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Nursing home residents are among the most vulnerable people in our society.

Almost by definition, they usually have infirmities that literally leave them at the mercy of others. That's what makes it so important for nursing homes to provide appropriate care for their residents and for the folks charged with monitoring nursing home care to make sure that they do.

Choosing a good nursing home has never been easy. For one thing, in past years little knowledge was available to the public about the level of care delivered in a particular nursing home. This issue was dealt with when Medicare developed "Nursing Home Compare." It can be accessed at www.medicare.gov/NHCompare/.

The central feature is a scoring system that uses from one to five stars.

The star ratings are based on rather complex formula incorporating a wide range of data from state inspections, information provided by the nursing homes and resident characteristics.

A one-star nursing home offers well below average care - an F, while a five-star nursing home offers well above average care - an A. A three-star nursing home gets the average rating - a C.

The site also offers a glimpse of the overall condition of nursing home care in the United States.

Nationwide, the average overall rating of nursing homes is three stars. However, there is a substantial variation by state. The state with the highest average overall care rating had a score of 4.53 stars. The state with the lowest average earned a 2 star rating. Indiana ranks 34th among the states with an average overall rating of 2.98 stars.

Nationwide, 16.7 percent of all nursing homes received one-star ratings. The state with best ratings had no nursing homes with a one- star rating.

In the state with the highest percentage of one-star nursing homes, 29 percent of the nursing homes had one-star ratings. In Indiana 19.3 percent of nursing homes received one-star ratings. Thirty-eight states had a smaller percentage of one-star nursing homes than Indiana.

Looking at the other end of the range, nationwide 14 percent of nursing homes received five-star ratings.

In the state with the smallest percentage of five-star nursing homes, only 4.6 percent were in this category.

The state with the highest percentage of five-star nursing homes had 32 percent at that level. In Indiana 14 percent of nursing homes were five star rated. Twenty-four states had a higher percentage of five-star nursing homes than Indiana.

The geographic distribution of nursing homes makes a difference. For purely practical reasons, residents must often choose a nearby nursing home. As a rule, the five-star nursing homes are the most desirable, but they are not distributed equally. For instance, only 50 of Indiana's 92 counties have a five-star nursing home.

The Medicare.gov site also provides information about health care deficiencies that were recorded during inspections. Nationwide, the average number of health care deficiencies was 7.8. The average for Indiana nursing homes was 10. Only nine states recorded higher health care deficiency averages.

It is hard to know whether nursing home care has improved significantly since the Nursing Home Reform Act of 1987, but what is clear is that we have a long way to go.

(c) 2010 Evansville Courier & Press. Provided by ProQuest LLC. All rights Reserved.

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