State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Maryland


Sample Performance Evaluation Guide

Maryland Nursing Home Performance Evaluation Guide7

The Maryland Health Care Commission (MHCC), in consultation with the Department of Health and Mental Hygiene and the Department of Aging, produced this Guide on nursing homes with the assistance of experts in long-term care, representatives of the nursing home industry in Maryland, as well as nursing home advocates and long-term care ombudsmen. The Maryland General Assembly established the Commission to carry out several health care reforms in the State, including development of information on nursing home quality. The Commission is a public regulatory agency.

This Guide is designed to assist consumers and their families in making decisions about selecting a nursing home. It includes:

  • An introduction to selecting a facility and a Consumer's Nursing Home Checklist
  • A way to search for nursing homes and to view information about their quality of care
  • Tips about how to obtain additional information
  • Information on how to pay for a nursing home

Facility Characteristics8

Allegany Nursing and Rehab Center 
Data Source: Maryland Long Term Care Survey 
Timeframe: 2000
Facility Ownership: This Facility Maryland*
For Profit: No 65%
Change in Ownership During the Past Year: No 4%
Member of a Chain/Health System: No 62%
Name of Chain/Health System: N/A
Number of Beds: 153 128 - state average
CNA Training Program: No 43%
Medicaid-certified: Yes 93%
Medicare-certified: Yes 92%
Rehabilitation Accreditation Commission Certification (CARF): No 4%
Clinical Services:  
Dementia/Alzheimer care: Yes 93%
Rehabilitation Care: Yes 98%
Dialysis care: Yes 24%
Peritoneal Dialysis care: Yes 17%
Ventilator care: No 7%
Care for Tracheostromy Patients: Yes 80%
Catheter care: Yes 99%
Central IV therapy: Yes 80%
Total parenteral nutrition (TPN): Yes 39%
Hospice available: No 83%
Respite care offered: Yes 80%

* This column refers to the percentage of facilities in Maryland that have this characteristic.

Resident Characteristics9

Allegany Nursing and Rehab Center 
Data Source: MDS 
Timeframe: 1/02 - 6/02
Gender: This Facility State Average
Percent Male: 22% 30%
Percent Female: 78% 70%
Mean Age: 81 79
Percent Under 65: 8% 12%
Percent 65-75: 17% 16%
Percent 76-84: 30% 32%
Percent 85 and Over: 46% 39%
Functional Status:  
Percent Ambulatory: 11% 12%
Percent with No or Mild Dementia: 31% 32%
Percent with Moderate Dementia: 28% 38%
Percent with Severe Dementia: 41% 30%
Percent with Retardation: 0% 1%
Percent Requiring Feeding Assistance: 68% 60%

Quality Indicators10

Allegany Nursing and Rehab Center 
Data Source: MDS 
Timeframe: 01/02 - 06/02
 = top 20% of all facilities (fewer adverse events) 
 = bottom 10% of all facilities (more adverse events) 
 = all others 
N/A = Indicator could not be calculated because too few residents met its criteria.
Category Total N/A Range of State Rates
Clinical 9 2 7 0 0 State Graph
Psychosocial 5 2 3 0 0 State Graph
Medications 4 1 2 1 0 State Graph
Functional 3 0 2 1 0 State Graph
Facility Total 21 5 14 2 0  
Click on any of the above categories to see detailed information about the specific measures that make up the category score.

The Quality Indicators (QIs) presented here have been developed for and are being used by the Centers for Medicare and Medicaid Services (CMS - formerly HCFA). The QIs are calculated using data from the Minimum Data Set (MDS). These data are collected on each resident and submitted to CMS by the indivdual nursing homes. Please note that the QI data presented in this Guide are abstracted from the quarterly and annual resident assessments. Assessments for newly admitted residents to a nursing home are not included in the calculations.

The detailed operational definitions for these indicators used in this Guide can be viewed on the website of their developer. This site also has background information detailing the development of the indicators.

QIs were developed to assist nursing homes with identifying areas for quality improvement or to monitor progress of improvement efforts. Nursing home inspectors use information derived from the QIs to target potential problem areas. In addition to the QI information, we recommend that prospective residents seek out other sources of information, such as speaking with family, friends, and healthcare providers, and also reviewing the facility characteristics, resident characteristics, and deficiency information presented in this Guide. You are also encouraged to visit nursing homes prior to making this important decision. We caution against judging a facility based on the QI scores alone, but are confident that the scores in conjunction with other information can help prospective residents to make informed decisions.


