Veterans Affairs Nationwide Ranking of 133 VA Nursing Homes

VA Publishes Nationwide Ratings for 133 VA Nursing Homes: What You Should Know

In a landmark move toward transparency, the Department of Veterans Affairs (VA) now publishes quality rankings for its 133 VA-operated nursing homes (also called Community Living Centers or CLCs). These ratings use a 1-to-5 star system to help veterans and their families compare facilities based on environment, care, and staff performance.

How the VA Rating System Works

• VA’s ratings are based on unannounced, onsite surveys of each facility across several dimensions (environment, care, staffing).
• Facilities receive separate star ratings for environment, caregiving quality, and staff, which then inform an overall star score.
• The VA commits to annual updates of these ratings. (VA News)
• You can see these ratings via VA’s online Community Living Center (CLC) Compare tool, which includes maps, searchable lists, and comparisons with private-sector nursing homes. (accesstocare.va.gov)

This is part of a broader push from the VA toward openness. The department already publishes several internal metrics such as hospital wait times, opioid prescribing rates, executive travel, and staff accountability actions. (VA News)

What the Initial Ratings Revealed

From the first release of ratings (circa 2018):

• 34 of the 133 VA nursing homes earned a 5-star overall rating. (McKnight’s)
• 73 facilities showed no change in their ranking. (abqelderlaw.com)
• One nursing home was downgraded from 5 to 4 stars, though it maintained a strong reputation overall. (abqelderlaw.com)
• The VA pledged to raise performance at its lowest-ranked (1-star) facilities by sharing best practices and monitoring improvements. (VA News)

When compared with the private sector (as rated by CMS’s Nursing Home Compare):

• Out of about 15,487 private-sector nursing homes, roughly 29% have 5-star ratings.
• The VA system had about 26% reach 5 stars in that comparison. (McKnight’s)
• Conversely, only 8% of VA homes were rated at the 1-star level, compared to 13% of private homes. (McKnight’s)

Because VA nursing homes often care for residents with more complex medical needs (including PTSD, spinal injuries, homelessness, and chronic conditions), achieving high ratings can be more challenging. (VA News)

What the Rating System Isn’t Perfect

It’s important to recognize the limitations and criticisms of the rating system:

• The VA Office of Inspector General (OIG) has found that star ratings may not distinguish well between poor care and patients with severe disease burden. (vaoig.gov)
• The system may not fully reflect certain factors like case mix, patient acuity, or more complex conditions that VA homes often manage. (vaoig.gov)
• Some performance metrics (for example, wound care, staffing turnover, or health outcomes) are difficult to compare across different types of facilities.

Thus, while the ratings are a useful tool for comparison, they should not be the sole basis for decisions.

Using Ratings to Choose the Best VA Nursing Home

1. Start locally: Use VA’s CLC Compare map to find nearby VA nursing homes and see their star ratings. (accesstocare.va.gov)
2. Compare with private options: Check the same facilities on Medicare’s Nursing Home Compare to see how they stack up.
3. Read beyond the stars: Visit in person, talk with staff, review recent inspection reports, and interview residents if possible.
4. Ask about changes: For a facility with recent upgrades or leadership changes, ask what improvements they are making.
5. Consider specialty care: Some VA homes specialize in spinal cord injuries, PTSD, or other conditions not always served in private facilities.

Bottom Line

The VA’s publication of nursing home rankings is an important step toward accountability and transparency. The data suggests that VA homes perform nearly on par with private-sector facilities, despite often managing much more complex patients. That said, the star system has its limitations, and qualitative factors still matter greatly.

If you or a loved one is considering a VA nursing home, or would like help interpreting these ratings in light of your specific Veteran’s service record and care needs, we can assist. Please Contact us for a consultation.