Methodology Overview

The rankings on BostonNursingHomeRankings.com are derived from analyzing recent public data from the Massachusetts Department of Public Health and from Medicare. While the data provided on this site is informative, please remember that reviewing this information is but one step in the process of choosing a nursing home.

There are 456 Medicare/Medicaid certified nursing homes in the state of Massachusetts. Nursing Homes are defined as facilities that provide short-term rehabilitation, long-term convalescent care, or both services. Since there is some variation (e.g., facilities that provide short-term rehab only), this information has been included on this site.

Since most people shop for nursing homes on a local level, each facility is compared to other facilities within the same "area" only. For example, all facilities within the "Boston Metro" area (see below) receive a ranking for the "Boston Metro" area only.  

Sample
Boston Metro: Boston, Brookline, Cambridge and Somerville
There are 37 Medicare/Medicaid certified nursing homes located in the “Boston Metro" area. A total of 35 facilities are ranked for the "Boston Metro" area. No data is available for 2 facilities in the Boston Metro area: Brighton House Rehab and Nursing and Hutchins TCU; therefore, these facilities were not included in the rankings. Also, some newer nursing homes may not be included due to unavailability of survey data. 

The information in the Boston Metro section reflects data gathered from September 2006. Click here to learn more about how often the data gets updated on our site. 

MetroWest: Framingham, Lincoln, Medfield, Natick, Needham, Newton, Sudbury, Waltham, Watertown, Wayland, Wellesley, Weston
There are 38 Medicare/Medicaid certified nursing homes located in the “MetroWest" area  A total of 36 facilities are ranked for the "MetroWest" area.  No data is available for 2 facilities in the MetroWest area: MetroWest Medical Center-Transitional and The Leland Home; therefore, these facilities were not included in the rankings. Also, some newer nursing homes may not be included due to unavailability of survey data.

The information in the MetroWest section reflects data gathered from November 2006.  Click here to learn more about how often the data gets updated on our site. 

Ranking Criteria

Department of Public Health Score 
DPH conducts annual inspections (also referred to as "surveys") of facilities to ensure that they are in compliance with State and Federal regulations governing nursing home care.  These inspections are incredibly rigorous. Several State surveyors come to a facility unannounced and over a period of several days analyze a random selection of medical records, administrative procedures and basic quality of life factors with a fine-tooth comb.  They spend time observing the overall environment and evaluate the quality of food served.  They also interview residents and family members to obtain more subjective feedback.

The surveyors assign performance scores within five key areas (Administration, Nursing, Resident Rights, Kitchen/Food Service and Environment).  The total maximum score possible is 132 points – this means that the facility is in 100% compliance with all regulations.  Scores reflect performance over the last three years.  The Statewide average score in Massachusetts is 123 points and the lowest score received by facilities on BostonNursingHomeRankings.com is 100.  For more information on survey methodology, go to: http://www.mass.gov/dph/qtool/qthome.htm.

The DPH score is given the most weight because it’s considered very reliable and comprehensive.  However, it’s important to evaluate additional quality factors for a more complete profile of each facility. 

Bonus Quality Score
BostonNursingHomeRankings.com analyzed other important factors that impact quality: staffing hours for Certified Nursing Assistants (CNA) and Licensed Nurses; type of ownership information; and complaints made about the facility.  

The factors that contribute to the Bonus Quality Score are assigned a “weight” that reflects how important that indicator is based on our judgment, which is informed by both personal experience and research findings. 

Facilities are compared to one another and given points relative to their performance in the specific category (i.e., staffing hours, type of ownership and complaints). The maximum number of bonus points available for each facility is 100.  

Please Note: the CNA and Nursing hour averages for facilities that offer only short-term rehab/nursing are quite different from those that offer both short and long-term care.  Therefore, short-term facility staffing values were considered independent of those that provide both short and long-term care. 

Below you can read more about the specific categories that comprise the "Bonus Quality Score."  Also, some of the research supporting the importance of each factor is noted. 

CNA Hours & Licensed Nursing Hours 
Research indicates that staffing levels impact quality of care.  For example: "The preponderance of evidence, from a number of studies, using different types of quality measures, shows a positive relationship between nursing staff levels and quality of nursing home care." Source: Institute of Medicine, Division of Health Care Services, 1996.

Another example: “Our findings to date show a strong association between staffing levels and quality care. This is the first time ever that a clear relationship between staffing levels and quality of care has been demonstrated in a statistically valid way, and marks a major step forward in understanding that relationship.” Nancy-Ann DeParle, U.S. Dep’t of Health and Human Services, Testimony on Nursing Home Staffing Before Senate Committee on Aging, 2000.

The Gerontological Society of America published research which found that higher staffing levels were associated with fewer lawsuits against nursing homes.  Click here to read full article.

Type of Ownership 
Research indicates that, on average, non-profit facilities provide better care and higher levels of staffing than for-profit/investor owned facilities (American Journal of Public Health, 2001).

“Not-for-profit nursing homes are more likely to provide good care than for-profits, based on our analysis of inspection surveys, staffing, and quality indicators.”  Consumer Reports, Nursing Home Guide 2006.  

Chain vs. Single Facility 
Some facilities are independently owned. Others are part of a "chain," meaning that the facility has two or more homes under ownership or operation. Based on their detailed and thorough analysis of inspection surveys, staffing, and quality indicators, Consumer Reports concluded that “independently run homes are more likely to provide good care than chains.” Consumer Reports, Nursing Home Guide 2006.

Complaints
A "Yes" value means that the facility was cited for a deficiency related to a complaint/serious incident, according to the Dep't of Public Health.  Data covers the period of 1998-2006.  Note: many facilities may receive complaints/allegations of serious incidents, but facilities are only cited (given a “yes” value) if an investigation determines actual wrong-doing (e.g., investigation of allegation found that abuse or negligence occurred).  If a facility did not receive serious complaints or the investigation found the complaint invalid, then a “no” value is given.  Facilities lose bonus points if they have received valid complaints.

Frequency of Data Updates

Since public data on the nursing homes changes periodically, the data on BostonNursingHomeRankings.com gets updated on the following schedule:

1.) DPH Score: Updated Bi-Annually
2.) Staffing Hours (CNA and Nursing Hours): Updated Annually
3.) Complaints: Updated Bi-Annually
4.) All Other Variables: Updated Annually

Visit our glossary, for more information about terms used on BostonNursingHomeRankings.com.

Please email us at info@bostonnursinghomerankings.com if you find any data errors or have questions about our information.