Senior Care Ratings and Licensing

Each state has a licensing division that oversees hospitals, nursing homes, assisted living facilities and group homes. A team of workers visits every facility at least once a year to conduct an inspection, called a “survey.” Depending upon the type of facility, they’ll review the charts of both active patients and patients who have been discharged (or died), follow nurses and other workers around as they perform their jobs, and evaluate the building safety. The report that they issue is important, because it offers a fair evaluation of the care the facility provides.

A type of rating for nursing homes and hospitals is published on the Medicare website – but that isn’t the actual inspection report. These ratings can be misleading, because the overall ratings are graded on a curve in comparison to the other nursing homes in the area. There can only be a certain percentage that “fails,” so even a nursing home with multiple problems found during an inspection can have an overall rating of “above average.” The Medicare website lists the results for medical providers only, so Assisted Living Facilities and Group Homes aren’t included in the five-star rating system.

This is why it’s important to view the actual inspection reports for any facility you’re considering to provide care for a family member. Some states offer reports online; they can be found either by searching the state website for facility licensing or the department of health. You can also obtain a hard copy of the inspection report by requesting it from the facility licensing division for your state.

When reading an inspection report, it’s best to keep an open mind. Some things aren’t as serious as they sound, while others are very serious. Any deficiency that a facility receives for abuse, neglect or any type of mistreatment should be taken very seriously. If the Medicare website rates a facility’s inspection as below average, the inspection report should be taken seriously, and if at all possible, you should look at other places to send your parent.

When a healthcare facility receives a poor grade, it usually is scheduled for a follow up inspection within a month or so. If the results of that inspection aren’t improved, it’s possible that the facility will lose its ability to admit new patients. Payments from Medicare and Medicaid are held, and there will be many follow up inspections to follow.

Besides reviewing the facility license, it’s possible to review the license of the administrator, director of nursing, and if it’s corporate owned, the license of the clinical team in the state where they’re located. All of this information can be requested from each state’s licensing boards, and can be helpful when attempting to find a facility for your family member.

Remember that you’re looking for a caregiver for your family member – do your homework before they’re placed in the facility, and follow up afterward to ensure that there aren’t problems with the annual inspection. If there are problems, you have the right to move your family member to another facility at any time.