Which kind of care is which
The words overlap, and people often hear all of them in the same week. Here is what each one usually means in Medicare's records.
- Nursing home
- A place where a person lives and gets nursing care every day. Some stays are short, for recovery after a hospital (often called skilled nursing or rehab); others are long term. Medicare pays only for limited short stays after a qualifying hospital stay; long-term care is usually paid privately or by Medicaid.
- Home health
- A nurse, physical therapist or other clinician who visits the home for a period of time, usually ordered by a doctor after an illness or hospital stay. It is not the same as a paid companion or help with daily chores, which Medicare generally does not cover.
- Hospice
- Care focused on comfort rather than cure, for someone a doctor expects to have six months or less if the illness runs its usual course. It is most often given at home, and also in nursing homes and hospice houses. A person can leave hospice if things change.
- Dialysis center
- A clinic that cleans the blood for people whose kidneys have failed, usually three times a week. Some centers also train patients to do dialysis at home.
What the star ratings tell you, and what they don't
They do
- Summarize measurements Medicare collects: inspection results, staffing hours, how patients fared, and surveys of patients or families.
- Put every place on the same 1 to 5 scale, so you can see which ones to look at more closely.
- Point to records worth reading, such as fines or citations for abuse.
They don't
- Show what a particular room, shift or caregiver is like today. Data can be months old.
- Mean the same thing across kinds of care. Five stars for a hospice and five for a hospital are built from different measures.
- Replace a visit. Go at different times of day, ask about staff turnover, and talk with residents and families if you can.
A place with no stars is not necessarily worse. Small or new providers often do not have enough data to be rated.