Medicare's Care Compare helps people examine nursing home quality information. The CMS Five-Star Quality Rating System includes an overall rating and separate ratings for health inspections, staffing and quality measures.
For nurses helping with a transition, the goal is to make the information understandable and connect it with the person's needs. A star count should begin the discussion, not end it.
Read the separate components
The overall rating is not a simple arithmetic average of the three component ratings. CMS's July 2026 technical guide begins with the inspection rating, then applies specified adjustments for staffing and quality measures, along with additional rules and limits.
Open each component rather than relying only on the overall result. Note which findings or measures account for concerns and when the information was collected.
Keep the facility's exact name and location attached to the comparison. Do not assume that another location with a similar name has the same results.
Interpret staffing information carefully
The staffing rating uses measures of staffing levels and turnover. CMS calculates the measures using Payroll-Based Journal submissions and resident census information derived from resident assessments.
These reported measures do not tell a reader exactly who will be present on a particular future shift. Ask the facility how care is organized for the person's expected needs, including how staff obtain help when those needs change.
For someone considering employment, ask how orientation, coverage and clinical escalation work on the unit. Treat public data as a prompt for a concrete conversation.
Match the information to the person
CMS advises using ratings together with other information, including visits and state or local resources. A rating cannot capture every relevant consideration, such as specialized services or how easily family members can visit.
Medicare recommends visiting the facilities under consideration, or arranging for someone else to visit. Its checklist can help organize observations and questions.
Before the visit, identify what matters most to the prospective resident. Examples might include communication support, access for visitors, rehabilitation needs or routines that affect daily life.
Ask how the facility would meet those needs rather than accepting a general statement that it provides “excellent care.”
Keep a comparison record
Use the same questions for each facility. Record the date, the person who answered and any point requiring confirmation. Distinguish public findings from what staff said during a visit.
Review inspection details and explanatory notes. If a measure or rating is unavailable, read the stated reason; do not replace it with a guessed score.
A high rating should not be treated as confirmation of an available bed, acceptance of a particular insurance plan or suitability for a person's current care requirements. Confirm those matters separately with the responsible teams.
Support a clear handoff
Once a facility is selected, use the transition process to confirm that it has received the needed clinical information and understands the agreed care arrangements.
For workforce and care indicators beyond a star rating, compare nursing-sensitive quality indicators.
Related pages cover skilled nursing facility transitions, long-term care nursing and facility ownership.
Sources
- Five-Star Quality Rating System (accessed 2026-09-17) — CMS.
- Five-Star Quality Rating System Technical Users' Guide (accessed 2026-09-17) — CMS, July 2026.
- How Do I Choose a Nursing Home? (accessed 2026-09-17) — Medicare.gov.