By BOB CHAREST, InDepthNH.org

The star rankings are found on www.medicare.gov
About the rankings: The Center for Medicare and Medicaid Services (CMS) provides federal funding to many long-term care facilities in New Hampshire and requires inspections to assure resident safety.

These reports are public information. The star system (one star for much below average, to five stars for much above average) for our report is the OVERALL QUALITY ranking. Those who want to see more detailed rankings of staffing, health inspection and quality of life measures may go to Medicare.gov.

All 74 New Hampshire nursing homes that receive Medicare and Medicaid funding are rated by the Center for Medicare and Medicaid Services. (Assisted-living facilities, which have had COVID-19 outbreaks, and other congregate settings such as the N.H. Veteran’s Home in Tilton and various private long-term care facilities that do not receive Medicare or Medicaid funding, are not included in the ratings and are not part of our report.)

In New Hampshire, here’s how the 74 nursing homes stack up in overall ratings:

One star: 12 facilities

Special Focus Facility: 1

Two stars: 9

Three stars: 11

Four stars: 16

Five stars: 25

That means more than half are ranked above average or much better than average.

Included in the Medicare.gov rankings are quality of care, staffing data, and any abuse issues. The Medicare website indicates: “Information on Nursing Home Compare is not an endorsement or advertisement for any nursing home and should be considered carefully.” Those using the lists should talk to their doctor or other healthcare provider and visit the nursing homes under consideration.

The quality of resident care measures on Nursing Home Compare aren’t benchmarks, thresholds, guidelines, or standards of care, and aren’t appropriate for use in a lawsuit. They are based on the average quality of care given to all the residents in a nursing home and don’t detail a single resident’s experience.

Most of these quality measures show residents’ health in the seven days before the assessment was done. This means that the quality measures may not show the residents’ health during the entire time between assessments.
No. certified beds: The number of certified beds comes from Medicare.gov, and the recent census information is from the COVID-19 inspection reports conducted by inspectors this spring.

Those reports are found here: https://forms.nh.gov/licenseverification/Search.aspx?facility=
Owner: The information on whether a nursing home is a nonprofit or a profit-making organization is found in corporation documents found on the N.H. Secretary of State’s website. The parent company and registration status are also found there.

COVID-19 Cases: In a declared outbreak of COVID-19, the numbers of residents and staff with confirmed cases of COVID-19, as well as the number of deaths reported at each long-term care facility, have been reported by the state for this report on the website: https://www.nh.gov/covid19/news
When no outbreaks are reported by the state, information on Covid-19 cases may be found on a CMS website (last updated Aug. 13, 2020) here: https://data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bkwz-xpvg
Fines in past 20 months: The fines assessed against a nursing home are reported on this website: https://projects.propublica.org/nursing-homes/state/NH

Staff hours per resident: The information for staff hours per resident is also from Medicare.gov. We have provided the facility ratios of staff time to patient (in minutes) as determined by the CMS inspector. To determine if a specific facility is providing a staff-resident ratio below or above the state and national averages, these are the national and statewide averages for hours of care per resident:
Registered nurses: 41 minutes for the nation and 43 minutes for New Hampshire
LPN or LVNs: 52 minutes for the nation and 47 minutes for New Hampshire
Nurse’s aides: 138 minutes for the nation and 141 minutes for New Hampshire
COVID-19 Inspection: These reports are found here: https://forms.nh.gov/licenseverification/Search.aspx?facility=

Specific inspection reports:
The incidents detailed on specific reports are usually answered by the facility, which puts a plan of remediation in place. In some cases, the inspector solved the issue at the time of discovery (expired medicines were discarded, rotten food was thrown out.).
For this listing, the inspection reports have been condensed, in some cases omitted.

We used only a sampling of incidents as reported by inspectors. Not all items are listed here. We went back 20 months. In several facilities, there were no inspection issues cited, and we reported that. Specific inspection reports may be found at this Medicare.gov website: https://data.medicare.gov/data/nursing-home-compare. Pro Publica has also reported these at https://projects.propublica.org/nursing-homes/state/NH

About the author

Bob Charest has been in the news business for three decades, formerly at the New Hampshire Union Leader and Eagle Tribune of Lawrence.  He currently reports and writes a column “Why You Should Care New Hampshire” for InDepthNH.org. He also serves as board secretary for the New Hampshire Center for Public Interest Journalism, the parent organization of InDepthNH.org. He was this year’s first-place recipient of the Community Service Award from the New Hampshire Press Association.