Nursing Home Abuse: Will The Rating System Reduce It?

One of the most daunting challenges facing elderly Americans and their families is the choice of a nursing and long-term care facility. Certainly going to visit potential choices can be informative but it is far easier for sub-par facilities to mask problems on a temporary basis than to correct them long-term.

A by-product of these difficulties is Medicare’s Five-Star Quality rating system.  Based upon more than twelve million nursing home assessments, the rating system provides five stars for the most highly acclaimed facilities and one star for the lowest.

The system examines three different rating categories including health inspections, staffing, and ten quality measures regarding physical and clinical features. Any specific facility is assigned a rating in each of the three categories along with an overall cumulative rating.

The website provides a good deal of general information along with nine or ten detailed downloads which include such topics as “Five-Star Quality Rating System Questions and Answers” and a brief consumer fact sheet. There are also links to a nursing home checklist for the all important visit to the facility at and to Medicare’s guide to choosing a nursing home. At

A wealth of more detailed and in some cases incomprehensible information is also available at the website.

 How useful is this information and are there state and local resources to supplement it? The answer is that it is a tool to be used in conjunction with your own eyes and ears and a dose of common sense. There are so many facilities that regular inspection is impossible. Wealthier states often have more resources to provide the public useful guidance. In Maryland the Office of Health Care Quality at, provides a vast array of material including the so-called Maryland Nursing Home Guide comparing more than two-hundred facilities and discussions of various other kinds of care including adult day-care and Assisted living.

Maryland also has a department of aging located on the web at which is a clearing-house for information and which includes an ombudsman for state long-term care issues.


Individually there are also long-term ombudsmen throughout the state who can provide guidance and information see link to


Inevitably the nursing home operators are not so enthusiastic about rating systems which inevitably result in a large group of one and two star ratings. Some suggest that the populations they serve are more difficult or that their reimbursements effect their staffing and other operations. Nonetheless, as the public becomes aware of this new rating system it seems likely facilities will strive to improve the quality and consistency of their product in the struggle to survive.


Despite the array of resources the ever-increasing population of elderly people drives the national need for more nursing homes and consequently more unscrupulous operators. Should your loved one sustain a serious injury or death at such a facility, contact Clark and Steinhorn at (800)304-2002 or reach us on the web at