CMS Revises Rating System for Nursing Home Compare Website

February 17, 2015 in News

On Thursday, CMS announced that it has updated the rating system for its Nursing Home Compare website in a way that makes it harder for facilities to receive top scores, the New York Times reports.


Medicare’s Nursing Home Compare rating system is used to rate nursing home facilities. The best possible rating Medicare can give to a nursing home is five stars.

In August 2014, a Times investigation found that the star-rating system often is based on incomplete information and can therefore mislead consumers and other stakeholders about nursing homes’ conditions. According to the investigation, ratings largely are based on self-reported data from the facilities that are not verified by the federal government, including staff levels and quality measures.

Details of the Changes

The updated ratings build off of earlier revisions, according to the Times. Last October, the government said it planned to require nursing home facilities to report staffing levels quarterly as part of a federal audit.

Under the adjusted ratings, CMS will:

  • Add quality measures about appropriate use of antipsychotic medications (Thomas, New York Times, 2/12);
  • Increase its use of on-site visits by state survey agencies as a way to assess the information the facilities report;
  • Raise performance standards for facilities to receive a high ranking; and
  • Require facilities to earn a minimum of three stars for ratings related to staffing levels for registered nurses, licensed practical nurses and certified nursing assistants (Rice, Modern Healthcare, 2/13)

Federal officials expected scores would drop for many facilities. Facilities were able to view their new scores last week, and the public will be able to review them on Friday.


Mark Parkinson — president and CEO of the American Health Care Association, which represents for-profit nursing homes — said facilities “are concerned the public won’t know what to make of these new rankings.” He added, “If centers across the country start losing their star ratings overnight, it sends a signal to families and residents that quality is on the decline when in fact it has improved in a meaningful way.”

CMS official Thomas Hamilton said the ratings website will explain the changes (New York Times, 2/12).

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