Rated star: Five-Star Quality Rating System | CMS

Five-Star Quality Rating System | CMS

CMS created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily and to help identify areas about which you may want to ask questions.  The Nursing Home Care Compare web site features a quality rating system that gives each nursing home a rating of between 1 and 5 stars.  Nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average.  There is one Overall 5-star rating for each nursing home, and separate ratings for health inspections, staffing and quality measures.

Caution: No rating system can address all of the important considerations that go into a decision about which nursing home may be best for a particular person.  Examples include the extent to which specialty care is provided (such as specialized rehabilitation or dementia care) or how easy it will be for family members to visit.  Visits can improve both the residents’ quality of life and quality of care, it may be better to select a nursing home that is very close over one that may be, rated higher but far away.  Consumers should therefore use the Web site  together with other sources of information for the nursing homes (including a visit to the nursing home) and State or local organizations (such as local advocacy groups and the State Ombudsman program).

The Downloads section below contains the Five-Star Quality Rating System Technical Users’ Guide that provides in-depth descriptions of the ratings and the methods used to calculate them.

The Related Links section below contains a link to the Nursing Home Care Compare web site where you can find and compare nursing homes near you.

January 7, 2022

QSOG Memo QSO-22-08-NH, Nursing Home Staff Turnover and Weekend Staffing Levels, has been posted. This memo describes the addition of staff turnover and weekend staffing measures to Care Compare. This information will be added to the Care Compare website in January 2022 and used in the Nursing Home Five Star Quality Rating System in July 2022.

December 4, 2020

QSOG Memo QSO-21-06-NH, Updates to the Nursing Home Compare website and Five Star Quality Rating System, has been posted. This memo describes changes to the Rating System to be implemented in January 2021. Specifically CMS will resume calculating nursing homes Health Inspection and Quality Measure ratings on January 27, 2021.

December 2, 2020

Now available! Our new Provider Data Catalog makes it easier for you to search & download our publicly reported data. We’ve also improved Medicare’s compare sites.

October 7, 2019

Changes were announced to the Five-Star Quality Rating System that will be implemented in October 2019.   Refer to CMS memoranda: QSO 20-01-NH (PDF) & QSO 20-02-NH (PDF).

How to compare plans using the Medicare Star Rating System

Changing Medicare coverage

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Part D drug plans and Medicare Advantage Plans vary greatly in terms of costs and coverage. Each January, plans can change their coverage and costs for the new calendar year. This means that each fall, you should review your plan’s coverage and compare it with other plans in your area to make sure you have the coverage that is best for you. Examine a plan’s coverage, costs, drug coverage, and the pharmacies in its network to see if it best meets your current needs. After considering those factors, you can use the plan’s star rating from Medicare to help you make a final decision.

What is the Medicare Star Rating System?

Medicare uses a Star Rating System to measure how well Medicare Advantage and Part D plans perform. Medicare scores how well plans perform in several categories, including quality of care and customer service. Ratings range from one to five stars, with five being the highest and one being the lowest. Plans are rated in each individual category. Medicare also assigns plans one overall star rating to summarize the plan’s performance as a whole. You can use the overall star rating to compare performance among several different plans. To learn more about differences among plans, look at plans’ ratings in each category.

Medicare reviews plan performance yearly and releases new star ratings each fall. This means plan ratings may change from year to year.

Medicare Advantage Plans are rated on how well they perform in five different categories:

1. Staying healthy: screenings, tests, and vaccines
2. Managing chronic (long-term) conditions
3. Plan responsiveness and care
4. Member complaints, problems getting services, and choosing to leave the plan
5. Health plan customer service

Part D plans are rated on how well they perform in four different categories:

1. Drug plan customer service
2. Member complaints, problems getting services, and choosing to leave the plan
3. Member experience with the drug plan
4. Drug pricing and patient safety

Remember: Before you consider a plan’s star rating, make sure the plan’s coverage and costs suit your needs. For example, if you are considering a Part D plan, be sure the plan covers you drugs at a cost that works for you.

