Since the fundamental methodology is intended to stratify facilities relatively evenly, but the actual scoring is based on a known point system, a gradual drift towards higher star ratings occurred over the past five years. Why was the Recent Rebasing Done and Why are Providers Unhappy? Also, if the facility is in the Special Focus Program, its overall star rating cannot be more than three stars. Special note: If a facility has a one star health inspection rating, its maximum overall rating is limited to two stars. Finally, add one star if the quality measure rating is five stars, or subtract one star if the QM rating is one star. Subtract one star if the staffing rating is one star. Next, add one star if the staffing rating is a four or five stars *and* the staffing rating is higher than the health inspection rating. With the complicated math behind, calculating the overall star score is easy. The current star distribution for quality measures, by state, looks like this: The total score is then applied to a scale to determine the star rating. Each quality measure is given equal weight, so the individual scores are simply summed. The scoring methodology is somewhat complex, but essentially point values are assigned for each measure based on the nursing home’s performance compared to other nursing homes in the same state.
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