Placing a loved one in a nursing home is among the hardest decisions you’ll ever make. Here’s how nursing homes in Virginia, DC stack up.

By Deb Belt, Patch National Staff | Feb 2, 2019 11:01 am ET | Updated Feb 2, 2019 12:02 pm ET

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WASHINGTON, DC — Putting Mom or Dad in a nursing home is one of the most complicated and emotionally painful decisions you may ever have to make. Where you live can dramatically affect the quality of care. Virginia, for example, ranks among the worst states for nursing home care, while the District of Columbia ranks among the best, according to an analysis of the latest data from the Centers for Medicare & Medicaid Services.

Care facilities in Virginia ranked 40th with a total score of 3.2 on a 5-point scale, according to the analysis by, which surveyed more than 900 people about the quality of nursing home care across America, and also where patients experience the most pain. Washington, D.C., ranked second with a total score of 3.89.

In the Commonwealth, 13.7 percent of nursing home patients are short-term care, compared with 6.5 percent in long-term care. In DC, 5.1 percent of patients are in short-term care, while 0.8 percent are long-term care.

The ranking of nursing homes in our state is based on how well they performed on the Centers for Medicare & Medicaid Services, or CMS, five-star, quality rating system. Nursing homes were rated for their performance in three areas:

  • Health inspections, based on the number, scope and severity of deficiencies identified during the two most recent annual inspection surveys, as well as substantiated findings from complaint investigations;
  • Staffing, based on two measures, solely related to the nursing staff: registered nurse hours per resident per day and total staffing hours (registered nurse and licensed practical nurse) per resident per day. (Other types of nursing home staff, such as clerical or housekeeping staff, are not included in this rating calculation);
  • Quality measures, based on the performance of 16 quality measures: seven for short-term stay residents and nine for long-term stay residents.

The top 10 states for nursing home quality are:

  1. Hawaii — 3.93
  2. District of Columbia — 3.89
  3. Florida — 3.75
  4. New Jersey — 3.75
  5. Colorado — 3.74
  6. Delaware — 3.73
  7. Connecticut — 3.73
  8. Minnesota — 3.72
  9. North Dakota — 3.71
  10. Idaho — 3.71

The 10 worst states for nursing home quality (No. 1 is the worst) are:

  1. Texas — 2.68
  2. Oklahoma — 2.76
  3. Louisiana — 2.8
  4. Kentucky — 2.98
  5. Georgia — 3.01
  6. New Mexico — 3.07
  7. North Carolina — 3.07
  8. Missouri — 3.12
  9. West Virginia — 3.15
  10. Illinois — 3.18

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National studies show that 75 percent of older adults prefer to age in their own homes with the assistance of family, friends or professional caregivers. But there may come a time when aging relatives need more care, and that’s where nursing homes come in. There are about 15,600 nursing homes in the United States that together have 1.7 million beds and 1.4 million patients.

Of those who answered the survey, 71 percent said they were satisfied with the care their loved one is receiving in a nursing home, 18 percent said they were dissatisfied and 11 percent said they were neither satisfied nor dissatisfied.

One of the primary advantages to placing a family member in a nursing home is that they have access to skilled care around-the-clock, but that doesn’t mean they are continuously monitored. On average, the report found, each patient receives about four hours of personalized care per day.

In addition to a higher level of medical attention at skilled care facilities versus assisted living facilities or in-home care, benefits of 24-hour care include meal services and assistance with strenuous activities.

More than half of those surveyed said they would provide full-time care to an aging relative if possible, but another 25.5 percent were unsure.

Respondents were also surveyed concerned the most common requests made during a relative’s nursing home stay. Topping the list was requesting special food items at just over 20 percent, followed by extra attention at 19 percent and environmental accommodations (e.g., room temperature) at 17 percent. And 42 percent of respondents said they asked for some type of special accommodation to make their loved one’s stay more pleasant.

Nursing home patients’ well-being also is affected by how often their loved ones visit. The survey also revealed some interesting findings about how people feel about putting their loved ones in a nursing home, as well as how they’d feel if the situation were reversed.

It found that respondents visited their loved ones six times a month on average, staying an average of one hour and 27 minutes per visit. Well over half of the respondents (55 percent) didn’t think they visited enough, averaging only four visits a month. And the 45 percent who were satisfied they were seeing their loved ones enough visited nine times a month.

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