Nursing Home Ratings: Not Always A Good Indicator! But What Is?

Nursing Home Negligence

The federal government has a five-star rating scale for nursing homes which might seem simple enough to use; the more stars the better! But that really isn’t always the case. For example, a large majority of the homes that have been rated as a 1-star home but actually improved in the past few years have yet to advance past a 1-star rating.

This is troubling though considering that the Centers for Medicare and Medicaid Services (“CMS”) who administers the rankings, say that a nursing home ranked at 1-star is “much below average” and has consistent problems such as dirty equipment and linens, mistreatment, and unlicensed caregivers or specialists.

Of the other rankings, 5-stars means “much above average,” 4-stars means “above average,” 3-stars is “average,” and 2-stars is “below average.” Here is a link with some of the star-ranking information: Additionally, CMS uses this 5-star rating system with a “curve” grading scheme within each state. Meaning, that no state will have all 5-star nursing homes and no state will have all 1-star nursing homes; they are all compared together. The top ten-percent in each State receives a 5-star rating. These are the homes with the lowest ten-percent in terms of health inspection deficiency scores. The middle seventy-percent of facilities receive a rating of 2, 3, or 4-stars with an equal number in each rating category. Finally, the bottom twenty-percent receive a 1-star rating.

So what are some of the indicators for improvement if you are currently seeking a nursing home for a loved one? Well yes, do use the star system because that is the easiest way to start. But also do research on the homes and look for violations by the Department of Health. In fact, homes actually need to have the violations posted in an open area accessible to all.

Another good indicator would be looking at the experience of the staff. Make sure the staff are who they say they are. Basically, make sure they are actually doctors, nurses, specialists, etc. But also make sure they do not have any complaints against them by the Department of Health or licensing agency.

Moreover, look at the overall patient satisfaction of the current residents. They are the best indicators of the home’s abilities. Don’t be afraid to ask and be aggressive on seeking a tour by the nursing home staff to see if residents look content, the facility is clean, people are walking around and not isolated to rooms, and other indicators.

But what do you think?! I welcome your phone call on my toll-free cell at 1-866-889-6882 or you can drop me an e-mail at . You are always welcome to request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website at