Five-star quality rating
How we calculate ratings
We create the overall 5-star rating for nursing homes based on 3 parts: 1) Health inspections 2) Quality measures (QMs) and 3) Staffing. Star ratings for each part and the overall rating range from 1 star to 5 stars, with more stars indicating better quality.
We assign the overall 5-star rating in these steps:
Step 1: Start with the health inspections rating.
Step 2: Add 1 star if the staffing rating is 4 or 5 stars and greater than the health inspections rating. Subtract 1 star if the staffing rating is 1 star.
Step 3: Add 1 star if the quality measures rating is 5 stars; subtract 1 star if the quality measures rating is 1 star.
Step 4: If the health inspections rating is 1 star, then the overall rating cannot be upgraded by more than 1 star based on the staffing and quality measure ratings.
Step 5: If a nursing home is a special focus facility, the maximum overall rating is 3 stars.
We briefly describe each of the 3 parts below:
- Health inspections rating:
We base health inspection ratings on the 3 most recent comprehensive (annual) inspections, and inspections due to complaints in the last 3 years. We place more emphasis on recent inspections.
- Quality measures (QM) rating:
We combine the values on 16 QMs (a subset of the 24 QMs listed on Nursing Home Compare) to create the QM rating. QMs are derived from clinical data reported by the nursing home.
- Staffing rating:
We base the staffing rating on 2 measures: 1) Registered Nurse (RN) hours per resident per day; and 2) total staffing hours per resident per day. Total staffing includes: RNs; Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs); and Certified Nurse Aids (CNAs). 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 5-star quality rating system, please visit the Technical Users' Guide - Opens in a new window.