America’s Best Nursing Homes

America's Best Nursing Home 2020
America's Best Nursing Home 2020

ElderPerfect a leading publisher on senior healthcare across the United States, today announced the recipients of the Best Nursing Homes for 2020. These awards are designed to recognize providers based on their ability to consistently deliver excellence in the areas of Health Inspections, Quality of Residence Care, Penalties and Staffing. We’ve evaluated over 15,512 facilities, of which 3,321 (21%) met our top rating. This report marks the Gold Standard in terms of care for seniors.

Ranked Best Facilities

Standard vs. Best Facilities

  • Average Number of Beds: 106 vs 95
  • Average Occupancy: 81% vs 83%
  • Average Health Inspection Rating: 2.82 / 5.00 vs. 3.90 / 5.00
  • Average Government Rating: 3.01 / 5.00 vs. 4.49 / 5.00

Rating Methodology

Health Inspections
Every year, the government assigns inspectors to conduct a formal review of nursing homes for regulatory purposes to meet the mandates outlined for Medicare and Medicaid, this aims to measure and improve the safety of residents across providers. Facilities may also be inspected when complaints are submitted or based on a reported incident. When noncompliance is identified, the facility is served a citation that indicates which regulation that was identified, along with the severity of the incident. Nursing homes are subsequently required to execute a program of resolution in order to meet compliance. Some scenarios require enforcement actions to be applied, such as a civil monetary penalty or withholding of payment(s), to incentivize resolution in a timely manner.

Facilities are applied 2 types of penalties due to non-compliance / accumulation of incidents. Civil penalties are monetary fines that may be applied to a facility based on citations / infractions identified during a review. The severity of a penalty is defined primarily by the size and frequency of the infraction.

Quality of Residence Care
There are 3 types of resident care ratings, but for this exercise, we primarily focused on the overall quality measure rating. The quality measures (QMs) include 17 data points that are derived from clinical information reported by the respective nursing home and also from Medicare claims data submitted for payment. Ratings are calculated for the QM domain using the 4 most recent quarters for which data are available. A nursing home receives points contingent on performance on each measure (weighting distribution is not equal).

Staffing research is submitted regularly by the facility and is adjusted for the requirement of the facilities residents. For each of registered nurse staff and total staffing, a 1 – 5 rating is applied according to definitions established for each category. These ratings are subsequently combined to assign an overall staffing rating. As an example, to get an overall staffing rating of 5 stars, nursing homes must earn a rating of 5 stars for both registered nurses and total staffing. Nursing homes could also be assigned a 1 star rating should they not have a registered nurse on-site daily, and do not submit staffing data, or which the data cannot be verified.

Best Nursing Homes by State