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A nursing home is only as good as the care it delivers. The Health Care Safety measure scores and ranks the frequency and severity of health care findings that may have negatively impacted the quality of care and safety for residents. The fewer the citations, the lower the severity of those citations when compared to other facilities in the same state results in a higher score and grade.

Nursing homes are residents’ homes. The safety of their physical environment will either enhance, or detract, from the residents’ overall welfare. This measure considers all aspects of environmental protocols that are required by nursing homes to follow. Fire safety, emergency preparation and disaster planning, and maintenance of sprinkler systems are just a few of the facility’s physical plant features that are reviewed and scored in this measure.

A critical staff position that propels nursing home performance is that of the frontline caregiver, or a position that, by some accounts, has been called the backbone of a nursing home. These certified healthcare assistants, under the supervision of a professional or licensed nurse, are trained to attend to the daily living activities and basic care needs of residents. Primary responsibilities include assisting residents to the bathroom, cleaning and bathing residents, serving meals, housekeeping management, repositioning residents to prevent skin breakdown, working with families to resolve care problems are just snapshot of daily assigned tasks. A nursing home’s successful rating often hinges on this particular measure.

Professional nurses are the quarterbacks of the nursing home care team. They oversee, train, and support direct caregivers and licensed nurses. Professional nurses ensure individual health care plans are followed in accordance with the resident’s wishes and that residents are, at all times, treated with utmost dignity and respect. In addition to fulfilling all the duties ascribed to other nurse personnel, professional nurses are charged with advanced nursing care responsibilities. Some of those duties may include administering medications, chronicling care issues, tracing health care patterns to formulate and update care plans, consulting with a resident’s physician about any change to a resident’s condition, and plotting overarching care strategies that will maximize service and support to residents. Exceptional nursing home care efficiency and efficacy are accomplished when strong and supportive leadership are reflected in this measure. The higher the number of hours reported indicate above average staff support, training, and management.

Licensed practical or vocational nurses have a wide range of supervisory and care responsibility in a nursing home. In addition to assisting in direct resident care when needed, licensed nurses regularly monitor a resident’s health status, check vital signs and assess overall condition; perform wound care management; insert catheters, and may assist in the documentation of a resident’s condition. Nursing homes are heavily reliant on these licensed nurses. The U.S. Bureau of Labor and Statistics estimates that 38 percent of the licensed nurse workforce is employed by nursing homes. This measure indicates how effectively nursing homes coordinate and deliver resident care by evaluating licensed nurse hours.