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The Five-Star Quality Rating System was created by the Centers of Medicare and Medicaid (CMS) to assist potential Residents and their families in choosing what community is right for them. The system is transparent with its information and gives each nursing home a rating of between 1 and 5 stars. Skilled Nursing communities with 5 stars are considered to have much above average quality compared to others across the state, and communities with 1 star are considered to have quality much below average. There is one Overall 5-star rating, and separate ratings given for health inspections, staffing and quality measures.