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Nursing-Home Ratings Are Unreliable and Raise Disturbing Questions. What’s a Family to Do?

The federal Centers for Medicare & Medicaid Services’ five‑star rating system, used by families to choose nursing homes, is under fire after new research shows extreme volatility and opaque calculations. Georgetown, Northwestern and Texas A&M researchers found that individual homes can gain or lose stars within six months, a shift unlikely to reflect real quality changes. The study highlights reliance on self‑reported data and state‑specific grading curves that mask true performance. For‑profit facilities scored lower, prompting industry groups to question the system’s credibility.