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VA Greater Los Angeles Healthcare System

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VA Community Living Centers Compared

The quality measures used by Centers for Medicare and Medicaid (CMS) have been displayed for private sector nursing homes participating in the contract nursing home program since June 2017 on the VA’s public facing website (www.accesstocare.va.gov). The contracted nursing homes overall 5-Star rating displayed as calculated by CMS.

VA Community Living Centers will have an overall 5-Star rating calculated to allow as close of a comparison to community nursing homes as possible. These overall 5-Star ratings for VA CLCs will be posted on www.accesstocare.va.gov along with the community nursing homes beginning in June 2018.

The Overall Star Rating for a nursing home/CLC includes assessments of several areas:

  • Health Inspections/Surveys – This rating contains information from the last 3 years of onsite inspections/surveys. This information is gathered by trained, objective inspectors who go onsite to the nursing home/CLC and follow a specific process to determine the extent to which a nursing home has met minimum quality requirements. The most recent survey findings are weighted more than the prior two years.
  • Staffing – The staffing rating has information about the number of hours of care provided on average to each resident each day by nursing staff. This rating considers differences in the levels of residents' care need in each nursing home/CLC. For example, a nursing home/CLC with residents who had more severe needs would be expected to have more nursing staff than a nursing home/CLC where the resident needs were not as high.
  • Quality Measures (QMs) – The quality measure rating has information on different physical and clinical measures for nursing home/CLC residents. This information is collected by the nursing home/CLCs for all residents using a form called the Minimum Data Set (MDS). The information collected includes the residents' health, physical functioning, mental status, and general well-being. Nursing homes/CLCs self-report this information. The QMs offer information about how well nursing homes/CLCs are caring for their residents’ physical and clinical needs. Nursing homes/CLCs use the quality measures to review and improve the quality of the care they give to residents. The quality measures are not benchmarks or standards of care. They are based on care given to all the residents in a nursing home/CLC, not to individual residents.

Things to Keep in Mind

No rating system can address all the important considerations that go into a decision about which nursing home/CLC may be best for a particular person. Examples include the extent to which specialty care is provided (such as specialized rehabilitation, hospice care, or care focused on behavioral or cognitive difficulties) or how easy it will be for family members to visit the nursing home resident. As such visits can improve both the residents' quality of life and quality of care, it may often be better to select a nursing home/CLC that is very close over one that may be, compared to a higher rated nursing home that would be far away. Veterans and their caregivers should therefore use CMS Star Ratings together with other sources of information, such as a personal visit and tour, to determine the long-term care setting that is most appropriate.