How CMS star ratings work
Reviewed by the KELN editorial team
Last updated:
The Centers for Medicare and Medicaid Services (CMS) rates nearly every certified nursing home from 1 to 5 stars. These are often called the Medicare ranking of nursing homes. KELN shows these ratings exactly as CMS publishes them.
The four ratings
- Health inspections: based on the last few years of state inspections and complaint investigations. Homes are compared with others in the same state.
- Staffing: based on nurse and aide hours per resident per day from payroll data, plus staff turnover.
- Quality measures: based on clinical outcomes such as falls, pressure ulcers, and returns to the hospital.
- Overall: starts from the health inspection rating, then adjusts up or down for staffing and quality.
What the stars do not tell you
Stars do not measure how a home feels, the food, or how well it fits a particular person. A missing rating usually means the home is too new or had too little data. Some homes under special focus are not rated.
Using ratings well
Treat ratings as a screening tool. Look at the health inspection rating closely, read inspection reports on Medicare.gov, and visit in person. See how to compare nursing homes.