The Nursing Home Five Star Rating: How does it compare to resident and family views of care?

May 21, 2014


  • Jane K. Straker
  • Robert A. Applebaum

In 2008, the Centers for Medicare and Medicaid Services (CMS) implemented a five-star rating system of nursing homes in the United States. These star ratings have been widely publicized both by CMS and the national and state media. Although the components of the star rating system take into account various dimensions of quality, satisfaction of nursing home residents and their families is not taken into consideration. The current study compares the CMS star rating system to nursing home satisfaction data reported by residents and their families in Ohio. Findings indicate that the star rating system does not adequately reflect consumer satisfaction. We recommend that the star system be refined to include a consumer component.

The Gerontologist, 56(2), 234-242. doi: 10.1093/geront/gnu043


  • Care Management
  • Long-Term Care Facilities