![]() The three domains are separately scored, each with highly complex scoring rules. Ratings in each domain and in the overall rating range from one to five stars, with one star reflecting the lowest performance (“much below average”) and five stars, the highest performance (“much above average”). The quality measures rating is based primarily on self-reported and unaudited resident assessment information provided by facilities.ĬMS assigns star ratings to each of the three domains, and an overall score which starts with the health survey rating and revises the overall rating downward or upward to reflect, respectively, one-star and five-star ratings on the staffing and quality measure domains. ![]() The nurse staffing rating is based on total nurse staffing (registered nurses (RNs), licensed practical nurses and nurse aides) and RN staffing and.The health survey rating is based on unannounced annual and complaint surveys conducted by state survey agencies, under contract with CMS.It provides information about three domains – health surveys, staffing, and quality measures – and an overall rating. The Centers for Medicare & Medicaid Services’ (CMS’) website Nursing Home Compare provides public information about nursing facilities that participate in Medicare or Medicaid or both. ![]() Quality measures do not reflect the quality of care residents receive. When facilities that are challenged with poor performance cite their “quality measures,” beware. The finding – that many facilities in the five states reviewed were able to boost their overall ratings in this way – undermines the validity of “quality measures” as reflecting the actual quality of care provided to residents by nursing facilities. The Center for Medicare Advocacy wanted to determine whether nursing facilities that had one-star in their health survey ratings on Nursing Home Compare were able to boost their overall ratings from one star to two stars through the designation of five stars in the self-reported quality measure domain.
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