About Nursing Home Compare

Nursing Home Compare, which is managed by the Centers for Medicare and Medicaid Services (CMS), provides quality ratings for each of the nation's approximately 16,000 Medicare and/or Medicaid-certified nursing homes. Each facility is rated from a low of one star to a high of five stars based on three critical areas: health inspection results, quality measures and staffing levels. An overall rating is also provided.

More information about the Nursing Home Compare rating system is available from the National Consumer for for Quality Long-Term Care.

How CMS calculates ratings

CMS assigns the Overall Five-Star rating using the following steps:

  1. Start with the Health Inspections Rating.
  2. Add 1 star if the "Staffing" rating is four or five stars and greater than the Health Inspections Rating. Subtract one star if the "Staffing" rating is one star.
  3. Add one star if the "Quality Measures" rating is five stars; subtract one star if the "Quality Measures" rating is one star.
  4. If the "Health Inspections" rating is one star, then the "Overall" rating cannot be upgraded by more than one star based on the "Staffing" and "Quality Measure" ratings.
  5. If a nursing home is a Special Focus Facility, the maximum "Overall" rating is three stars.

What are the ratings?

  • Health Inspections rating is based on the three most recent comprehensive (annual) inspections, and inspections due to complaints in the last three years. We place more emphasis on recent inspections.
  • Quality Measures (QM) rating combines the values on nine QMs (a subset of the 19 QMs listed on Nursing Home Compare) to create the QM rating. QMs are derived from clinical data reported by the nursing home.
  • Staffing rating is based on two measures: the number of registered nurse (RN) hours per resident day and the total staffing hours per resident day. Total staffing includes RNs, licensed practical nurses or licensed vocational nurses, and certified nurse aids. Staffing data are submitted by the facility and are adjusted for the needs of the nursing home residents.

For more in-depth information of the Five-Star Quality Rating System, please read the Technical Users' Guide.