What You Can Learn About Assisted Living From Medicare Nursing Home Ratings

Most assisted living communities do undergo inspections. However, these reviews are conducted on a state-by-state basis, and they vary greatly depending on location.

So, while the Centers for Medicare and Medicaid Services operates across the country to regulate and provide ratings for nursing homes — not assisted living communities — you can still find assisted living ratings by looking in the right places. A Place for Mom’s comprehensive guide to state regulations for assisted living is a great place to start. Valuable information regarding assisted living annual surveys and deficiencies can be found with state Health and Human Services agencies.

Before opening for business, assisted living communities need to get a license from the appropriate state agency. Then, the communities are inspected and surveyed on a regular basis. About half of U.S. states, including Arizona, Colorado, and Delaware, are inspected and rated annually. Other states, like Minnesota, California, and Wisconsin, require assisted living communities to be inspected every three to five years.

During inspections, state agencies note deficiencies, sometimes called violations or citations. These deficiencies are recorded in a state database, and they can offer insight into quality of care. When a deficiency is found, the community must submit a plan of correction explaining how they will remedy the issue.

Medicaid and Medicare assisted living ratings may exist for communities that offer a spectrum of care — specifically communities offering both assistance with ADLs and higher-intensity medical care in separate wings of a building.

Is assisted living the right fit?

The FSQRS was designed to find and compare nursing homes, hospice companies, home health care agencies, and other long-term services and supports.^[01] It considers the following factors:

• Health inspections, which are determined by the number and severity of deficiencies found in recent annual reviews
• Staffing, which includes both turnover and number of resident hours per medical professional
• Quality measures, which are based on nine long-stay measures and six short-stay measures, including quality of life and jeopardy to resident safety

Since staffing at assisted living communities typically doesn’t include medical professionals, the FSQRS isn’t a helpful system for rating those communities. That said, families can consider both health inspections and quality measures in their search for assisted living. Staffing is also important — on a community tour, ask about turnover, staff hours, and your loved one’s ability to interact with the same care aides consistently.

Put simply, Medicare doesn’t rate assisted living communities, even if they’re Medicare or Medicaid eligible. Why? The FSQRS uses the ratio of trained medical professionals to residents as a key metric in their ratings determinations.

Assisted living communities provide housing, supportive services, meals, housekeeping, and activities to keep residents social and engaged — but they generally don’t offer intensive medical care. That’s the key difference between assisted living and nursing homes.

Assisted living questions? Get expert help

While the FSQRS is designed to rate nursing homes, not assisted living communities, Medicare.gov does offer some helpful tools for families to use when determining the best community for their loved one.^[02]

They suggest asking these questions:

• Are the facility and current administrator licensed by the state?
• Does the community have a bed or room available?
• Is the community close enough for friends and family to visit, or will a resident be able to access their preferred doctors, religious institutions, and establishments?
• Are there extra charges for additional services, like beauty shops, laundry, and housekeeping?
• Does the community regularly create and evaluate care plans?
• Is there a relationship with a local hospital?
• Are violations and abuses tracked? If so, where can prospective families find them?
• Is there information on how to report concerns about the safety and care of residents?

In addition to survey information provided by the state, families can look to multiple other sources to determine the quality of assisted living communities. Check out this guide to assisted living reviews from A Place for Mom, or peruse our best of assisted living page for the top communities near you.

Choosing the best assisted living community with your loved one is about more than reviews, though. Ask them about their priorities: Which activities do they value most? Are there specific amenities they’re looking for?

Once you’ve reviewed state survey information and assisted living ratings from A Place for Mom and other external sites, it’s important to ensure your loved one’s needs are met. Conduct research based on their interests and passions, and go on community tours together. On a tour, you can request additional safety and rating information while gaining insight into everyday life.

Contact A Place for Mom’s Senior Living Advisors to set up community tours. They can guide your family through the assisted living search and provide additional state-by-state regulation information — all at no cost to you.

Assisted living reviews from residents and families