Understanding Medicare's nursing home star ratings

Medical News Today

03-07-2025

Medicare's nursing home ratings are one tool people can use to evaluate potential long-term care facilities. While they offer insight into staff levels and performance on health and quality inspections, they do not capture all aspects of a nursing home's suitability.Nursing homes are residential care facilities for individuals requiring 24-hour access to medical and personal care services. A person may require a stay in a nursing home due to their age, a health condition, a disability, or another reason that has made living alone difficult or impossible.Medicare does not cover long-term stays in a nursing home. However, it may cover short-term stays when necessary for rehabilitation. Medicare Part A does offer coverage for the first 100 days in a skilled nursing facility.To aid beneficiaries in their decision making, Medicare assigns star ratings to nursing home facilities. These ratings — and the data on which they are based — add transparency to the decision making process and help hold facilities accountable for providing substandard care.Learn what the ratings mean, how Medicare determines them, and what limitations they have.Medicare nursing home ratingsMedicare's nursing home star ratings are a sum of a facility's performance in three areas:health inspectionsstaffingquality measuresEvery facility is given a rating of 1 to 5 in each of these areas as well as an overall rating. A rating of 5 stars is considered 'much above average,' whereas a rating of 1 star is considered 'much below average.'The ratings are based on different types of information:Health inspections: This score reflects how a nursing home performs in inspections of health and safety conditions, complaints, and infection control. The most recent health inspection reports are available for review, along with any complaint reports.Staffing: This rating reflects how staffing levels (and experience) compare with the size of the resident population. It also looks at staff turnover.Quality measures: This rating reflects the care that residents receive in both short-stay and long-stay settings. »Read more:Does Medicare pay for nursing home care?Where to find the ratingsThe best place to review Medicare's nursing home ratings is through the Care Compare search tool on Medicare.gov.Users can find lists of local nursing homes by entering their ZIP code. Each facility on the list is accompanied by an overall star rating.The tool allows users to compare up to three facilities side-by-side and view a wide array of information, such as:star ratingsownership informationnumber of bedshealth inspection reportsnumber of health citationscomplaint inspection reportsstaffing summariesPlus, facilities are flagged in the results lists if they have been cited for abuse (denoted by a red hand sign) or have a history of serious quality issues (denoted with a yellow warning sign).Limitations of the star ratingsWhile Medicare's nursing home ratings offer a wealth of useful information and context about different facilities, a person should not base their care decisions on star ratings alone.Other important steps in the research process include making on-site visits and speaking with staff and residents at potential nursing facilities.Further, star ratings may not align with the experiences of residents, as they do not consider factors such as:special programmingfacility and room amenitiesfacility culturestaff attitudesTakeawayMedicare nursing home ratings give prospective residents insight into a facility's quality and help them narrow their search.Medicare bases its ratings on health inspections, staffing details, and the medical outcomes of residents.A person should use the ratings alongside in-person visits and conversations with individuals who have experience with each facility when evaluating options.Other factors that are not captured by star ratings, such as location and convenience, may play a role in someone's decision making.