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What is the Medicare Five Star Rating System?

What is the Medicare Five Star Rating System?

What is the Five Star Rating System?

The system awards skilled nursing providers a rating of one to five stars, with five the highest possible rating. The overall rating is based on three areas, each of which also gets a star rating.

Factors that determine a provider’s Medicare 5 Star rating include:

  1. Health Inspections. Data from the last three years of onsite inspections is collected. The most recent data weighs more heavily in the overall Health Inspections star rating. 
  2. Staffing. The number of hours of nursing care every resident receives each day is also factored into the score. 
  3. Quality Measures (QMs). Medicare considers there to be 11 different criteria for measuring the quality of care. The QMs cover both physical and clinical aspects of care, including the use of antipsychotic drugs.

How is the Rating System Used?

Nurses and doctors in hospitals often use the Medicare ratings when making their discharge referral decisions. Individuals may also use the rating system as part of their overall decision-making process when they need skilled nursing. If you’d like to look up a skilled nursing service near you, there’s a tool on the Medicare website where you can search by location or name

Keep in mind, however, that you still need to do your homework and make in-person visits to each skilled nursing care center.

There Are Limitations to the System

The Medicare rating system is a step in the right direction, but it’s still important to be an informed consumer. No one rating system can convey everything you’ll need to know. Let the star ratings be a starting point in your search for skilled nursing, but don’t end your investigation there. 

Many skilled nursing settings look good on paper but may lack what you’re looking for. Likewise, some get low star ratings but are more in line with what you seek. 

Take the time to visit the candidates on your short list. Not everyone has the luxury of a lengthy decision-making process, but make the best of the time you have by talking to staff and residents. You can learn a lot beyond what the Medicare Five-Star Rating system reveals. 

Some families will make multiple visits, even arriving unannounced to get the real flavor of the quality of service. 

Visit Five Star Senior Living 
If you or a senior loved one needs assisted living care, we encourage you to visit a Five Star Senior Living community near you. There, you’ll get to see the many ways our caregivers help seniors live their best life. 

Not sure if assisted living is what your senior loved one really needs? Visit us online to take a look at the services we offer. From independent living to assisted living and memory care, our continuum of care means seniors receive the care and service they need to live their best life. 

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