Most nursing home comparisons happen under time pressure. A discharge planner has six hours. A family is on the phone with their mother in the hospital and needs to make a call before the end of the business day. A placement agent has eleven referrals and one of them needs a shortlist sent to the family before dinner.
This is the comparison routine I recommend when 90 seconds is what you have. It will not catch every problem, but it will catch the big ones, and the buildings that pass it are rarely the ones that surprise you later.
The six checks
Run these six checks, in this order. Most can be answered in under ten seconds each on a well-organized facility profile.
1. SFF or SFF Candidate? (5 seconds)
This is the hard stop. If the building is on the Special Focus Facility list or the SFF Candidate list, you don't proceed without explicit, documented family acknowledgment and a documented clinical reason for considering it anyway.
A 4-star building can briefly land on the candidate list after a star recalculation. A 1-star building may not be on the list at all because the candidate pool is constructed differently than the star formula. Check the badge regardless of the star.
(Background: Florida Special Focus Facilities.)
2. Overall Five-Star, plus the components (10 seconds)
Note the overall star, then look at the three components: Health Inspection, Staffing, Quality Measures.
A 4-star overall built on 3-Health, 5-Staffing, 5-QM is a different building than a 4-star overall built on 4-Health, 4-Staffing, 4-QM. The first is a building with a recent survey hit that is being held up by good staffing and clinical metrics. The second is steady across the board.
The component split tells you what story to read more carefully.
3. Most recent survey: any G-or-above tags? (15 seconds)
Skim the most recent two surveys. Are there any deficiencies at scope/severity level G or above? G means "actual harm to a resident was documented." Below G is "potential for harm," which is real but a different category.
A clean G-or-above record across the most recent two surveys is a strong signal. A single G in the most recent cycle is a question to ask. Multiple Gs, or any H/I/J/K/L, is a slow-down moment.
(Background: How to read an AHCA 2567 like a pro.)
4. Total nurse HPRD: weekday and weekend (15 seconds)
Look at the staffing numbers. Total nurse HPRD above 3.5 (case-mix adjusted) is strong. Below 3.0 is a yellow flag. The federal mandatory minimum is 3.48 with a 0.55 RN floor.
Then look at the weekend number. If the weekend HPRD is more than 0.5 below the weekday HPRD, the building runs lean on weekends — a real operational signal that won't always show up in any other metric. If the weekend gap is small or non-existent, that is a quietly excellent operation.
(Background: Staffing HPRD.)
5. Recent ratings trend (10 seconds)
A snapshot doesn't tell you the trajectory. Look at the trend across the most recent four to eight quarters.
A building that was 4-star a year ago and is now 3-star is on a downward trajectory; the next quarter is more likely to be 3 than 4. A building that was 3-star a year ago and is now 4-star is moving in the right direction.
Trajectories continue more often than they reverse. Bet accordingly.
6. Anything specialty-relevant for this resident? (15 seconds)
Does the resident need something specific — memory care, a vent unit, dialysis on-site, a specific language capability, religious affiliation, hospice contracts? Buildings vary wildly on these specifics, and a building that fails on a specialty fit is worse than a slightly lower-rated building that nails it.
This is the check that most quantitative comparison routines miss. Don't skip it.
What the 90 seconds doesn't catch
Three things this routine will miss:
- Pending litigation or pending enforcement actions that haven't yet shown up in published data.
- Recent leadership changes (new administrator, new DON) which are predictive of operational change in the next 6–12 months but typically lag in the public data.
- Family experience reality — what walking in the front door feels like, how the staff interact with residents, smell, sound, light. This is not in any dataset and you will only know it from a tour.
For a candidate the resident or family is seriously considering, these three are exactly what the in-person tour is for.
How ClearLTC supports this routine
Every facility profile is laid out in this order. SFF/Candidate badges are surfaced inline. Five-Star components are visible without scrolling. The most recent survey is summarized with G-or-above tags highlighted. HPRD weekday/weekend is in one chart. The 8-quarter trend is in another. Specialty filters (memory care, vent, dialysis, language, religious affiliation) are first-class search filters.
The Compare view runs the same routine across two facilities side-by-side. The Workspace view runs it across as many as fit on the screen.