Where can I find information on my plan’s star rating?

Star ratings can be found using Medicare’s Plan Finder tool or by calling 1-800-MEDICARE. New plan quality ratings come out each October and apply to the next calendar year (for example, plan ratings for 2021 will be available in October 2020).

Note: Star ratings in the Medicare & You handbook may be outdated. For up-to-date information on star ratings, check Plan Finder or call 1-800-MEDICARE.

How can I use the star ratings to inform my plan choice this year?

You can use star ratings to compare plans in your service area by the categories, listed above, that Medicare finds important indicators of plan performance. Remember that a plan’s star rating is only one factor to look at when comparing plans. Even though a plan has a high star rating, it may not be right for you. You should also consider the plan’s costs, coverage, and network for providers and pharmacies.

If Medicare gives a plan fewer than three stars for three years in a row, Plan Finder will flag the plan as low-performing. The symbol Plan Finder uses to show that a plan is low-performing is an upside-down red triangle with an exclamation point inside of it (similar to a caution sign). Medicare will notify you if the plan you are enrolled in is flagged as low-performing. You will not be removed from the plan, but you may want to check the plan’s costs and coverage to make sure it is still a good plan for you.

Note: If you plan to enroll in a low-performing plan, you must call 1-800-MEDICARE or the plan directly. You cannot use Plan Finder to enroll in low-performing plans.

What is the five-star Special Enrollment Period (SEP)?

Generally, you can only change your plan or enroll in a new one during specific times. Special Enrollment Periods are periods of time outside normal enrollment periods, triggered by specific circumstances. If you want to enroll in a plan or change plans, you can take advantage of an SEP to join or switch to a five-star Medicare Advantage or Part D plan. This means that you can enroll in a Medicare Advantage Plan or stand-alone Part D plan in your service area that has an overall plan performance rating of five stars. You may only use this SEP once per calendar year.

• This SEP begins December 8 of the year before the plan is considered a five-star plan (remember that ratings come out in October) and lasts through November 30 of the year the plan is a five-star plan
• Enrollments in December are effective January 1
• Enrollments from January to November are effective the month following the enrollment request

To use the five-star SEP, contact Medicare at 1-800-633-4227.

Rating layout in the form of stars

08/22/2019

71496

To bookmarks

Layout of rating and rating display controls without images and JS.

1

The radio button is hidden, but has a dual role – it submits an evaluation with the form, and if you add checked, it will select the desired star and all previous ones.

HTML

 .rating-area {
overflow: hidden;
width: 265px
margin: 0 auto;
}
.rating-area:not(:checked) > input {
display: none;
}
.rating-area:not(:checked) > label {
float:right;
width: 42px
padding: 0;
cursor: pointer;
font-size: 32px;
line-height: 32px;
color: light grey;
text-shadow: 1px 1px #bbb;
}
. rating-area:not(:checked) > label:before {
content: '★';
}
.rating-area > input:checked ~ label {
color: gold;
text-shadow: 1px 1px #c60;
}
.rating-area:not(:checked) > label:hover,
.rating-area:not(:checked) > label:hover ~ label {
color: gold;
}
.rating-area > input:checked + label:hover,
.rating-area > input:checked + label:hover ~ label,
.rating-area > input:checked ~ label:hover,
.rating-area > input:checked ~ label:hover ~ label,
.rating-area > label:hover ~ input:checked ~ label {
color: gold;
text-shadow: 1px 1px
}
.rate-area > label:active {
position: relative;
} 

CSS

2

HTML

 .rating-result {
width: 265px
margin: 0 auto;
}
.rating-result span {
padding: 0;
font-size: 32px;
margin: 03px;
line-height: 1;
color: light grey;
text-shadow: 1px 1px #bbb;
}
.rating-result > span:before {
content: '★';
}
. rating-result > span.active {
color: gold;
text-shadow: 1px 1px #c60;
} 

CSS

3

To display the rating in lists and listings.

