Medicare's 5-star rating system is the most trusted way to compare nursing home quality. Here's how it works and how to use it.
How does Medicare's nursing home rating system work?
Medicare's Care Compare assigns each certified nursing home an overall rating from 1 to 5 stars, built from three components. Health inspections reflect findings from state surveys over the past three years, weighted toward recent and serious deficiencies. Staffing measures registered-nurse and total nurse hours per resident per day, since staffing strongly predicts quality. Quality measures track clinical outcomes like falls, pressure ulcers, and hospital readmissions. Five stars means 'much above average' for the state; one star means 'much below average.' The ratings are updated regularly and freely available at medicare.gov/care-compare. They're an excellent starting point. Call 1-800-MEDIGAP (1-800-633-4427) for help reading them.
How should I use nursing home ratings when choosing?
Use star ratings to build a shortlist, not to make the final decision alone. Pay special attention to the staffing and health-inspection sub-ratings, which are harder to game than self-reported quality measures. Then dig deeper: read the full inspection report for any abuse, neglect, or safety citations, and note whether problems were recent or resolved. Finally, visit in person — ratings can't capture cleanliness, staff warmth, or how residents are treated day to day. Combine the data with what you see and hear from current families. Our specialists can help you interpret ratings and reports at no cost. Call 1-800-MEDIGAP (1-800-633-4427).