What Are Star Ratings?

The Centers for Medicare and Medicaid Services (CMS) created the Five-Star Quality Rating System in 2008 as a way to provide residents and their families with an easy-to-understand summary of three dimensions of nursing home quality: health inspection results, staffing data, and quality measure data.  These ratings were made available on Nursing Home Compare, the website CMS has created to help the public research Skilled Nursing Homes.

The Star Ratings have been refined a number of times since their inception, and now hold a special significance not only for residents and their families, but also for the folks who staff, manage, own and invest in the homes.  The media constantly references Star Ratings, so it’s important for stakeholders to understand how they’re calculated, and for facilities to ensure that their ratings remain high.

Click Here to read more about the importance of Star Ratings.

How the Overall Star Rating is Calculated

The Overall Star Rating represents the facility’s high-level performance across several areas, and the chart below shows how the Overall Rating comes together. 

The Health Inspection (also called Survey) rating, which CMS views as the most important, forms the basis.  Facilities then have the opportunity to earn “bonus stars” for high ratings in both Staffing and Quality, but they may also be assessed “penalty stars” for poor performance.  Their rating can also be capped if they’re a special focus facility, or “not rated” if they’re too new, or are missing other ratings. 

Our guide provides an overview, but for detailed information, please see the detailed documentation from CMS.