Finding the Right Nursing Home in 2025: Why the Five-Star Rating System Isn’t Enough

At The Lansky Law Firm, we know how emotionally overwhelming it can be to select the right nursing home for a loved one. Many families begin their search by turning to the Centers for Medicare & Medicaid Services (CMS) Five-Star Quality Rating System. Created in 2008, the system was meant to offer an at-a-glance summary of a facility’s quality. However, as of 2025, its limitations have become more pronounced—and relying on it exclusively may lead to uninformed decisions.

How the Five-Star Rating System Works

The CMS star rating is determined using three major components:

• Health inspections

• Staffing levels

• Quality measures (such as patient outcomes and care practices)

While this system appears to streamline the decision-making process, it fails to provide a complete and consistently accurate picture.

Where the System Falls Short

Self-Reported Data May Be Misleading A significant portion of the CMS data is reported directly by the nursing homes. This includes:

• Staffing statistics

• Quality of care metrics

• Incident reports

Investigations have shown that facilities sometimes:

• Inflate staffing levels

• Underreport safety concerns

• Misrepresent resident health conditions and treatments

Inconsistent Inspection Standards Health inspections are conducted by state agencies, which results in inconsistent enforcement. Additional concerns include:

• Advance notice of inspections, allowing facilities to temporarily “fix” issues

• Varying standards from one state to another

• Major infractions not being reflected in a facility’s star rating

At The Lansky Law Firm, we encourage families to go beyond these surface-level ratings and take a more hands-on approach.

A Better Way to Choose a Nursing Home

The Lansky Law Firm recommends a multi-step approach when selecting a nursing facility:

1. Visit the Facility in Person There is no substitute for seeing a facility firsthand. Observe staff interactions, cleanliness, safety protocols, and the overall environment.

2. Ask the Right Questions Speak with nurses, administrators, and caregivers. Inquire about:

• Staff turnover

• Medical care procedures

• Emergency preparedness

• How dementia and memory care are handled

3. Talk to Families and Residents Hearing directly from those living in the facility—or their family members—can offer real insight into the day-to-day experience.

4. Consult Additional Resources Go beyond the CMS site and look into:

• Tennessee Department of Health inspection reports\

• Long-term care ombudsman program evaluations

• Recommendations from healthcare providers or elder care professionals like The Lansky Law Firm

5. Use a Checklist Bring a structured tool such as the AARP Nursing Home Checklist to help guide your visit and ensure you’re asking the right questions.

Legal Planning is Essential

Choosing a facility is only one part of the long-term care equation. At The Lansky Law Firm, we help families prepare for the legal and financial challenges that come with aging and caregiving. We assist with:

• Powers of Attorney

• Healthcare Directives

• Living Wills

• Trusts and asset protection

With proper legal planning, you can ensure your loved one’s wishes are honored, and you are empowered to act on their behalf when necessary.

Plan with The Lansky Law Firm

The CMS Five-Star Rating System may be a helpful starting point—but it should never be your only guide. At The Lansky Law Firm, we’re here to help you navigate your long-term care options and protect what matters most.

Visit Us: 6800 Poplar Ave #225, Memphis, TN 38138

Call Us: (901) 767-7006

The Lansky Law Firm

Peace of Mind through Preparation.