Nursing homes usually get a bad rap — for reasons that are sometimes justified. Stories of substandard care abound, and for many seniors, nursing homes are a residence of last resort, when failing health puts other living arrangements out of reach.
But many nursing homes — also sometimes called skilled nursing facilities or SNFs — rise above their industry’s reputation. Some provide excellent care not only to long-term residents but also to relatively healthy people who only need a short stay for rehabilitation after elective surgery or an unexpected health event that landed them in the hospital.
To help patients and their families select the right facility for their needs, U.S. News journalists and data analysts developed a rigorous new data-driven methodology for evaluating nursing homes. New ratings evaluate each nursing home in two arenas: short-stay rehabilitation care and overall care, which is often focused on long-term residents. Now, for the first time, these brand-new Best Nursing Homes ratings are available to the public.
An Option for Recovery After a Hospital Stay
Contrary to a common misconception, nursing facilities aren’t used only by people who are old and infirm. Every day, thousands of patients who are ready to begin recovery after a hospitalization are discharged from a hospital to nearby a skilled nursing facility. Some have recently experienced a medical event such as heart attack, stroke or serious infection. Others may be recovering from an accident or other physical trauma. Still others may be on the mend after a hip or knee replacement or other elective surgery.
A temporary SNF stay may last days or weeks — Medicare will cover the cost of up to 100 days — and frequently involves rehabilitation therapy, which can include a combination of physical, occupational and speech therapy. When patients are ready to leave the SNF, many return to their homes — sometimes healthier and more physically able than when they left.
Because medical professionals call hospital care “acute care,” short-stay skilled nursing care is often called post-acute care. Some nursing facilities even specialize in post-acute care and may not have any long-term residents.
The new U.S. News ratings identify 1,874 Best Nursing Homes in Short-Stay Rehabilitation. That’s a small fraction of the 15,000-plus nursing homes in America — fewer than 1 in 8 facilities nationwide met U.S. News’ exacting standard.
Some states and regions have more good options for short-stay rehabilitation care than others. In Wisconsin, for example, U.S. News found half of all rated nursing homes to be high performing — our top rating — in short-stay rehabilitation care. By contrast, good skilled nursing facilities are hard to come by in much of the South. Across Arkansas, Louisiana, Oklahoma and Texas, for example, fewer than 1 in 50 nursing homes received a high-performing rating in short-stay rehabilitation.
Post-acute care and rehab can occur in settings other than nursing homes, including a patient’s own home or a specialized kind of hospital known as either a rehabilitation hospital or inpatient rehabilitation facility. The right setting for post-acute rehabilitation depends on an individual patient’s health status and needs as well as the availability of support from family — and whether high-quality skilled nursing or rehabilitation facilities exist in their area.
U.S. News publishes a separate ranking of the Best Hospitals for Rehabilitation.
A Permanent Home for Mom or Dad
The other type of care that nursing homes provide is long-term care for residents, often elderly, who are no longer capable of taking care of themselves. Nursing homes can be the last stop in a continuum of senior care that ranges from living on one’s own to living in an independent living facility, an assisted living facility and, finally, a nursing home. Some residential communities — called continuing care retirement communities — offer independent living, assisted living and nursing care under one roof. A resident can move from one retirement setting to the next level of care as his or her needs change.
The U.S. News ratings include an overall rating for each nursing home, which reflects how good the facility is at serving the needs of both its post-acute patients and its long-term residents. The best of these facilities are identified as high performing in overall care and recognized as Best Nursing Homes.
Just 1,837 nursing homes met that bar. Only 736 of those were also rated high performing in short-stay rehabilitation.
As those numbers make plain, patients and families must be discriminating if they want to obtain the best nursing home care available in their communities. The new U.S. News ratings give them a good place to start.
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