Quality ratings of nursing homes are not necessarily what they seem, according to a recent analysis.1

Researchers analyzed 264 reviews of 51 nursing homes in California. Yelp reviewers gave significantly less favorable ratings than those found on the Centers for Medicare & Medicaid Services (CMS) Nursing Home Compare website.

“Consumers view the quality of nursing homes as poorer than the CMS is reporting it to be,” said Anna Rahman, PhD, a co-author of the study and an assistant research professor at the USC Leonard Davis School of Gerontology in Los Angeles.

More than half of Yelp reviewers posted comments related to staff attitude and caring. Nearly one-third commented on staff responsiveness. Yelp reviewers often posted about the physical environment. Quality of healthcare provided and concerns about resident safety and security were mentioned infrequently. In contrast, Nursing Home Compare ratings focus solely on staffing levels, clinical processes, and outcomes.

Each ratings system has drawbacks, says Rahman: “We advise consumers to consult both sites and then do their own research by visiting the nursing homes they are most interested in.”

Warning consumers about the limitations of Yelp ratings is probably not necessary, says Rahman. Most people are aware some reviews are inaccurate, biased, or even fake.

“In contrast, CMS, as a federal agency professing a commitment to promoting transparency in healthcare data, has a special obligation to inform consumers about known and suspected limitations of its Nursing Home Compare ratings,” says Rahman.


1. Kellogg C, Zhu Y, Cardenas V, et al. What consumers say about nursing homes in online reviews. Gerontologist 2018; 58:e273–e280.