The latest report by the Kaiser family foundation analyzed the government rating of nursing home and found some enlightening findings.  The Kaiser study, based on an analysis of star ratings in the Nursing Home Compare database, finds higher overall ratings among non-profit homes, with one-third of non-profit homes earning 5 stars compared to 18 percent of for-profit homes. It also finds generally higher ratings for smaller nursing homes (with fewer beds) than larger ones. Thirty-nine percent of homes with fewer than 60 beds got a 5-star rating compared 14 percent of homes with more than 120 beds.

The report documents considerable variation in nursing home ratings across the states.  In 22 states and the District of Columbia, for example, at least half of nursing homes received relatively high ratings of 4 or 5 stars.  Conversely, in 11 states more than 40 percent of nursing homes got relatively low ratings of 1 or 2 stars.  The states with the greatest share of low-rated nursing homes include Texas, where  51 percent of all nursing homes received a 1 or 2 star rating, followed by Louisiana (49%) and Georgia, Oklahoma and West Virginia (46% each.) In 9 states, at least one in five nursing homes received only 1 star, the lowest possible rating.

This data may provide a guide to elders and their families as to how to select a nursing home, furthermore it should direct “corporate” buyers such as large medical providers and health plans to look deeper when choosing their partner nursing homes.

The message to organizations dedicated to quality improvement, like CALTCM,  is go out there and  learn what makes the small and non -profit better performers than the large for profit nursing homes. Analyze what is the “secret sauce” that makes them successful. We as a quality oriented organization, can vet and disseminate those best practices through training, coaching and leadership in implementation strategies.

Base on this data, my choice would be a small nursing home  with  non -profit ownership  staffed with a qualified medical director certified as a CMD and or member of CALTCM who attended it’s trainings. This medical director will  more likely than not, be part of a team consisting of a registered nurse as the director of nursing services, a competent administrator with good interpersonal skills and in the ideal world, a  nurse practitioner and a competent and motivated consultant pharmacist. This structure of a leadership team is more likely to  use  best practices, utilize Quality Improvement strategies and be patient centered in their approach. This is the type  where I would have my mother, grandmother or my other loved ones stay if needed. Wouldn’t you?

For all of us Californians, the good news is that 28% of the nursing homes are 60 beds or less, and  >50% of nursing homes have  4-5 stars! So our cup is half full, more power to all of us.

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