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Iredell Skilled Nursing Excels in the Latest Federal Evaluation, Earns 5-Star Rating

Tuesday, June 11, 2019

Iredell Health System’s Hospital-Based Skilled Nursing Facility recently earned an overall five-star rating from the Centers for Medicare & Medicaid Services (CMS), a rating system created to help consumers, their families, and caregivers compare skilled nursing facilities more easily.

“We focus heavily on the patient care we provide on a day-to-day basis,” said Lindsay Smith, Iredell’s Skilled Nursing administrator. “We make sure we meet the needs of each resident. We don’t focus every day on a five-star rating, but on continually providing care with a compassionate heart.”

CMS’s rating system shows how skilled nursing facilities have fared in staffing standards, quality measurements, and recent health and safety inspections. CMS lists the results on its online tool Nursing Home Compare, allowing consumers to compare and select skilled nursing facilities based on their level of safety, quality of care, and staffing ratios.

The per-patient state and national averages showed Iredell Skilled Nursing, the only Iredell County skilled nursing facility to receive an overall five-star rating, to have more successful patients return home, fewer re-hospitalizations, fewer emergency room visits, fewer falls with injury, and higher delivery of needed vaccinations.

“We are always challenged with how we can do better, how we can provide the best possible healthcare, and how we can make a difference to those we serve,” said Jessica Hicks, Iredell Skilled Nursing’s director of nursing. “We deliver care based on our values: compassion, integrity, collaboration, and respect. We value those we care for, and we value each other.”

Similar to the crisis of an emergency hospital visit, the subsequent need for post-acute care from a skilled nursing facility can arise just as unexpectedly. For those with little time to spare, Nursing Home Compare provides a platform to easily research options.

“We are honored to have our Skilled Nursing Facility receive a five-star overall rating from CMS,” said Iredell Health System President & CEO John Green. “The rating is a reflection of our commitment to providing our community with an exceptional post-acute care option. We are dedicated to serving local patients and their families and will remain devoted to meeting and exceeding their healthcare needs.”

Previously, Iredell Skilled Nursing’s patients were all former Iredell Memorial Hospital patients, but its patients now come from medical facilities inside and outside Iredell County, including other area hospitals and medical centers. The facility’s five-star evaluation is leading to a high volume of referrals. As of June 6, the facility had 34 patients.

“We don’t do this to receive awards or stars; we do this because we know that our patients deserve nothing less,” Hicks said. “We do this because we are servants to the citizens of Iredell County and all those who choose us.”

To utilize the ratings, compare facilities, and view the surveys performed by CMS inspectors, visit

Nursing Home Compare

Despite more than 15,000 skilled nursing facilities fulfilling requirements to serve Medicare patients, the quality of rehabilitation care varies greatly, making the federal government’s spotlight on the facilities invaluable to consumers.

Patients needing post-acute care are welcoming the rating system’s in-depth measurements, recognizing that the decision directly affects their speed of recovery and prospect of living independently.

Nursing Home Compare provides a rigorous evaluation of skilled nursing facilities’ performances broken down by staffing levels, state health inspections, and a broad range of quality measures such as patient injuries, hospitalizations, and medication management.

Staffing levels

This year, CMS heightened its rating system’s staffing standards, including how often a registered nurse was onsite. The update dropped the ratings of thousands of skilled nursing facilities nationwide.

“Nurse staffing has the greatest impact on the quality of care nursing homes deliver, which is why CMS analyzed the relationship between staffing levels and outcomes,” the agency stated. “CMS found that as staffing levels increase, quality increases.”

Iredell Skilled Nursing’s total number of licensed nurse staff hours per resident per day amounted to 4 hours and 22 minutes, while the North Carolina average was 1 hour and 31 minutes. Iredell also averaged 16 minutes for the amount of time a physical therapist spent with a patient per day, while the state average is 5 minutes.

Health inspection rating

CMS based its health inspection star rating on the three most recent health inspection surveys, in which health care professionals inspect each facility annually. Iredell Skilled Nursing had only one health citation, while the state average was 6.3.

Quality measures

CMS assigns skilled nursing facilities a quality of resident care star rating based on their performance on certain measures, reflecting the short-stay quality of care delivered to temporary residents seeking to improve their health status and return home.

Smith explained ways her staff’s performance resulted in five-star quality measures.

“The documentation our nursing staff keeps is helping our quality measures grow,” she said. “And we are monitoring the overall acuity of the residents. So, if we feel a resident is struggling with communication, we’re immediately notifying the physician by asking, ‘How can we alter the treatment to help the patient be more alert and oriented?’”

Iredell Skilled Nursing’s percentage of short-stay residents re-hospitalized after admission was 14.7 percent, while the state average was 22.3 percent. The state’s percentage of short-stay residents who later had an outpatient emergency department visit was 11.5 percent, while Iredell Skilled Nursing totaled 2.5 percent.

While performing well on technical measures, Iredell Skilled Nursing’s team members strive to never abandon their focus on providing personalized care.

“I tell our staff it takes a special person to provide this care to people who have so many comorbidities, and their passion shines every day,” Smith said. “They are invited to patient funerals. They are invited to birthday parties. And when patients leave here, many of them and their families continue to reach out to us or volunteer. We’ve been fortunate and blessed to have team members who truly care.”