How CMS Rates the Nation's Nursing Homes

CMS builds the overall five-star rating from three domains — the health-inspection survey, staffing, and quality measures. Because staffing and quality can lift a facility above what its inspections alone would suggest, the overall rating and the inspection rating frequently diverge. In this snapshot, of the 14,568 facilities CMS rates on both, the overall rating is higher than the health-inspection rating 30.5% of the time, equal 56.6% of the time, and lower 12.9% of the time.

The practical takeaway for a family: a strong overall star is not the same as a clean inspection history. Our guide on how to read CMS ratings walks through reading the component ratings, and every facility profile shows all four.

CMS flags facilities with an abuse icon when recent inspections cited abuse or potential for harm. In this snapshot 1,482 facilities — 10.1% of all 14,700 — carry the icon. Read its presence and its absence differently: when the icon is there, specific documented citations sit behind it and are worth reading first; its absence is the ordinary case for the remaining 89.9% and says nothing about the rest of a facility’s record. See what the CMS abuse icon means and our report on how common it is, and where.

These figures describe a dated CMS snapshot, not live conditions, and CMS star ratings summarize past data rather than judge current care. Facilities without a rating are excluded from rating percentages, not treated as low. Nothing here is a recommendation about any individual provider. Confirm the current record on Medicare’s Care Compare. Methodology and data cadence: Methodology, Data updates.