Top performers among the U.S. News and World Report’s nursing home ratings for 2027 – released Tuesday – are defined by a significant reduction in emergency room visits compared to the national average.
The report also highlights moderate staffing gains as a win for the nursing home sector.
The best nursing homes on the list also had 21% fewer hospital readmissions compared to other facilities, the U.S. News noted. These top facilities also provided 19% more total staffing per resident per day compared to the national average.
Modest gains in nurse staffing levels were one of the most surprising findings from the report, according to Jordan Derk, senior care researcher with U.S. News. Direct care nursing minutes increased from 26.5 to 27 minutes per resident per day.
“While that’s a small increase, it’s encouraging since that is such a big issue across the industry,” said Derk. U.S. News saw a slight increase in staff retention as well, from 53% on average to 54%. Again, a modest increase, but reflective of the modest increase among nurse staffing levels.
Short-term rehabilitation patients at top performing nursing homes experienced 19% fewer emergency room visits compared to the national average, the report found.
“That’s not just for emergency visits. We’re also seeing similar trends for visits to the hospital in general. That is also along the same lines of nurse staffing … all of these measures are working together to improve the quality of care,” said Derk.
Still, it’s a significant difference compared to the national average, he said, with last year’s difference being 20% between high performing nursing homes and the national average, when it comes to ER visits.
Acute care hospitalization rates and short-term care hospital readmissions did rise nationwide, but the nursing homes that were high performing did perform significantly better than the average nursing home, added Derk.
Meanwhile, depressive symptoms among residents are a new troubling trend noted in the report, Derk said. Such symptoms among long-term care residents rose sharply, from 10% to 13% compared to last year.
Indicators of quality and methodology changes
Top performing facilities offered two times as much physical therapy per resident day as the national average, according to the report.
U.S. News framework for its nursing home report uses process, structural and outcome measures, Derk said – these pillars reinforce each other when determining scores. Physical therapy is a structural measure that reinforces outcomes, Derk said.
U.S. News provides two different evaluations for short-term rehabilitation and long-term care, using 17 measures for each. There’s a small amount of overlap, but Derk said the different care needs of these two populations require different methodologies.
Physical therapy hours and reduced ER visits are emphasized for short-term rehabilitation residents, while long-term care methodology focuses more on consistent daily nursing support and lower infection rates.
Researchers understand the importance of the need, and how needs differ between these two groups, said Derk. The group is very mindful of these differences when putting together the annual report. Now, it’s all about providing consistent data on these two groups.
“Last year U.S. News made some significant changes to its methodology. This year, with the data available, we wanted to maintain consistency from last year,” said Derk. “While we do see trends in the data from last year to this year, our methodology and how we score them has not changed.”
Since last year, the report used expanded metrics for evaluation while also adding data from a greater variety of sources than in the past. Quality indicators improved by nearly doubling. The data also captured staffing across different roles – and just like last year, the results this year showed a correlation between staffing levels and top-rated facilities.
Top performers by metropolitan area
More than 14,600 skilled nursing facilities were evaluated by U.S. News for its 2027 report, and 18% earned the “Best Nursing Home” designation for 2027.
About 43 metropolitan areas stood out as having 10 or more of the Best Nursing Homes, including larger cities like Los Angeles, New York City and Chicago with populations ranging from 2.7 million to 8.5 million, but some smaller areas fared well too. These included Allentown, Pennsylvania, with a population of 130,000 inhabitants, Buffalo, New York, with 274,000, and Oxnard, California, with about 200,000.
Taking Buffalo as an example, the area offers 45 nursing homes and skilled nursing facilities in the metropolitan area, and of these 14 received the high performing rating in either short-term rehabilitation, long-term care or both.
Among the top performers in Buffalo were 272-bed Beechwood Homes, Brothers of Mercy Nursing & Rehabilitation Center with 240 licensed beds, and Degraff Memorial Hospital Skilled Nursing Facility with 80 beds.
Allentown, meanwhile, which offers 37 nursing homes, 12 were high performing properties, including small facilities such as the 46-bed Advanced Health Care of Hanover and 70-bed Country Meadows Nursing Center of Bethlehem.
Companies featured in this article:
