US News Rolls Out New Nursing Facility Rankings with Short-Term Focus

A leading national publication on Tuesday rolled out a new set of nursing home rankings, with a particular focus on how the nation’s providers stack up on short-term rehabilitation stays.

U.S. News & World Report has produced its Best Nursing Homes list since 2009, offering an alternative to the Centers for Medicare & Medicaid Services’ (CMS) Nursing Home Compare website. But this year, the publication devised a separate quality measure for short-stay care, arguing that CMS’s overall five-star metric doesn’t provide the full picture of a facility’s strengths and weaknesses.

“They’re just looking to produce a single summary of each nursing home’s care, whereas our long-term vision might be closer to: If you have a stroke, and you’ve just been discharged from a hospital, which skilled nursing facility might be right for you?” Ben Harder, chief of health analysis at U.S. News & World Report, told Skilled Nursing News.


The publication classifies a facility’s short-term rehabilitation care quality as “high performing,” “average,” or “below average,” specifically focusing on the performance of residents who spend under 100 days at the facility.

The calculation does incorporate data from CMS, but places more emphasis on three key outcome measures — hospital readmissions, emergency room visits, and successful transitions to home — than CMS’s overall rankings, according to Harder.

“Those are all available for consumers to look at on the Nursing Home Compare website, but they don’t get much weight in the star ratings that CMS publishes, and meanwhile, many of the measures that CMS gives a great deal of weight to actually do not appear to be correlated with quality,” he said, specifically citing pain management as a metric that serves as a poor predictor of good care.


The U.S. News team also more heavily weighted each building’s staffing levels when developing its overall ranking, based on feedback from researchers and other stakeholders indicating the general importance of strong staffing coverage in patient care. To avoid some of the recent issues that have clouded the measurement of staffing statistics at SNFs, the publication only used data from April 2018 and after — correlating with CMS’s shift to payroll-based staffing data from self-reported stats.

While there were some instances of facilities that performed well on long-term care but poorly on short-term stays, U.S. News & World Report health data scientist Greta Martin said the top nursing facilities generally had solid results across both types of care.

“I think in general, the two align, because there are a lot of structural measures that aren’t going to change based on why the patient’s there,” Martin said.

More than 15,000 facilities received a ranking from U.S. News, with 2,975 making the cut as a “Best Nursing Home” — meaning it had at least one “high-performing” designation and one “average” or better ranking between the overall and short-stay categories.

Written by Alex Spanko

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