Choosing a nursing home: what the CMS rating does and does not tell you

Health inspections, staffing and quality measures behind the CMS nursing-home rating — and what to ask when you visit.

CMS rates nursing homes on three dimensions — health inspections, staffing and quality measures — plus an overall rating. For families comparing options, staffing is often the most informative: it covers nurse hours per resident per day and how often staff turn over.

What to look at first

• Staffing hours and turnover. Consistent carers matter more than a brochure; high turnover is a warning sign.
• Inspection results. Deficiencies are listed by scope and severity.
• Quality measures. Falls, pressure ulcers, antipsychotic use and similar outcomes.

What the rating does not capture

Food, activities, the atmosphere of the building, or whether the home accepts your family member's insurance. Those need a visit, a meal and questions. Use the rating to build a shortlist, not to make the decision.

The free US Nursing Homes directory covers 15,056 facilities with ratings, staffing, beds, ownership and contact details from CMS.

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