BUFFALO, NY - The New York State Department of Health is out with its annual ratings of nursing homes, based on the health department’s assessment of quality, compliance, and efficiency, as well as any deficiencies cited during inspections.

Facilities are then ranked by the state in five quintiles.

The lowest-performing facilities are found in the 5th quintile, while the highest performing are found in the first.

This can be confusing because the quality measures used in the state's assessments are partially derived from the federal government's Centers for Medicare and Medicaid Services rankings, in which the rankings are presented in a numerically opposite order-- with 5 reflecting the best rating, and 1 reflecting the worst.

“The state ratings aren’t always fair because you are looking at data, and posting data information which is two years old," said Randy Gerlach, an administrator at the Schofield Residence in Kenmore and the District 10 President of the New York State Health Facilities Association.

“This information makes up the quality performance section and that information accounts for 70 points out of 100 which the state uses as a scoring system for their nursing home quality initiative,” Gerlach told WGRZ-TV.

The state stresses the ratings, while important, should only be used as a guide for those seeking to place loved ones in long term nursing care.

The Commissioner for the Department of Senior Services in Erie County agrees.

“This is one tool to use, but I recommend mostly that family members and care givers make sure to visit the facilities,” said Timothy Hogues, who added that while you can spend hours perusing data, your gut could tell you more in just a few minutes.

“We encourage folks to go to these facilities in different hours of the day to check out staffing levels, and how staff interacts with residents and one another,” said Hogues. “Note the cleanliness of it…look at it first hand, and note especially the proximity to where the residence is to where you live.”

Hogues contends the proximity between a nursing home and the homes of those who their place loved ones in a facility’s care is crucial.

“One of the most important things is to be able to have loved ones visit on a regular basis, not only so that the relative has a sense that their family still cares about them, but also because studies show that when individuals actively participate and show up regularly, the quality of the care provided to their loved one will improve.”

In many cases, but certainly not all, nursing homes in rural communities tended to score lower than their suburban counterparts in the state rankings.

“It’s a point worth noting,” said Todd Hobler, Vice President of 1199SEIU United Healthcare Workers East, a union representing over 400,000 nurses and caregivers throughout several states.

“Many rural facilities, as well as many in the inner city, are heavily Medicaid dependent in terms of their patient makeup,” he said.

According to Hobler, this can directly impact staffing levels, which he says are critical to the level of patient care.

“When you have low Medicaid reimbursement rates to for-profit operators who are trying to make a buck when there’s not a lot of bucks to be made, in a facility where 70% of their costs is for labor, the cuts being made are cuts in staffing,” he said. “So the jobs get harder and the care declines and it’s a real problem.”

Added Gerlach: “When you are in rural areas you have to consider that it’s more difficult for some facilties to recruit staff in specific outlying areas.”

Click here to view the latest ratings of nursing homes from New York State

Click here to see the federal ratings for nursing homes.