Credit: “The Nursing Home Five Star Rating: How Does It Compare to Resident and Family Views of Care?”

A paper, published in the most recent issue of The Gerontologist, uses data from tens of thousands of resident and family surveys to examine the link between star ratings and consumer satisfaction in Ohio nursing homes.

In 2008, the Centers for Medicare Services launched the modern iteration of its Nursing Home Compare tool, which rates facilities from one to five stars in key categories.

If you’ve had to research nursing homes in recent years, chances are you’ve used it yourself – eight years on, and it’s still the dominant online directory of U.S. nursing home ratings and information.

But how accurate are the star ratings? Do more stars truly reflect a better consumer experience, and vice versa?

New research says: not quite.

From the paper:

Although it was promising to find that nursing homes receiving higher ratings on NHC [Nursing Home Compare] tended to have higher consumer satisfaction scores, the limited relationship between consumer satisfaction scores and the NHC star ratings is cause for concern.

For example, although the mean satisfaction score for those nursing homes receiving one star in the NHC overall domain was significantly lower than the mean satisfaction score for those nursing homes receiving five stars, the categorical comparisons between the NHC overall ratings and the consumer satisfaction categories demonstrated the inconsistencies that exist.

Many nursing homes that received five stars on the NHC overall rating had moderate to very low consumer satisfaction (41% compared with family satisfaction and 54% compared with resident satisfaction), and many nursing homes that received one star on the NHC overall rating had high to very high consumer satisfaction (20.0% compared with family satisfaction and 19% compared with resident satisfaction).

With such high rates of inconsistency between the NHC overall ratings and consumer satisfaction scores, it is difficult to say that consumer’s views of nursing homes are adequately reflected in the NHC overall rating.

The paper, titled “The Nursing Home Five Star Rating: How Does It Compare to Resident and Family Views of Care?”, can be viewed here (subscription required).

The research was published in the April 2016 issues of The Gerontologist, and was written by Anthony Williams, MGS, MBA,, Jane K. Straker, PhD, and Robert Applebaum, PhD, all of Miami University of Ohio.