Five-Star Quality Rating System

CMS created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily and to help identify areas about which you may want to ask questions. The Nursing Home Care Compare website features a quality rating system that gives each nursing home a rating of between 1 and 5 stars. Nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average. There is one Overall 5-star rating for each nursing home, and separate ratings for health inspections, staffing and quality measures.

Caution: No rating system can address all of the important considerations that go into a decision about which nursing home may be best for a particular person. Examples include the extent to which specialty care is provided (such as specialized rehabilitation or dementia care) or how easy it will be for family members to visit. Visits can improve both the residents' quality of life and quality of care, it may be better to select a nursing home that is very close over one that may be, rated higher but far away. Consumers should therefore use the website together with other sources of information for the nursing homes (including a visit to the nursing home) and State or local organizations (such as local advocacy groups and the State Ombudsman program).

The Downloads section below contains the Five-Star Quality Rating System Technical Users' Guide that provides in-depth descriptions of the ratings and the methods used to calculate them.

The Related Links section below contains a link to the Nursing Home Care Compare website where you can find and compare nursing homes near you.

What’s New -

January 18, 2023

QSOG Memo QSO-23-05-NH, adjusting quality measure ratings based on erroneous schizophrenia coding, and posting citations under dispute, has been posted. CMS will be conducting audits of schizophrenia coding in the Minimum Data Set data and, based upon the results, adjust the Nursing Home Care Compare quality measure star ratings for facilities whose audits reveal inaccurate coding. Also, to be more transparent, CMS will now display citations under informal dispute on the Nursing Home Care Compare website.

January 7, 2022

QSOG Memo QSO-22-08-NH, Nursing Home Staff Turnover and Weekend Staffing Levels, has been posted. This memo describes the addition of staff turnover and weekend staffing measures to Care Compare. This information will be added to the Care Compare website in January 2022 and used in the Nursing Home Five-Star Quality Rating System in July 2022.

December 4, 2020

QSOG Memo QSO-21-06-NH, Updates to the Nursing Home Compare website and Five-Star Quality Rating System, has been posted. This memo describes changes to the Rating System to be implemented in January 2021. Specifically CMS will resume calculating nursing homes Health Inspection and Quality Measure ratings on January 27, 2021.