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Nursing Homes

How Nursing Homes are rated

What goes into the CMS rating for nursing homes — and how to use it.

The three building blocks

A nursing home's overall rating is built from three components: health inspections (on-site state surveys of safety and care), staffing (how many nurse and aide hours each resident gets per day, adjusted for resident needs), and quality measures (clinical outcomes for long- and short-stay residents).

How the overall star is calculated

CMS starts with the health-inspection rating, then moves the overall star up or down based on staffing and quality-measure performance. Strong staffing can add a star; poor inspections cap the overall rating.

What to watch for

Staffing and recent inspection results are often the most actionable. A facility flagged with an abuse icon, or with many fines and penalties, deserves extra scrutiny — but always confirm the current situation directly with the facility.

Source: CMS Five-Star Quality Rating System.

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