How does a nursing home end up losing their 5 stars?

Another thing to remember is that the Medicare ratings, while helpful, are generally more quantitative - they're based on certain criteria, not necessarily the warm and fuzzy feelings we might or might not get when we tour the facility itself.

And that's of necessity; Medicare has to have some quantitative standards to use for comparison of different facilities on the same level.

I remember asking someone about his experience at a specific rehab when I was looking for a place after my father fell the first time. This person loved the place and had nothing but excellent recommendations.. So I toured it but found it to be mediocre.

I usually take those ratings for rehab/nursing homes with a grain of salt.... same with rating groups such as Angie's List. Today on the morning news there was a segment where people are being paid to write wonderful reviews for restaurants, services, etc. even though those writers never set foot in the places or had said services done.

My Mom is in a rehab/long term care which was known under a different name in a different location... the reviews were very negative. The old rehab/long term care was bought out by another company and they built a brand new building a few miles away, which open a year ago, and closed down the old location. If you put in the new name the old name will still pop up with all those negative reviews.

As mentioned above, visit the places first hand... but one has to remember that long term care facilities aren't going to be 5-star hotels... a building could be old and drab looking but the care is outstanding.

I think EaseLiving pretty much put this all into perspective, if a center KNOWS in advance they're getting inspected..well, I'd clean my house too.

The official star ratings are not worth much. I was the director of rehab at a facility for a while and went through a number of the inspections that determine these ratings. It is known well in advance roughly when the inspectors are coming so there is a lot of prep and putting on the best. Even with surprise inspections it is easy to clean things up. The best way to know is to visit- and visit often. I would honestly take consumer ranking sites more seriously than the government sites with the caveat that people tend to use those sites to complain more than to complement.

My Mom went to 2 nursing homes last year for rehab. One that I know of lost a star. Both had 5 star medicare ratings, but in the first they just let Mom lie there and she developed a 4 stage bedsore and UTI she was hospitalized for. Did not send her back there! The second nursing home was also a "5 star" and one stupid aide dropped her while putting her into a wheelchair and broke my poor Mom's leg. Four out of Five nurses were really mean and this place was a constant calamity while Mom was there for rehab. Aides bragging about their patients not wanting to get up out of bed so they didn't have to dress them on weekends etc. I witnessed one nurse have a meltdown and yelling to Jesus while she was wallking down the hall, because a resident had fallen and hit her head. This upset the other residents. I saw feces on the wall where aides had thrown a soiled brief at the wastebasket. Once day hot dogs were served for lunch AND dinner. People were constantly crying in there. And this was just what I saw once a day while I visited. I began to go 2x to make sure Mom was ok the remaining days she finished the rehab, and got scowling looks everytime I walked by the nurses desk though I knew better than to bother them with anything. It was like they had something to hide and didn't like family visiting. The director knew of all this and it seemed she was not able to control the rest of the staff. This is how they lose a star. When you enter the place the lobby is all nice furniture and chandeliers but go down the halls it is a different story. Don't let that 5 star rating fool you or the decor out front or a website that makes the place look like a fancy resort. It was anything but that!

Here is the Medicare rating system explained - this is the one that I was talking about - though I agree that ratings on websites, such as Google, can be good to look at also. We had a bad experience with a home that actually started with a five star and went to a three star - then back to a four star (!)
Link: https://www.medicare.gov/nursinghomecompare/About/HowWeCalculate.html

Mother was in a nursing home that misrepresented the type of rooms they offered (all private, when in fact there were 2 private rooms, the rest were doubles) and the basic kind of care she'd get. She didn't VISIT the place, she went on how close it was to the 2 kids who care for her. Disaster. This place has been constantly in the "hot seat" and everyone in my area knows not to use it. She could have just asked me. It is maybe a 3 star, didn't look up the ratings, myself, but there clearly was not enough staff, she'd fall and it could take up to 10 minutes for someone to show up. I think with the internet, you can check out a NH within a few minutes. And don't totally ignore "social media" comments, but take them with a grain of salt. When mother left this facility the director begged us not to downgrade them to the "outside world". We didn't, they serve their purpose and aren't horrible....just not what they presented themselves to Mother. I had a friend who stayed in this same facility for 4 months and thought it lovely. A lot of reasons to lose a "great" rating that can have nothing to do with patient care, which is our major concern as caregivers.

Most NH's are under an "umbrella" company, e.g. Westford NH under Genesis Health Care. They COULD be the ones who do the performance reviews.

A nursing home in my area lost stars because there were not enough employees and also because they were not keeping up with patients medicine - bad record keeping.

Looked it up and it is a rehabilation center for ot, Pt and speach. It is not a long term facility.

Whose rating system are you observing? Medicare? State Health Dept? Please don't say social media, because they use review postings to do their star rating, which is totally inaccurate.