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Medicare 5 star Rating for Skilled Nursing Facilities

Updated on March 14, 2016

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Medicare Five Star Rating

Nursing Homes Use a 5 star rating system to make themselves look good, when the fact is they recieved an extremly low rating from their state inspection.

Funny how it all works. Let me break it down from my own personal experience.

I walk into a nursing facility looking for a nice place for my mother and father in law.

Like everyone else in my position, I'm both nervous and scared. This is an emotionally challenging change of life for me, as well as for my mother and father in law.

The administrators, aiming to please, proudly display Medicare's 5 star rating for their nursing home at the front door. The administrators enjoy going over (in detail) exactly how they achieved this "prestigious" ranking.

5 stars is a top knotch nursing home. Impressive! I'm feeling a bit less nervous now.

Impressing? With the superior cleanliness of the facility, and all of the residents seemingly very happy and content (In fact I stopped and talked to a few of them). The staff were all super friendly, caring , as helpful as they could be. Wow this must be the place huh?

Well, I couldn't have been more wrong! My father in law ended up very sick with a stage three bedsore and multiple infections within a few weeks pf entering this nursing home. Sadly, he did pass away after suffering from his infections for 40 days!

Do I feel guilty? No, not really. Angry? Oh -Yeah you bet I'm angry! After my father in law passed away and I removed my mother in law from the facility I realized a few things and did a ton of digging.

What did I realize about this nursing home?

The staff was super friendly because their boss was right there giving me the tour.

The Residents I talked to were content because they were over-medicated..

The place was so nice and clean because they spend more time cleaning than they do caring for the patients.

You see, janitors cost less than nurses do so, a super clean facility can actually be a drawback, not a good thing. Like the old saying goes, don't judge a book by it's cover!

What else did I learn?

This particular nursing home had been sued and had also filed bankruptcy.

Moral of this story -

When looking for a good nursing home do some serious research. Unfourtanatly for my father in law I believed these administrators and trusted Medicare's judgement of the facility.

I have since removed my mother in law and brought her home

How and What kind of Research to do before placing a loved one in a nursing home?

Check with the county courthouse for past lawsuits that settled out of court as well as in court- they are public information -

Check with your state agency for past inspection results

Google the name of the nursing home

Check names of staff members and administrators - get refrences for them and check them out on something like - background checks on the internet - find out where they have worked previously and why they left - did I mention - check refrences of all nurses and staff who will be caring for your family member - including the people cooking their foods -

Once your loved one is placed in the home:

Check on them regularly at all hours of the day and night

Actually un-dress them and do a entire body look-over at least once a week -checking for sores skin discolorations and bruising

Ask them when you visit if anything hurts

Check with the nurses as to bathing schedules, medication schedules,what kinds of medications they are recievieng and follow up by making sure its done

Google the medications if you do not know what they are for (My mother in law was on three different tranqulizing meds) (12 meds total per day Funny how now she only takes six)

What I Dug Up On The Internet

For the State Inspection of medicare and medicaid compliance the home had failed. Not once, but numerous times although they still had a 5 star rating from medicare!

What the heck? The place had failed numerous State Inspections for faliure to give medications, bad ( I mean really bad) food,allowing residents to administer their own medications without supervision, and a whole list of other things.

The State Program overseeing Medicare and Medicaid payments had at one time refused to pay this facility for lack of compliance and had forced them to give all of their residents a 30 day notice to vacate.

I felt I could trust what medicare had to say about the facility - I mean gee whiz how can they have a 5 star rating with Our Governments Medicare System and not be in compliance with the state agency who handles the medicare and medicaid payments?

What To Do With An Elderly Family Member?

See results

© 2009 starme77


Submit a Comment

  • starme77 profile imageAUTHOR


    8 years ago

    not really , bed sores do not come from disease, they come from not being cleaned properly and the skin not being taken care of properly , my mother in law is 86, has altzheimers, lives with me and , in the two years I have cared for her so far , she has not one sore - my father in law - whom this article is about - was in the bed totally reliant on me for two months and had not one sore - it only took the nursing home 6 weeks of crappy care and he had a bedsore that ended up killing him - its not at all disease - its crappy care

  • dmleon profile image


    8 years ago from California

    I agree with you that the five star rating is not what it is suppose to be. Unfornately, even in the best nursing homes peole develop bedsores. This is due to the disease process. As the body shuts down it cannot heal itself. I am really sorry for your loss.

  • starme77 profile imageAUTHOR


    8 years ago

    Thanks Brenda - Its nice to know there are facilities that actually do care for the elderly for real , God Bless and thanks for your contibutions and hard work in putting humanity first :)

  • profile image


    8 years ago

    I am a third generation owner and provider of nursing home services. My brother and I run a smaller Skilled nursing facility and we are in our 24th year of doing so. Let me apologize for those in my industry that are not quality providers. We too have a problem with the 5 star system Medicare uses as we think it allows facilities that are good at playing the paperwork game to look good and get 5 star ratings when in fact they are no where near a quality provider.

