CMS Enhances Nursing Home Rating System with Staffing and Turnover Data

July 29, 2022
Policy Snapshot

This week the Centers for Medicare & Medicaid Services launched its enhanced Nursing Home Five-Star Quality Rating System, which integrates data nursing homes report on their weekend staffing rates for nurses and information on annual turnover among nurses and administrators.

CMS research shows that higher nurse turnover is associated with lower quality of care. Nurses who have worked at a facility longer are more likely to know residents well enough to recognize small health changes and act before they become larger issues. Similarly, administrators with longer tenures help create stable leadership, which can lead to more consistent policies and protocols that are tailored to better serve residents.

In January, CMS began posting weekend staffing and turnover rates on Medicare’s Care Compare website. With this announcement, the agency is now incorporating that information into the consumer-friendly Nursing Home Five-Star Quality Rating System. Through this change, CMS will hold facilities to a higher standard and incentivize more robust staffing by strengthening personnel’s impact on overall star ratings.

The new nurse staffing information includes registered nurses, licensed practical nurses, vocational nurses, and nurse aides who work under the direction of licensed nurse staff and provide much of the day-to-day care for nursing home residents, such as eating, bathing, grooming, and toileting.

Ratings are updated quarterly. A summary of the changes to the methodology can be found in this Fact Sheet, and the details of the methodology can be found in the Five Star Rating Technical Users’ Guide.

For a fact sheet on the July 2022 Updates to the Care Compare Website, please visit: