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How QRS Evaluates Hospital-based Nursing Facilities

    Overview       Comparisons      Facility Inspections      Quality Profiles      Rating Scales

Go To Top Overview: Hospital-based nursing homes are usually located within a hospital. Such facilities are commonly used to provide transitional services for individuals who are recovering from a hospitalization. Others may actually provide long term care. Hospital-based facilities are compared in QRS on the basis of two dimensions or axes that measure compliance with state and federal regulations.

A brief background history of QRS development as well as answers to providers' frequently asked questions are available on the QRS Provider FAQ page.

Interpret QRS ratings cautiously. QRS nursing facility ratings are based on a reporting period that tends to indicate each facility's recent performance. QRS ratings do not indicate facility performance over the long term. Further, because QRS is only updated monthly, it is possible that very recent performance problems will not be reported. Even a facility that appears to have favorable QRS ratings may be under sanctions or penalties due to performance problems that occurred outside the QRS reporting period. The Regulatory Compliance History and Events and Actions sections of each facility's quality profile contain additional historical information that can help you to better judge the consistency of facility performance over time.

Use QRS information to help you make a nursing facility selection rather than as a short-cut to finding the LTCSearch@hhsc.state.tx.us best nursing facility. You may also contact the DADS Consumer Information Hotline at 1-800-252-8016 or via e-mail to request additional consumer information about a particular facility.

Go To TopComparisons: QRS uses comparison tables to show ratings for hospital-based nursing facilities. These comparison tables include an overall rating score for each facility. Interpret this overall score with caution. The overall rating is the simple average of the quality axis scores. It arbitrarily assigns equal importance to the quality axes. As you read individual facility quality profiles, you will need to decide whether these axes are indeed equally important to you.

Nursing facilities are listed in the comparison tables from highest overall rating to lowest. When several facilities earn the same overall rating, they appear in alphabetical order. Thus, if facilities South Village Hospital, West Oaks Medical Center and Davis Hospital and Rehabilitation Center all have the same overall rating, they will appear in the comparison table in the order Davis Hospital and Rehabilitation Center, South Village Hospital and West Oaks Medical Center.

Go To TopFacility Inspections: The Investigations and Inspection scores rate the facility's compliance with all applicable regulations and requirements.

Investigations Score: DADS investigates all complaints that come to its attention concerning nursing facilities. Substantiated complaint allegations that constitute a violation of state or federal regulations are usually cited by DADS as nursing facility deficiencies. The Investigations Score is based on the nature, severity and scope of the deficiencies cited in each facility during the preceding six months.

Inspection Score: A DADS inspection team also inspects each nursing facility at least once every 15 months (every 12 months on the average). The results of the most recent routine inspection determine the Inspection Score. This rating may not be a sensitive quality measure if the most recent inspection occurred many months earlier; the quality of any service can change markedly over the course of a year.

NOTE CAREFULLY: The number of deficiencies does not determine the compliance score; it is the nature, scope, and severity of the most severe deficiency that determines the score. A nursing facility cited for a deficiency has a right to appeal the citation, and there are occasions on which such appeals lead to the reversal of even the most severe deficiencies. Therefore, both the Complaint and Inspection ratings can appear to be poor only to suddenly improve as the result of such a reversal. In order to provide the most accurate ratings possible, all ratings are recalculated each month.

Go To Top Quality Profiles: QRS can show a quality profile that explains the facts behind the ratings assigned to a facility. This additional information may help you decide whether the facility is one that you want to consider further. The profile is a written report that includes the following:

Go To Top Rating Scales: Each QRS rating scale consists of five rating symbols. A sixth symbol, NR, is used to show that the facility could not be rated for lack of information. The rating symbols range from Most Favorable - the most favorable rating to Least Favorable - the least favorable rating. Holding the mouse pointer over any rating symbol for a few seconds will show a brief description of a rating symbol on any QRS page. Most Web browsers will show the text explanation for any picture when this is done. The precise meaning of each symbol in each rating scale is given in the tables below.


The investigation and inspection scores are based on the following scale.
Total Compliance In total compliance with regulations. No deficiencies were cited.
Substantial Compliance In substantial compliance with regulations. No cited deficiency resulted in actual resident harm or immediate jeopardy or had more than potential for minimal resident harm.
Out of compliance/No harm or jeopardy Not in substantial compliance with regulations. A cited deficiency had the potential for more than minimal harm but did not cause residents either actual harm or immediate jeopardy and did not constitute Substandard Quality of Care.
Out of compliance/Actual harm or jeopardy Not in substantial compliance with regulations and having at least one deficiency that caused actual resident harm or jeopardy to resident health or safety. A cited deficiency either caused actual resident harm or constituted immediate jeopardy to the Health or Safety of residents but did not constitute Substandard Quality of Care.
Substandard Quality of Care Substandard Quality of Care. A cited deficiency involved regulations that govern Quality of Care, Quality of Life, or Resident Behavior and Facility Practices such that: 1) there was a widespread occurrence with more than the potential for minimal harm, 2) there was a pattern or widespread occurrence of actual harm, or 3) there was immediate jeopardy to the Health or Safety of at least one resident.
No Rating Available No Rating Available.

Caution: This web site does not reflect recommendations of any specific provider by DADS. It is simply a tool that you can use to help you make a selection. Because QRS shows information from a limited time period and is updated only once each month, it may not include some important events that are either older or more recent. QRS rating systems are developed in collaboration with long term care providers and consumer advocates and may include some self-declared and unverified information.

DADS strongly encourages you to visit with providers that you consider and talk with people who receive services from them. To obtain the most recent information about a provider, contact DADS Consumer Information Hotline at 1-800-458-9858. For general inquiries, send an email to LTCSearch@hhsc.state.tx.us.

Last Update 02/22/2017