CMS Nursing Home Quality Initiative

The federal Centers for Medicare and Medicaid Services (CMS, formerly HCFA) has committed itself to an ongoing process of quality improvement in nursing homes. As part of this effort, CMS contracted with health care experts to identify a set of measures for further testing and analysis. From this, a new set of quality measures was developed. Several of these measures utilize a more concise risk-adjustment methodology to account for the severity of illness of nursing home residents. CMS is reporting the new measures publicly for nursing homes nationwide. These quality measures for each nursing home in Maryland are reported on the CMS website, Nursing Home Compare, showing the results for a particular nursing home compared to the state average and the national average. The Maryland Health Care Commission is presenting results of the Nursing Home Quality Initiative for individual nursing homes on this website in the same format used for the Quality Indicators that it currently displays. Each nursing home's score is compared to the range of scores for all other nursing homes in Maryland. To view the CMS Quality Measures on this website, click on the box below.

Click here to go to CMS's Nursing Home Compare website to learn more about the Nursing Home Quality Initiative and how the measures are risk-adjusted:

Deficiency Report11

The Office of Health Care Quality (OHCQ) in the Department of Health and Mental Hygiene (DHMH) conducts at least one annual inspection of every nursing home in Maryland. Inspections are conducted by nurses, dieticians, and sanitarians and take an average of three to five days to complete. Surveyors review all areas of a nursing home operation including nursing, medical care, food services, cleanliness, and resident rights.

When a problem is found, surveyors determine the severity and scope of the violation. A score from A through L is assigned to each deficiency, with "A" affecting the least number of people and being the least severe and "L" affecting the most people and being the most severe. The nursing home is then notified and required to submit a Plan of Correction. If appropriate, follow-up inspections are conducted to make sure problems are corrected.

The Guide includes deficiency information for all nursing homes in Maryland that have been inspected since January 1, 2002. If no deficiency or only minimal deficiencies (scores A, B, and C) have been found during the inspection, a facility is labeled as being in substantial compliance with the regulations. For all other deficiencies, their type as well as their scope and severity are listed. The nursing home's Plan of Correction is not included, but is available on request for a small fee from the OHCQ.

If you are looking for a nursing home's inspection report that is not listed (i.e., the inspection occurred before January 1, 2002) or need additional help, please call OHCQ at 410-401-8201 or email to:

Listed below are the deficiencies that have been found by state surveyors in their most recent inspection. The information includes:

  • The date the survey was conducted;
  • The type of survey that was conducted: for example, a full inspection (which is usually the annual recertification) or a focused inspection (often a follow up of previous citations or a complaint investigation);
  • The number of deficiencies issued for substandard quality of care issues;
  • The number of deficiencies issued for all other reasons.

Further detail on the nature of the citations for any survey is available by clicking on the hyper linked "type of inspection" box entry.

Allegany County Nursing & Rehabilitation Center 
Data Source:
Timeframe: 01/01/01 - 11/01/02 
Last Update: 3/15/2003

Date of Inspection Type of Inspection Numbers of Deficiencies
  Substandard Quality of Care All Other Deficiences
07/29/02 Full Inspection 0 1
06/11/01 Full Inspection 0 0

Listed below are any specific deficiencies cited during this inspection. In the absence of any citations, it was determined that the facility was in substantial compliance with regulations.

Date of Inspection: 07/29/02 
Type of Inspection: Full Inspection

Level of Severity/Scope Description Substandard Quality of Care
Potential for more than minimal harm / Isolated (D) Facility Failed to Inform Resident, Physician and/or Family of Change in Status NO

Date of Inspection: 06/11/01 
Type of Inspection: Full Inspection

Level of Severity/Scope Description Substandard Quality of Care
NA * In Substantial Compliance * NO

For a complete summary of the deficiencies cited among all Maryland facilities, please click here.

  1. Source:, 4/1/2003.

  2. Source: http://209.219.237/01001_facilityCharacteristics.htm, 4/1/2003.

  3. Source: http://209.219.237/01001_resident.htm, 4/1/2003.

  4. Source:, 4/1/2003.

  5. Source:, 4/1/2003.

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