Nursing home care can be as short as a few days or weeks after a hospitalization, or it can be years if aging family members can no longer live on their own. To help find the best match for a loved one, U.S. News evaluated more than 15,000 facilities throughout the country and rated most of them in two different areas: short-term rehabilitation and long-term care. This year, U.S. News revised its Short-Term Rehabilitation rating and debuted the Long-Term Care rating. This FAQ explains how nursing homes were evaluated and responds to questions that nursing home patients, residents and families may have about the U.S. News ratings.

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For more detailed information on how U.S. News Best Nursing Homes ratings were determined, the methodology report can be found here.

When did U.S. News begin rating nursing homes?

Since their inception in 2009, the U.S. News Best Nursing Home ratings have relied on data from Nursing Home Compare, a program run by the Centers for Medicare & Medicaid Services, the federal agency that sets and enforces standards for nursing homes.

In 2018, U.S. News added a Short-Term Rehabilitation rating evaluating the care delivered to patients after a hospitalization for surgery, heart attack, stroke, injury or a similar condition. This year, U.S. News added a Long-Term Care rating to improve our ability to provide consumer decision support. Long-Term Care evaluates the care delivered to residents who are no longer able to live independently and need help with daily activities such as eating, getting in or out of bed or a wheelchair, using stairs or getting dressed, as well as administering needed medical care.

Which nursing homes were eligible for rating?

All Medicare- and Medicaid-certified nursing homes that were part of the July 2019 CMS nursing home provider census that was made available in August 2019 were evaluated by U.S. News. Nursing homes did not apply nor did they provide any data or materials to U.S. News.

To be eligible for a Short-Term Rehabilitation, Long-Term Care or Overall rating, a home must have met the following inclusion criteria:

• Received reimbursement from CMS in July of 2019.
• Had sufficient data to evaluate quality in that rating.

What makes a facility a U.S. News Best Nursing Home?

Facilities were considered U.S. News Best Nursing Homes if they were rated “high performing” in either Short-Term Rehabilitation or Long-Term Care. A total of 2,969 facilities were recognized as U.S. News Best Nursing Homes: 2,250 in Short-Term Rehabilitation and 1,139 in Long-Term Care. This year, 420 nursing homes received this designation for both stay types.

How did U.S. News determine its Overall Rating?

The U.S. News Best Nursing Homes assigns each eligible nursing home an Overall rating from 1 to 5. This rating evaluates a wide range of the care in the home, including both long-term residents with chronic needs and short-term patients who may receive rehabilitation following a hospital stay.

Each nursing home that was rated in Short-Term Rehabilitation, Long-Term Care or both received a U.S. News Overall rating. The Overall rating is based on a 5-point scale that averages the short- and long-term scores, weighting each equally, where high performing receives a value of 5, average receives a value of 3 and below average receives a value of 1. If a home was only eligible for one of the two component ratings, the Overall score reflected that rating.

For more detailed information on how this rating was determined, our methodology report can be found here.

How and why did the overall rating change from previous years?

Because U.S. News now calculates both a Short-Term Rehabilitation Rating and Long-Term Care Rating for each nursing home, we chose to use these as the foundation for the summary Overall score, rather than CMS-issued domain-specific star ratings.

How did U.S. News determine its Short-Term Rehabilitation rating?

The Short-Term Rehabilitation rating is based on 10 quality measures focusing on staffing, outcomes, resident complaints and processes of care. U.S. News used scientific literature review, expert consultation and statistical modeling to select these measures. This rating designates nursing homes as high-performing, average or below average in the care they provided to patients who spent 100 days or less at a skilled nursing facility.

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