Nursing Homes by Star Rating
CMS Five-Star Quality Rating breakdown for 14,703 Medicare and Medicaid certified nursing facilities.
The CMS Five-Star Quality Rating System assigns each Medicare and Medicaid certified nursing home an overall rating from 1 to 5 stars, based on three components: health inspection results, staffing levels, and quality measures. A 5-star rating indicates performance well above average, while a 1-star rating means performance substantially below average. The rating system is updated quarterly and is intended to help consumers compare nursing home quality.
Facilities by Overall Star Rating
Distribution of nursing homes across all five CMS quality tiers.
Most Fined Facilities
Nursing homes with the highest total CMS civil monetary penalties.
| Facility | State | Fines |
|---|---|---|
| AUTUMN MEADOWS OF CAHOKIA | IL | $955,600 |
| Nexus Pavilion at Belleville | IL | $876,893 |
| Waterview Heights Rehabilitation and ... | NY | $842,850 |
| MAJESTIC GARDENS AT MEMPHIS REHAB & SNC | TN | $810,404 |
| BRIA OF CAHOKIA | IL | $798,532 |
| AVIR AT LINDALE | TX | $774,461 |
| MOHAWK MEADOWS | NJ | $738,307 |
| BISHOP REHABILITATION AND NURSING CENTER | NY | $699,602 |
| Legacy Nursing at St. Christina | LA | $656,474 |
| Springfield Health & Rehab | VT | $637,467 |
| ELEVATE CARE COUNTRY CLUB HILL | IL | $626,850 |
| Natchitoches Nursing and Rehabilitati... | LA | $616,611 |
| RIVER VIEW REHAB CENTER | IL | $613,285 |
| BRIDGEWOOD HEALTH CARE CENTER | MO | $611,126 |
| CHICAGO RIDGE SNF | IL | $607,418 |
Lowest Rated Facilities
1-star facilities with the most deficiency citations on record.
| Facility | State | Deficiencies |
|---|---|---|
| AUTUMN MEADOWS OF CAHOKIA | IL | 29 |
| Nexus Pavilion at Belleville | IL | 21 |
| MAJESTIC GARDENS AT MEMPHIS REHAB & SNC | TN | 7 |
| BRIA OF CAHOKIA | IL | 17 |
| AVIR AT LINDALE | TX | 12 |
| MOHAWK MEADOWS | NJ | 10 |
| BISHOP REHABILITATION AND NURSING CENTER | NY | 6 |
| Legacy Nursing at St. Christina | LA | 21 |
| Springfield Health & Rehab | VT | 41 |
| ELEVATE CARE COUNTRY CLUB HILL | IL | 4 |
| Natchitoches Nursing and Rehabilitati... | LA | 12 |
| RIVER VIEW REHAB CENTER | IL | 17 |
| BRIDGEWOOD HEALTH CARE CENTER | MO | 38 |
| CHICAGO RIDGE SNF | IL | 20 |
| ARCHER HEIGHTS HEALTHCARE | IL | 32 |
How the CMS Five-Star Rating Works
Three Rating Components
The overall star rating combines three domain scores. The health inspection domain is based on the number, scope, and severity of deficiencies found during annual and complaint inspections over the past three years — more recent inspections are weighted more heavily. The staffing domain reflects nursing hours per resident per day for RNs and total nursing staff, adjusted for the acuity of the resident population. The quality measures domain covers 15 long-stay and 5 short-stay clinical measures such as pressure ulcer rates, falls, and antipsychotic medication use.
Limitations of Star Ratings
The Five-Star system has well-documented limitations. Staffing data is self-reported by facilities, and until the introduction of payroll-based journal (PBJ) data, was not independently verified. Quality measure scores are also based on facility-submitted clinical data. Health inspection scores are considered the most objective component because they reflect observations by state surveyors. Consumer advocates recommend using star ratings as a starting point rather than a final verdict — visiting the facility, speaking with staff, and reviewing the detailed inspection reports in the CMS Care Compare database provides the most complete picture.
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