Nursing Home Ratings – Low Overall Quality Found

An analysis by USA Today finds that among 15,700 nursing homes nationally, about 20% receive low marks for overall quality, and those with the lowest ratings – one or two stars – are owned by for-profit companies.

There are an estimated 1.4 million Americans in nursing homes. About a quarter-million live in the low-ranked nursing homes. But even they must satisfy the basic Medicare requirements. USA Today examined the federal government’s data from the first ratings of the homes’ performance. Late in the Bush administration, the Centers for Medicare & Medicaid Services (CMS) began assigning the Zagat-like ratings based on quality, staffing, and health inspections. The Five-Star Rating System launched at

Among the lowest rating – one star- nursing home, there was an average of about 14 deficiencies per home, including safety violations and quality-of-life measures. Unfortunately, in many states, homes with poor ratings may be the only nursing homes for miles.

Problems include infected bedsores, medication errors, poor food, and abuse and neglect of nursing home patients. About 20 percent of the more than 37,000 complaints inspectors received last year concerned abuse or neglect of patients.

What to look for in a nursing home?

  • Visit the home and review staffing data to make sure that every shift, every day is covered
  • Observe – do residents look clean and well groomed? Are call lights answered in a timely manner? Does the staff address one another and residents with respect? Is the facility clean and well managed?
  • State and local long-term care ombudsmen advocate quality of life and care as well as respect for individual rights. They can provide consumers with information about homes in their area and explain regulatory survey results. Consumers looking for the State Ombudsman phone number should visit or at
  • Consumers will also want to be sure they read the fine print on any nursing home or care facility contract as binding arbitration clauses have become standard.

The Fairness in Nursing Home Arbitration Act (S. 2838 and H.R. 6126), would have invalidated mandatory arbitration clauses in nursing home and long-term care facility contracts. Under the language, residents would no longer be required to give up their right to sue a facility if it abuses or neglects residents. The bill died in committee last year. Consumers should know they are signing away their right to a civil remedy through the courts if they sign a binding arbitration clause.

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