3 Min Read Posted on November 10, 2026November 10, 2026 New Research Reveals Gaps in Nursing Home Star Ratings The Centers for Medicare & Medicaid Services (CMS) uses star ratings to help families compare nursing homes, but a high rating doesn’t always tell the full story of a facility’s safety record. Our team analyzed federal records for 14,690 nursing homes and found that nearly 1 in 10 facilities rated 4 or 5 stars had a serious red flag in their published inspection history. We created CMS Star Ratings vs. Nursing Home Safety: The Gap to share what we found and help families look beyond the ratings. Our new, free research includes a searchable state-by-state table, explanations of federal safety warnings, and a 6-step checklist families can use when choosing a nursing home or checking on a loved one’s care. This screening tool requires JavaScript. Please call (855) 264-6310 to speak with our team. What Our Nursing Home Safety Research Found A closer look at the CMS data as of August 1, 2026, revealed additional findings about nursing home safety records. Here are some of our key findings: 554 highly rated facilities had at least one Immediate Jeopardy-level citation, CMS’s most serious violation category 19 4-star nursing homes carried a federal Abuse Icon 49.8% of nursing homes rated 1 to 3 stars had a red flag, more than 5 times the rate among highly rated facilities Rhode Island had the highest rate of serious federal red flags among highly rated nursing homes, at 33.3% These findings reflect published inspection histories, not necessarily current conditions. Some citations are several years old and no longer affect a facility’s current rating. Why Our Team Conducted This Research Families often rely on CMS star ratings to compare nursing homes. The ratings are a useful starting point, but they don’t always reflect everything in a facility’s inspection history. At the Nursing Home Abuse Center, we wanted to understand how often highly rated facilities had alarming instances of nursing home abuse and neglect in their federal records. Our research team examined CMS data, compared ratings with inspection histories, and organized the findings into a free resource families can use to make more informed decisions. “Families are told to look at one number, and that number is only a starting point. We conducted this research to help families look beyond star ratings and know what to check when choosing a nursing home or raising concerns about a loved one’s care.” – Julie Rivers, MBA, Certified Senior Advisor, Nursing Home Abuse Center We also published our methodology and sources so families can see how we reached our findings and check the information themselves. How Families Can Use Our New Research We designed CMS Star Ratings vs. Nursing Home Safety: The Gap for anyone comparing nursing homes or concerned about the care a loved one is receiving. Our free research includes: A searchable table with findings for all 50 states, Washington, D.C., and Puerto Rico A 6-step checklist for looking beyond star ratings, including checking inspection reports, staffing ratings, and federal warning signs Plain-language explanations of the CMS rating system, Abuse Icons, and Immediate Jeopardy-level citations Expert advice on evaluating facilities and responding to suspected abuse or neglect in nursing homes Full methodology and sources so readers can review the federal data behind our findings Families can use the checklist alongside Medicare’s Care Compare tool to review a facility’s inspection history and learn what warning signs to look for. If you already suspect nursing home abuse or neglect, don’t rely on a facility’s star rating to decide if your concerns are justified. “Believe yourself. Start documenting immediately.” – Ricky A. LeBlanc, Managing Attorney, Sokolove Law LeBlanc also explains that reporting suspected abuse “provides a written record of what occurred” and can prompt an investigation to protect residents. Get Legal Help for Nursing Home Abuse or Neglect A high star rating does not guarantee that a nursing home is providing safe care. If your loved one has been harmed by abuse or neglect, your family may have legal options. The Nursing Home Abuse Center works with trusted legal partners who help families pursue compensation and hold negligent facilities accountable. Call us right now at (855) 264-6310 or get a free case review to find out how we may be able to help.