    Since we are a small provider, we do not possess the numbers of people the bigger chains have to become fluent in all the constantly changing Medicare regulations that are used to judge us. Rather than that, we spend our resources on taking care of the residents and making sure they have what they need and get the care they deserve. Our motto has always been, "Take care of the resident and everything else will take care of itself." There is a huge disconnect between the 5 star system and reality. We usually get 3 stars no matter how hard we try. Yet, our resident and family satisfaction surveys are always around 90%. These surveys are done by our state, not by us, so there is no bias. Well, 3 stars out of 5 translates to 60%, not good. However, I am at a loss to explain that compared to our satisfaction surveys at 90%. I've told my staff that we are here to please the residents and not the inspectors. You would think that the inspectors and the inspection process would start and finish with what the residents thought about the place they spend 24/7/365 in versus a few hours the inspectors spend.

    My advice to those looking at making that tough decision of placing a loved one in a long term care facility is to visit it more than once. Visit during the off hours when the office people and the professional marketing person is not there and see how it is. Talk with other family members and get their input, especially ones that have had their loved one there for awhile. Word of mouth is usually a better indicator than any inspection or 5 star rating system the government runs.

    Starme77 had it right about how nice a building looks. It shouldn't be a turn off, but the other saying my brother, an RN BSN, has is, "Bricks and sticks don't take care of anyone." Use your nose as well. There will be times when there will be odors, but it should never be a constant odor.

    I wish you well, and everyone else also, that find themselves taking care of loved ones at home, or having a loved one in a facility.

  • BEAUTYBABE profile image


    9 years ago from QUEENSLAND AUSTRALIA.

    Hi Starme,

    You have certainly done your homework with this hub, and I commend you on a most informative hub with regard to Nursing Homes. I guess what it boils down to is that there are good ones and not so good ones. Just like anything else in are country, Nursing Homes can be split into the ones that do a great job at keeping their residents comfortable,clean, safe and above all happy. The last thing a resident needs is to be somewhere that is both unsafe, unsanitary, unhappy and just doesn't care who is wet and who isn't. My Grandmother died in a Nursing Home that showed no regard for her at all. In fact, we were unaware of this until it was too late. We arrived to visit her and were told that she'd had a belt strapped around her abdomen and she was slipping half-way through it and almost on the floor. Had she slipped any further, she could have eventually hung herself. It is lucky that one of the other resident's visitors noticed and let a staff member know about her. It made me so mad to think that it was a visitor and not a staff nurse, that was supposed to be looking after her,who found her in this predicament. I did nursing and not only this some day I may have to go to one of these places myself because of my MSA, I am so worried that I am going to end up in a place similar to the one my Gran died in. I am hoping I will be able to stay at home until the day for me to go arrives.

    It sickens me to think that our elderly residents, some of them who fought in the wars, etc, being treated in such a way that you would not treat your dog or other pet. I am appalled like you at the lack of support out there for these poor souls. I have also done a hub on Community Care but mine is more about bring home care to the home, rather than at the Nursing Home situation itself. I know where I would rather end up for my last days on earth and it is not in one of those establishments. Thanks for writing this and addressing these problems that are so prevalent in our Nursing Homes.I would like to be a follower of yours Starme

    God Bless and take care from Beautybabe. x

  • starme77 profile imageAUTHOR


    9 years ago

    Thanks habee I appreciate ya :) Glad ya liked it

  • starme77 profile imageAUTHOR


    9 years ago

    Thanks habee I appreciate ya :) Glad ya liked it

  • habee profile image

    Holle Abee 

    9 years ago from Georgia

    This is great info for anyone with an aged loved one. Thumbs up!

  • starme77 profile imageAUTHOR


    9 years ago

    I'm glad you read this and hope it helps - I wish you luck in finding a goo, quality home for your grandfather

  • edguider profile image


    9 years ago

    Relay gave me some great insight. I will be searching for a nursing home in the upcoming months for my grandfather and this surely helps

  • starme77 profile imageAUTHOR


    9 years ago

    Thanks for the wonderful compliment - comming from such an established person - it really means alot - after all of this - I went to work at an adult foster home - that revealing experience - is another article on another day

  • loislane profile image


    9 years ago from Los Angeles

    What a great service you've provided with this hub. I've spent many years investigating nursing homes and even wrote a book about how to find the best long-term-care.

    I'm a journalist whose article about abuse and neglect in a nursing home was the basis for the ABC television movies "When You Remember Me".

    Bravo to you for what you revealed.

    Best Wishes, Rena Dictor LeBlanc


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