Nursing homes will get a “star rating” from the federal government to help consumers pick the best facilities. It is expected that this sweeping governmental initiative may create “peer pressure” among owners to improve care. The ratings, from a low of one star to a high of five, will be posted starting in December 2008 on the Nursing Home Compare Web site of the Centers for Medicare and Medicaid Services (Medicare.gov – Nursing Home Compare). The Centers for Medicare and Medicaid Services (CMS) plans to decide how many stars each nursing home gets by using data from the past three years of inspections, several measures of quality that include the percentage of residents who have bedsores, and staffing information. The star rating system is the latest of a series of steps taken by the CMS in recent years which are designed to protect the more than three million people who receive nursing home services each year by increasing pressure on nursing home owners. For example, last year the CMS initiated and began to publish a national watch list of nursing homes that data showed provided poor care and had failed to improve despite agency warnings. CMS data showed that about half of the nursing homes on the nationwide watch list significantly improved their quality of care within 24 to 30 months of being listed and that about 16 percent were terminated from Medicare and Medicaid because they showed no or insufficient improvement. Federal officials are asking for comments about the star rating system. Comments may be sent to BetterCare@cms.hhs.gov.