Five-Star Rating Calculator
Set the three CMS domain ratings to see the overall star rating. To score a domain from its inputs (citations, staffing levels or quality measures), switch it to Calculate.
How the overall rating is built
- Start with the health inspection rating.
- Add one star if staffing is 5 stars; subtract one if it is 1 star.
- Add one star if quality measures are 5 stars; subtract one if they are 1 star.
The result stays between 1 and 5 stars. When health inspections are 1 star, the other two domains can raise the overall rating by one star at most. The abuse icon caps health inspections at 2 stars (so overall at 4), and a Special Focus Facility gets no ratings.
What drives each domain
- Health inspections
- Each citation earns points by severity and scope. The latest standard survey counts three-quarters and the one before it one-quarter. Homes are then ranked within their state: the best 10 percent get 5 stars and the bottom 20 percent get 1. See Five-Star by State for every state’s cut points.
- Staffing
- Six measures (nurse and RN hours, weekend hours, turnover and administrator departures) earn up to 380 points on fixed national bands. Days with no RN or late staffing data force 1 star.
- Quality measures
- Fifteen long- and short-stay measures earn points against the national distribution. CMS raises the star thresholds every six months, so steady results slowly lose stars.
Questions
What is the abuse icon and how does it affect the rating?
CMS marks homes cited for abuse (tags F600, F602 or F603) at harm level on the most recent standard survey or a complaint or infection control survey in the last 12 months, or cited at potential-harm level or higher in both of the two most recent periods. The health inspection rating is capped at 2 stars, so the overall rating cannot be higher than 4 stars.
How often do Five-Star ratings change?
CMS refreshes Care Compare monthly. A health inspection rating changes when the home's score changes: a new standard survey, complaint or infection control citations, a repeat revisit, a dispute outcome, or older complaint citations moving into a lower-weighted period. Staffing uses quarterly payroll data, and quality measures use the most recent four quarters.
Why might this calculator differ from a home's rating on Care Compare?
CMS holds a health inspection rating until the home's score changes, fills in missing quality measure data with the state average, treats past non-compliance at immediate jeopardy as a G-level citation, removes duplicate citations found within 15 days of each other, and applies staffing and coding audit downgrades it does not publish home by home. The calculator applies the published method to what you enter; it is an estimate.
Estimate only, following the CMS Nursing Home Five-Star Quality Rating System Technical Users’ Guide (September 2026) and CMS’s monthly state cut points. It does not reproduce every adjustment CMS makes, looks nothing up for a particular nursing home, and is not a rating determination. BARA Analytics is independent and is not affiliated with or endorsed by CMS.