The Centers for Medicare & Medicaid Services (CMS) performs a range of quality measures on nursing home. The quality of the nursing home is graded on a 5-tiered scale based on a nursing home's performance on these measures.

Star Rating

Quality Level

5 stars


4 stars

above average

3 stars


2 stars

below average

1 stars



Separate star ratings may be given for:

(1) short-term stays

(2) long-term stays

(3) overall performance


Quality measures include:

(1) staffing levels

(2) turnover in staff and management

(3) claim-based quality measures (QMs)

(4) state health inspections

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