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The Five-Star Quality Rating System is a tool to help consumers select and compare skilled nursing care centers.  Created by the Centers for Medicare & Medicaid Services (CMS) in 2008, the rating system uses information from Health Care Surveys (both standard and complaint), Quality Measures, and Staffing. The Nursing Home Compare website features the rating system. 

On March 5, 2019, CMS announced many new changes to its Five-Star Quality Rating System that will be published on Nursing Home Compare in late April. The latest changes include updated thresholds for assigning stars (or moving the “goal posts” back) for both the staffing and quality components of the system that will abruptly cause significant changes.

To read AHCA's position on the latest changes, click HERE.

These changes build on modifications implemented by the agency in 2015. Below is a brief timeline leading up to the recent changes:

  • October 2014: The President issued an executive action instructing CMS to make changes to the system.
  • February 12, 2015: CMS announced changes to the Five-Star Quality Rating System that impacted how CMS assigns stars for both the Staffing and Quality Measure components. 
  • March 3, 2016: CMS announced the addition of new Quality Measures on Nursing Home Compare and Five-Star.
  • April 27, 2016: CMS published six new Quality Measures on its Nursing Home Compare website. There are now 15 long-stay and nine short-stay QMs on the website. 
  • July 2016: CMS added five new measures and incorporated other changes to Five-Star.



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