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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 skilled nursing community is right for them. The system is transparent with its information and gives each nursing home a rating of between one and five stars. Skilled nursing communities with five stars are considered to have above average quality compared to others across the state, and communities with one star are considered to have quality below average. There is one Overall five star rating, and then three separate ratings for health inspections, staffing and quality measures.