CMS recently announced significant changes to Nursing Home Compare and the Five-Star Quality Rating System. The agency also says that it is considering abandoning the star ratings for hospitals completely.

The Nursing Home Compare website and Five-Star Quality Rating System are aimed at helping consumers, families, and caregivers compare nursing homes. CMS says the recent changes are meant to make the tools more accurate.

“Our updates to Nursing Home Compare reflect more transparent and meaningful information about the quality of care that each nursing home is giving its residents,” CMS Administrator Seema Verma said in announcing the changes.

“Our goal is to drive quality improvements across the industry and empower consumers to make decisions, with more confidence, for their loved ones,” Verma said.

Nursing Home Compare gives each nursing home a rating between 1 and 5 stars, with one overall 5-star rating for each nursing home, and a separate rating for health inspections, staffing levels, and quality measures.

The recent changes include revisions to the inspection process, new staffing information, and new quality measures.

CMS is lifting the freeze on the health inspection ratings instituted in February 2018, which it implemented to avoid some facilities being surveyed under the old process and others under the new process implemented then.

CMS also is setting higher thresholds and evidence-based standards for nursing homes’ staffing levels.

Under current standards, facilities that report seven or more days in a quarter with no registered nurse on site are automatically assigned a one-star staffing rating. The trigger for an automatic downgrade to one star will be reduced from seven days with no RN on site to four days.

CMS also is implementing changes intended to improve how it identifies differences in quality among nursing homes, raise expectations for quality, and incentivize continuous quality improvement.

CMS also recently updated the ratings for hospitals on Hospital Compare, the first time in almost 15 months. Consistent with previous years, most hospitals received two to four stars and few received the lowest rating of one star or the highest rating of five stars. (Hospital Compare is online at:

However, CMS indicated that it is considering scrapping the basis of the whole star ratings system.

It opened a public comment page soliciting feedback on potential changes to the ratings program, including eliminating the latent variable model altogether. (The public comment page is online at: The comment period ended on March 29, 2019.)

In what it called a “long-term” approach with changes that wouldn’t be made before 2020, CMS said it is considering “replacing LVM (the latent variable model) with an explicit approach (such as an average of measure scores) to group score calculation.”