HTML

 .rating-mini {
display: inline-block
font-size: 0;
}
.rating-mini span {
padding: 0;
font-size: 20px;
line-height: 1;
color: light grey;
}
.rating-mini > span:before {
content: '★';
}
.rating-mini > span.active {
color: gold;
} 

CSS

22.08.2019, updated 07.10.2020

71496

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#Forms

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Ratings, stars, thumbs up, thumbs down. The Psychology of Rating Systems from a Developer’s Perspective

For many users, ratings and ratings are a key factor in choosing products and services. However, people are not always aware of what mechanisms and psychological laws underlie various models of rating systems. This question was addressed by the developer of Himanshu Khanna in an article on Hacker Noon.

Uber, like other consumer services, has a very interesting rating system – for passengers and for drivers. Service client Arjun leads in the rating of passengers with a score of 4. 91 – but not because he uses special tricks, but simply because he is polite and knows how to easily start a conversation. One day, he received a “count” from one of the drivers. When Arjun asked what he got the minimum score for, the driver replied with a smile that he gave him the best rating: No. 1.

Should we abandon the “stars”

In 2017, Netflix made a big breakthrough by abandoning the star rating system in favor of thumbs up, thumbs down system. A similar model of likes and dislikes back in 2009introduced YouTube. As explained in the accompanying blog post, the all-or-nothing pattern was the cause.

The vast majority of videos on YouTube had a 5-star rating. This meant that users tended to go to extremes and only rate a video when they were either completely delighted or disgusted. In other cases, they did not react to the videos in any way. It is important to note that the average YouTube video rating was the total for all users. Five red stars on Netflix means that a movie or series is perfect for the tastes of a particular user. The rating a person saw next to each movie or series on Netflix was average among viewers with similar preferences to , and not for all users, unlike YouTube.

How often users rate

Uber once wanted to force riders to rate a driver before allowing them to make their next ride. Now this can be done at will, but users refrain from rating only in rare cases. In 2014, Uber released a driver guide explaining how the rating system works. In addition, if the driver’s rating was below 4.6 points, the service could deactivate his account.

“Disabling the accounts of drivers who consistently deliver poor service will help Uber maintain its image as a quality company.”

Drivers compete for a high rating because their earnings depend on it. Just like restaurants, whose attendance depends on the rating, and many other products and services, the profit of which is also proportional to the rating.

But perhaps not all people understand ratings in the same way. First of all, you need to understand the idea of ​​such a rating system in principle, especially in the context of modern digital products.

A rating system in a digital world

A rating system can be seen as a user investment in a product. As soon as they clearly understand their benefit from this investment and want to receive it, they will be more likely to invest in the product and participate more actively in the rating system. They will become the engine of product growth, encouraging good practices and curbing bad ones.

In one survey on the subject, more than half of respondents said they would not watch a movie if it had an IMDB rating below 7, and for programs and series they “set” a minimum viewing threshold of 8 points. One of the respondents noted that he almost never gives a film more than 8, provided that it is a perfect film. While 7 is considered acceptable, 9Films are evaluated only in exceptional cases. On Netflix, the same users would vote for the same movie in the same way: “thumbs up”.

Platforms, their usage, rating systems, and overall engagement score likely play a huge psychological role in how a user evaluates a piece of content. Colors, labels, and direct ranking impact are also important factors.

About 80 percent of those surveyed say they use Uber at least once a week, with more than 30 percent daily. About 50 percent of these passengers will cancel a trip if the driver’s rating is below 4.5 out of 5.

Respondents in the same sample view the listings of Zomato (a global online platform that provides information about restaurants around the world) at least once a month. But here the requirements for establishments are lower: 3.8 out of 5. In this case, the perception of the rating is influenced by the frequency of use and significance in everyday life.

“A score of 4 means that the product or service meets expectations, a score of 5 means that it exceeds expectations.”

