Nursing homes and long-term care facilities are among the many health care providers that can submit reimbursements to Medicare and Medicaid, which are federal programs administered through the states, for expenses incurred for treating and caring for patients who are insured by Medicare or Medicaid. These federal program s lay out certain rules that providers must follow in order to maintain eligibility for such reimbursements.
The government also provides reviews and ratings on certain facilities, including disciplinary action taken against them for violating rules. The Centers for Medicare and Medicaid Services (CMS) specifically uses what it calls a “Five-Star Quality Rating System” for its Medicare program to provide information to consumers, including patients and/or their families and caregivers, in doing the due diligence to find the right facility for the best level of care. As the New York Times describes it, it is like a hotel-style rating. Approximately one fifth of the over 15,000 nursing homes across the United States has the top 5-star rating.