09/16/2025
Why You Shouldn’t Rely Solely on Medicare Star Ratings When Choosing a Nursing Facility
When families begin the search for a skilled nursing or rehabilitation center, one of the first resources they often find is the Medicare Nursing Home Compare star rating system. At first glance, this tool seems like the easiest way to judge quality—after all, who doesn’t want a “five-star” facility?
But while star ratings can provide a starting point, relying on them alone can paint an incomplete or even misleading picture. Here’s why.
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1. Much of the Data Is Self-Reported
The Medicare star system relies heavily on information reported directly by facilities themselves—particularly in areas like staffing levels and quality measures. While oversight exists, self-reported data can be inaccurate or incomplete, and sometimes it reflects the way numbers are recorded rather than the care residents truly receive.
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2. Inspections Aren’t the Same Everywhere
Health inspections form the backbone of the rating system, but the process isn’t uniform across states or even survey teams. Some inspectors may be stricter, while others are more lenient, meaning that two facilities with similar issues could end up with very different star ratings simply because of where they’re located.
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3. Ratings May Be Outdated
Conditions inside a nursing facility can change quickly—new management, staffing challenges, or improvements in care programs may occur long before the ratings are updated. That means what you see on Medicare may not reflect what’s happening today.
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4. Missing the “Human Factor”
Star ratings measure compliance and clinical outcomes, but they don’t capture:
• The kindness and attentiveness of staff
• Resident and family satisfaction
• Specialized therapies or innovative programs
• The comfort and atmosphere of the environment
For families, these “intangibles” often matter just as much—if not more—than a number on a website.
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5. Rehab and Short-Term Care Aren’t Fully Represented
The Medicare system was built with long-term nursing home residents in mind. Many of the measures (like rates of pressure ulcers or long-term weight loss) don’t apply as directly to patients seeking short-term rehab after a hospital stay. As a result, the rating might not tell you much about how well a facility helps people recover and return home.
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What Families Should Do Instead
While Medicare can be a helpful starting point, it should be just one tool in the decision-making process. Families should also:
• Visit the facility in person to see the environment and observe staff interactions.
• Ask questions about staffing ratios, therapy intensity, and average length of stay for rehab patients.
• Review full inspection reports, not just the star summary.
• Speak with residents and families to hear firsthand experiences.
• Consider hospital referrals, as hospitals often know which facilities deliver strong outcomes.
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The Bottom Line
Medicare star ratings aren’t “wrong”—but they’re incomplete. Choosing a nursing facility is a deeply personal decision that requires more than a quick glance at a star system. By combining the Medicare data with visits, conversations, and deeper research, families can make a more confident and informed choice for their loved one.
