Five-Star State-Level Cut Point Tables Posted – May 2022

Mary Madison, RN, RAC-CT, CDP 
Clinical Consultant – Briggs Healthcare

On May 25, 2022, CMS posted the Five-Star State-Level Cut Point Tables for the month of May.

The Five Star Quality Rating System Technical Users’ Guide: State Level Health Inspection Cut Point Table – provides the data for the state-level cut points for the star ratings included in the health inspection domain. Cut points for the staffing ratings and for the QM ratings have been fixed and do not vary monthly. Data tables giving the cut points for those ratings are included in the Five Star Quality Rating System: Technical Users’ Guide.

CMS’ Five-Star quality ratings for the health inspection domain are based on the relative performance of facilities within a State. This approach helps to control for variation between States. Facility ratings are determined using these criteria:

• The top 10 percent (lowest 10 percent in terms of health inspection deficiency score) in each State receive a five-star rating.

• The middle 70 percent of facilities receive a rating of two, three, or four stars, with an equal number (approximately 23.33 percent) in each rating category.

• The bottom 20 percent receive a one-star rating.

This distribution is based on CMS experience and input from the Project’s TEP. The cut points are recalibrated each month so that the distribution of star ratings within States remains relatively constant over time in an effort to reduce the likelihood that the rating process affects the health inspection process. In the rare case that a State or territory has fewer than 5 facilities upon which to generate the cut points, the national distribution is used. Cut points for the health inspection ratings by state for the month of May 2022 are shown in Cut Point Table 1 (CP Table 1).

Notes: A higher score indicates worse performance on health inspections. The cut points are based on facility health inspection scores and are set separately for each state to achieve this distribution:

• 5 stars: ≤10th percentile
• 4 stars: >10th percentile and ≤ 33.33rd percentile
• 3 stars: >33.33rd percentile and ≤ 56.667th percentile  
• 2 stars: >56.667th percentile and ≤ 80th percentile  
• 1 star: >80th percentile

Due to the small number of facilities, the cut points for Guam and the Virgin Islands are based on the national distribution of health inspection scores.