What You Need to Know About the Nursing Home Rating System

| May 29, 2020 | Firm News

When deciding on a nursing home or assisted living facility for your loved one, you want to get a snapshot of the level of care they’ll receive.

An important resource to leverage when doing your research is the Nursing Home Rating System.

If you’re unfamiliar, The Centers for Medicare & Medicaid Services (CMS) have created a Five-Star Quality Rating System to help consumers compare and select nursing homes.

The system is used to give nursing homes an overall rating of 1 to 5 stars.

In addition to the overall rating, the facility will receive a star rating for three key areas:

  • Health Inspections
  • Staffing
  • Quality Measures

To start your research, head over to medicare.gov and pay close attention to facilities with at least three stars and avoid any with a one- or two-star rating.

To give you a better understanding of what to look for, you’ll want to understand how the facilities are scored.

Let’s take a look at the three key areas:

Health Inspections

This includes the three most recent inspections and investigations due to complaints. The information is pulled by trained, objective inspectors who visit the facility and follow a defined process to understand the extent to which the nursing home meets or falls short of Medicaid and Medicare’s minimum quality requirements. Please note the most recent survey holds more weight than the surveys in the past two years.


This rating takes into account the number of Registered Nurses (RNs) that are working each day compared to the number of residents as well as the total staffing hours of RNs, Licensed Practical Nurses (LPNs) and Nurse Aides.

Each of these positions serves a different purpose and offer a unique level of care that’s needed in nursing homes on a daily basis.

To get an overall 5-star rating for staffing, the nursing home must achieve 5 stars for their number of RNs and 5 stars for their total staffing hours.

Quality Measures (QMs)

Quality is measured on an ongoing basis and includes information based on 15 different clinical and physical measures for the residents.

The QMs offer insight into how well the nursing home cares for its residents on a daily basis.

QMs are in place to make sure necessary care is being given to the residents and the facility as a whole is free of abuse and neglect.

There are many signs of abuse and neglect, however, some of the examples of QMs that factor in the rating are the percentage of residents:

  • With pressure ulcers that are new or have worsened
  • Who are suffering from dehydration
  • Who have developed infections of the lung, urine, or even from a sore
  • Experiencing unexplained weight loss or a decrease in appetite or awareness
  • Who have fallen and experienced a major injury

Though the rating of a nursing home is important, it shouldn’t be the only deciding factor.

As we mentioned in our previous blog, there are other elements to consider when making the decision about care.

If you feel your loved one is a victim of neglect or abuse, contact us today.