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Last reviewed 2026-10-14

How to choose a nursing home using CMS star ratings

What Medicare’s 1-to-5 star ratings measure, and what a tour still has to answer.

This is general information, not a coverage decision and not medical advice. Rules change, and a Medicare Advantage plan can differ from Original Medicare. Confirm a specific stay with Medicare, the plan, the hospital discharge planner, or your county Aging and Disability Resource Connection.

Medicare rates nursing homes from 1 to 5 stars. In Your Guide to Choosing a Nursing Home, 1 means quality much below average, 3 means average, and 5 means quality much above average. The overall rating combines health inspections, staffing, and quality measures. Medicare says the stars are not a substitute for visiting.

Read the three parts, not only the overall star

  • Health inspections reflect yearly inspections, infection-control inspections, and inspections from complaints. Care Compare can show the inspection reports.
  • Staffing uses hours worked by nurses and other staff, including registered-nurse hours, total nurse staffing, weekend staffing, and turnover. The hours are reported by the nursing home.
  • Quality measures use selected clinical measures for short-stay and long-stay residents, such as flu shots, hospital transfers, falls, and antipsychotic use. They describe the home’s average results, not one resident.

How this directory uses the rating

When a New Jersey license matched a CMS row on name and ZIP, the profile copies the overall star rating and labels it as a CMS figure. It is not our rating and it is not a ranking. If the files did not match, the profile says the CMS rating is unknown. An abuse icon, when the CMS file includes one, is repeated with a note to confirm it on Care Compare.

Before you decide

  • Open the nursing home on Medicare Care Compare and read inspections, staffing, and quality measures, not only the overall star.
  • Visit at different times of day. Medicare’s guide treats the visit as essential.
  • Ask for the latest New Jersey inspection as well. State and federal reviews are not the same document.
  • Ask who is in the building at night, and what happens when a short rehab stay is no longer covered.
  • Ignore any price or opening that is not on the profile. Those facts are not in the CMS file we use.

Sources

Listings that use these rules

Nursing homesShort-term rehab