Nursing home administrators are worried, and for good reason. The new Medicare nursing home comparing site at Medicare.gov/nhcompare has gone live. Nursing homes are given ratings, from one to five, in four categories. This is a simple rating system for complex elder care centers. Please use this as a tool, but use it with great care.

I knew this rating system would result in problems. Many privately run rating sites have been online for years, as have many county inspection rating sites. I've often checked the ratings and compared them to what I see and hear locally.

I write a column in a medium sized newspaper that has a broad readership in two states. I receive dozens of e-mails every day from local readers of the column, as well as readers of this site and of my other national work, so I have a fair overview of the quality of homes nationally, though not specific homes out of my area. Let's say I've heard horror stories about facilities that wouldn't last a day in North Dakota or Minnesota. There are some very bad nursing homes around the country.

However, when choosing a care center, the criteria most people instinctively use is that of the level of family satisfaction. And from what I hear and read, if the ratings of the nursing homes in my area are any example, this new Medicare rating system has a lot of tweaking to do to be useful. They need at least one other category - family satisfaction. People also need to be aware that this rating is a one-time snapshot. The numbers could be totally different in another month.

For over 15 years, I had from one to three loved ones in a home just two blocks away from where I live. I visited every day. I knew the staff at the nursing home, and still am in contact with some of them. They cared lovingly for my family members, some of whom suffered from very difficult conditions. I saw them also care lovingly for many other elders, some of whom were quite difficult to love.

Was the home perfect? No. At the time, while the physical plant was very well kept, it was in need of modernizing. That has since been done (my family jokingly calls the new addition the "Bradley Wing," as every cent my parents had went into that facility. But we have no regrets).

The remodeling was being done as my last elder, my mother, was nearing death. I asked her if she wanted to have a new room, but she declined. She was used to her room, liked her window by her bed and didn't want to move. She died not long after the new wing opened.

Once the new wing opened, the staff moved residents to the new area and the rest of the building was remodeled, creating a locked memory floor, among other improvements.

Okay, I'll name the center. It's Rosewood On Broadway, in Fargo, North Dakota. Rosewood has a savvy young administrator who was first a nurse, and is not above wiping a runny nose or settling someone in a chair as he walks around visiting residents. He makes the rounds of all the floors, including the adult day care (they also have a child care center there), and knows the residents by name. They also know him as a friend.