Likes on Instagram or Facebook and retweets on Twitter are also rating systems, only binary. Usually, users do not rate something mediocre. They react to something that evoked a strong emotional response in them: delight or hatred. Social networks (Facebook, Twitter and Instagram) are not interested in the second type of content. They value and promote what their audience likes. Binary systems make scoring easier because in this case, users need to take a targeted action only when they like something on the platform.

Group norms and conformity

In 1936 Muzafer Sherif conducted a classic experiment. Participants were placed in a dark room, where they had to observe a point of light at a distance of about 5 meters and try to determine how much, in their opinion, it had moved. In the case when the participants took the test individually, their scores varied significantly more than in groups of three – then the subjects called more similar numbers. This experiment showed that instead of making independent decisions, people tend to conform to the opinion of the group.

An Instagram user sees that a particular post has received 5,059,031 likes and, succumbing to the opinion of other users, puts another like. This conformity works with ratings, stars, votes, and other rating systems if the sum (or average) of the ratings is shown before a person makes an independent decision. This phenomenon may be one of the key factors of virality in social networks.

Applause as a rating tool

In mid-2017, Medium replaced the binary equivalent of a like, a heart-shaped “recommend” button, with “applause”. This radical step turned the reader from a connoisseur of the article into an appraiser. A user can “clap” up to 50 times on one article, and the number of claps in the range from 0 to 50 times will reflect the degree to which he liked it (or its quality), which is not much different from the “star” rating system.

On Facebook, a user can like their own post. You can’t clap yourself on Medium.

There is one unusual difference between the “star” ratings and the applause system on Medium – the visual inaccessibility of the calculations. If in the star format the user is offered five rating options, then on Medium the choice is, figuratively speaking, endless. Many fear that this innovation will lead to “inflation” of the “valuation currency” on the platform, that is, a decrease in the importance of one cotton in the overall rating of the article: 20,000 claps now seem not so outstanding compared to the previous 2,000 recommendations. Although if the phenomenon of conformism continues to work, the article has a better chance of getting even more claps if it has already scored 20 thousand of them than 2 thousand.

Looking further

In some cases, the principle of calculating the average value of all ratings turns against the rating system itself. Let’s say that with a critical number of ratings in a 5-point system, the average rating of a product or service turned out to be 4.3. In most cases, going forward—assuming users continue to actively rate—it will take a fair number of extremes (1 or 5) to shift the rating by 4. 2 or 4.4. After the nth number of ratings, a score of 4.3 out of 5 will become a stable average rating. Then no response – even the most enthusiastic or devastating – will significantly affect this indicator, and potentially important feedback will go unnoticed.

All Uber drivers are required to rate each passenger at the end of the ride, unlike riders who can do so at will. Likewise, Zomato and Amazon users may or may not leave feedback on purchases at their discretion. In addition, Amazon allows reviews of products that were not purchased directly through the platform, which can drop their rating down to as little as 2 points.

“Reviews on Amazon are sometimes written by not quite adequate people. I have bought products with a rating of 2-3 more than once, and I was very pleased with them.

The nature, mood and environment of the user, the urgency of the purchase, the satisfaction and benefit of the purchase, influencers and their proximity to the user – all these factors significantly affect the user’s assessment. Another notable finding from the survey was that it is very easy for users to rate apps from smartphones due to their convenience. 74 percent of respondents prefer to rate mobile phones more than other devices. However, some users refuse to rate apps or services if they are required to write a detailed review.

The future of rating systems

In one of the Black Mirror series, the authors depicted the onset of the digital age and the psychology of rating systems. This is a satirical series in which people could rate each other on a 5-point scale in the real and virtual worlds. Everything: status in society, access to certain services, a person’s chances of finding a job – was determined by his rating.

Mankind has raised a generation of obsessive critics who watch every move of a waiter in a restaurant, evaluate the clash of appliances when they are placed on the table, look closely at how respectfully the waiter takes the order, vividly taking notes and mentally building algorithms to calculate the appropriate rating, after which they switch to the next subject of criticism.