Nursing Home Grades

When it is time to choose a nursing home for your loved one, there are many sources of information available to help educate you and provide you with a fuller picture of how one nursing home stacks up compared to another. There is no doubt that you want information concerning staffing levels, rates of nursing home abuse and neglect, or instances of accidental falls in a particular home. Below are just a few examples of entities that score nursing home facilities on some of these criteria.

Non-Profit Organization: Families for Better Care

The nonprofit elder advocacy group Families for Better Care issues annual report cards in a project called Nursing Home Report Card. The program analyzes, compares, and ranks nursing home quality in each state based on many criteria, with staffing levels being one of them.

Federal Agency: Centers for Medicare & Medicaid Services

Each year, the Centers for Medicare & Medicaid Services conducts an annual survey of nursing home facilities that participate in the Medicare & Medicaid programs and compiles the results into an annual compendium. One of the more important features of the compendium is that it makes note of the percentages of nursing homes in each state having health deficiency citations, and classifies these citations by grades A-L. The further into the alphabet the grade is, the more dangerous, egregious or severe the risk of harm is. The letter grades are arranged in a 3×4 grid, with each set of three, i.e., A, B, and C; D, E, and F; G, H, and I, etc., representing increasing levels of prevalence of the potential level of harm. For example, grades A, D, G, and J correspond to isolated instances of the health deficit, grades B, E, H and K correspond to a pattern of nursing home health deficiencies, and grades C, F, I, and L indicate that the problem is widespread or systemic within the nursing home.

In terms of the levels of danger, the grades are broken into 4 levels, gradually increasing from no actual harm to indications that the health or safety of a resident is in immediate jeopardy. For starters, grades A-C correspond to citations where there is no actual harm yet, but there is the potential for minimal harm to be sustained by residents of the nursing home. This group is also considered the “minimal harm” group of citations. Grades D-F are citations where again, no actual harm is present, but there is the potential for more than minimal harm to occur. This band of grade letters comprises a majority of all deficiency citations, with more than half of the annually issued citations being classified as “grade D.” Grades D-F, are awarded when there is no immediate jeopardy to the health and safety of a resident and is also considered the “greater than minimal harm” group of citations. Grades G-I corresponds to citations that indicate that there is actual harm, however, the harm does not place the resident’s health or safety into immediate jeopardy.  This group is also termed the “actual harm” group of letter grades. Finally, the worst grades are J-L, which signify that a resident’s health or safety is in immediate jeopardy. Naturally, the group is referred to as the “immediate jeopardy” group of letter grades.

If you are worried that your loved one’s nursing home is not living up to nursing home care standards or is providing inadequate care of supervision of residents, please contact the Rooth Law Firm online or by phone at (847) 869-9100.


Centers for Medicare & Medicaid Services, Nursing Home Data Compendium 2012 Edition

Families for Better Care, Inc., Illinois’s 2013 Nursing Home Report Card