On the right hand side of each table are a set of performance measures. The performance in each category is indicated by stars. The more stars (up to 5) that are shown, the better the facility scored on that particular measure. The broadest measure of performance is Overall Inspection. The eight other categories represent different pieces of the Overall Inspection rank.
Each of the performance measures represents how a nursing home ranked within its
geographic region. The regions are defined as follows:
As stated above, these ranks indicate only relative rankings within a region. All of the nursing homes in a particular region could perform better than the statewide average. Therefore, a low rank does not necessarily indicate a "low quality" facility. Similarly, all of the nursing homes in a particular region could perform lower than the statewide average. Therefore, receiving a high rank does not necessarily indicate a "high quality" facility. All facilities listed in this guide have met the requirements for being licensed as a nursing home.
Any performance measure will have strengths and weaknesses. These are discussed below.
InspectionThe goal of the Inspection measures is to assess how well the nursing home complies with the federal laws governing nursing homes that accept Medicare or Medicaid payments. While the laws are federal, the state of Florida conducts the actual inspections as a subcontractor to the federal Centers for Medicare and Medicaid Services (CMS).
For the 6 nursing homes that accept neither Medicare nor Medicaid these federal laws do not apply. Therefore, they can only be inspected for compliance with state of Florida laws. The scoring procedure for these 6 nursing homes is very similar to that used for the other nursing homes. On average, less then 2% of nursing homes do not accept Medicare nor Medicaid. The differences are discussed below in the section titled Scoring and Ranking Algorithm . For the nursing homes that do accept Medicare or Medicaid, the general scoring procedure is discussed next.
Complete inspections are conducted on average once per year. They are unannounced, and typically last three to four days. In addition, AHCA may conduct additional inspections of nursing homes, if concerns or complaints of regulatory violations arise.
If the nursing home is found to be out of compliance during an inspection, deficiencies are issued to the facility. The deficiencies are assigned a severity (e.g. is a resident merely at risk for being harmed, or has a resident experienced actual harm) as well as a scope (e.g. is only one resident affected or are many residents affected). Deficiencies are given points according to the level of the scope and severity (the more serious the deficiency, the more points assigned). Points are doubled for deficiencies that represent substandard quality of care.
Total deficiency points are used to compute a score for the nursing home. This score takes into account the number of deficiencies, their scope, and their severity over the past 30 months.
The ranks shown in this guide are based on the facility's score over the past 30 months divided by the number of complete inspections. This time period will typically encompass at least two inspections. If the ownership of the facility has changed within the past 30 months, then the ranks will include deficiencies involving both the new owner and the previous owner(s).
Five stars overall indicates that the facility had a lower score relative to most other facilities in its region. Having only one star indicates that the facility had a higher score relative to most other facilities in its region.
Facilities have the right to appeal the deficiencies. The underlying scores do not include deficiencies that were overturned after appeal at the federal level.
The overall score is broken down into the three categories: Quality of Care, Quality of Life, and Administration. The combination of all three categories contains all 255 possible deficiencies that comprise the Overall Inspection rank.
There were many specific areas of interest expressed by consumers while developing this guide. The five of greatest interest are included as the Components of Inspection. Because of their narrow focus, these components collectively represent 18 out of the 255 possible deficiencies. However, in many cases they represent the more frequently cited deficiencies at the higher severity and scope levels.
Star Summary (Review):
Months will typically pass between inspections. Much could change for the better or worse in a facility between inspections. Therefore, you must always inspect the facility yourself before making such an important decision.