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Understanding Medicare’s nursing home rating system

If your aging parent cannot care for himself or herself, moving into a nursing home may make sense. Because you want your mother or father to be in good hands, though, you must realize that not all nursing homes offer the same level of care.

To provide insight into the quality of long-term care facilities, Medicare officials regularly rate nursing homes. Therefore, you may want to refer to Medicare’s star-based rating system when deciding which nursing home is right for your elderly loved one. While it does not tell you everything you need to know about the nursing home, Medicare’s star rating system is a good place to begin your research. Still, because the system can be a bit confusing, you must understand how it works.


Nursing home residents are prone to many medical complications. Accordingly, the Medicare rating system considers a facility’s health inspections over a three-year period. As part of this review, officials examine medication administration, food preparation and storage, patient hygiene and other health-related matters.


Medicare’s rating system also looks at the quality of the nursing home. The facility’s quality of care is vitally important. If a facility has a high percentage of residents with any of the following, it is not likely to have a high-level quality rating:

  • Unexpected hospital admissions
  • Pressure sores
  • Worsening mobility issues


Many nursing homes do not have enough staff to meet the needs of residents. Therefore, Medicare’s rating protocols require an accounting of the number of registered nurses at the facility. The system also looks at how many hours each day residents spend with nursing home staff.

The final rating

After gathering relevant information, Medicare officials assign a star rating using a five-star system. To decide how many stars are appropriate, officials begin with the nursing home’s health inspections. Then, they add or remove stars for both quality and staffing metrics.

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