards

This component specifically records the quantity and availability of the nursing staff. Other community team members, while important, aren’t measured here. CMS measures how many hours registered nurses spend with each resident each day, as well as how many hours the total nursing staff — registered nurses, licensed practical nurses and nurse aides — spend with each resident each day. A senior care facility must meet or exceed the CMS staffing study thresholds (the staffing level CMS deems sufficient) to receive a 5-star rating.

Freedom Village at Brandywine. Your 5-Star Decision.

As a Life Place Community, we’re dedicated to providing the highest quality lifestyle and care in all our senior living options, from independent living to skilled nursing. To learn more, use our Community Assistant chat feature or contact us here.