How CMS Rates the Nation's Nursing Homes
The whole federal picture, not one facility: how CMS overall star ratings are spread across the country, why the overall number sits above the inspection record that feeds it, and how often the abuse icon appears.
What the national data shows
- Nursing homes analyzed
- 14,700
- CMS-certified
- With a CMS overall rating
- 14,568
- 99.1% of all
- Rated 5 stars
- 20.9%
- of rated facilities
- Carry the CMS abuse icon
- 10.1%
- of all facilities
The national distribution of CMS overall star ratings
CMS overall star rating — all rated nursing homes
How many facilities sit at each star level, nationally.
Of 14,568 rated facilities, 19.8% are one-star and 20.9% are five-star. 132 facilities carry no CMS overall rating and are excluded from the percentages.
CMS-reported data · site-calculated context, not a CMS rating
Methodology
Why the overall star is not the inspection record
The overall rating blends three things; the inspection is only one.
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.
Ownership structure of the nation's nursing homes
Nursing homes by ownership type
How the sector splits between for-profit, nonprofit, and government operators.
CMS-reported data · site-calculated context, not a CMS rating
Methodology
How often the CMS abuse icon appears
CMS flags a small share of facilities with an abuse icon when recent inspections cited abuse or potential for harm. In this snapshot 1,482 facilities — 10.1% of all14,700 — carry the icon. It is uncommon by design, which is exactly why it is worth checking on any facility you are considering. See what the CMS abuse icon means.
Limits of this analysis
What the public data can and cannot tell you.
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.