By Richmond Senior Advisor Care Team · September 17, 2026
In October 2026 CMS data, the 37 certified nursing homes in the Richmond region and Tri-Cities split widely: 4 five-star, 3 four-star, 11 three-star, 7 two-star and 11 one-star overall, with one not rated. Use the overall rating to shortlist, then read health inspections and staffing before choosing.
How are Richmond-area nursing homes rated overall?
CMS assigns each certified nursing home an overall rating from one to five stars, built from its health inspection rating, staffing rating and quality measures. In the October 2026 Care Compare data for the twelve localities we cover, the spread was wide.
| CMS overall rating | Number of homes |
|---|---|
| 5 stars | 4 |
| 4 stars | 3 |
| 3 stars | 11 |
| 2 stars | 7 |
| 1 star | 11 |
| Not rated | 1 |
More than half of the region's homes sit at two stars or below. That does not make them unsafe, but it does mean families should not assume that the home with an open bed is a good one.
Which CMS rating matters most?
The health inspection rating carries the most weight in CMS's method and reflects what state surveyors actually found during standard and complaint surveys. The staffing rating reflects nurse and aide hours per resident from payroll data. Quality measures cover outcomes such as falls with injury, pressure ulcers and rehospitalization.
For a short-term rehab stay, short-stay quality measures and therapy matter more. For long-term care, look harder at staffing and long-stay measures, and at whether the home has repeat deficiencies.
What should I look for beyond the stars?
Open the home's page on Medicare Care Compare and read the most recent health inspection: how many deficiencies, how serious, and whether any involved harm. Check whether the home has fines or payment denials in the past three years, and whether CMS has flagged it with an abuse icon or as a special focus facility. Our nursing home directory shows the overall, health inspection and staffing ratings, the last standard survey date, the deficiency count and fines for every home in the region, sortable.
How recent is the data?
CMS updates Care Compare regularly, and the ratings we show carry CMS's processing date. A home's rating can change after a new survey, so check Care Compare directly before making a final decision, and ask the administrator about any recent survey that is not yet reflected.
How do I compare two Richmond nursing homes with the same star rating?
When two homes share an overall rating, the components usually differ. One three-star home may earn it with strong staffing and weak inspections, another the reverse. For long-term care, many families weigh the health inspection rating and the number and severity of recent deficiencies first, then staffing, then quality measures.
Look at turnover too. Care Compare reports nursing staff turnover and how many hours registered nurses work per resident each day, including on weekends. A home with stable staff and steady weekend RN coverage is often a better bet than one with a slightly higher overall rating built on quality measures alone.
Then visit both. Sit in the dining room at lunch, watch call lights, and ask residents' families in the lobby how responsive staff are at night.
What do the CMS icons and special designations mean?
Care Compare marks some homes with an abuse icon when they have recent citations for abuse or neglect, and lists homes in the Special Focus Facility program, which CMS uses for homes with a persistent record of serious problems. Either designation should prompt a direct conversation with the administrator about what has changed and a close read of the latest inspection.
Ownership information on Care Compare can also help: it shows whether a home belongs to a chain and the chain's average ratings, which can hint at how much support a local building gets.
Do assisted living facilities have CMS ratings?
No. CMS rates only certified nursing homes. Virginia's assisted living facilities are licensed by the Department of Social Services, which does not publish star ratings; the public record is the inspection history on the VDSS search. If a continuing care campus in the Richmond region has both, check the nursing center on Care Compare and the assisted living on VDSS separately, because each part can perform differently.
Be skeptical of any assisted living 'rating' you see online that does not say where it came from; it is not an official Virginia rating.
What questions should I ask a Richmond nursing home in person?
- How many residents are here for short-term rehab, and how many long-term?
- What are the nurse and aide staffing levels on nights and weekends?
- How often does a physician or nurse practitioner see residents?
- What happened after your most recent survey's deficiencies?
- Do you accept Medicaid, and is a Medicaid bed available if my parent stays long term?
Nursing homes are licensed by the Virginia Department of Health and certified by CMS, so complaints about care go to VDH's Office of Licensure and Certification, and the long-term care ombudsman can help residents and families resolve problems.
Frequently asked questions
How many certified nursing homes are in the Richmond region?
Thirty-seven across the twelve localities we cover, in CMS's October 2026 data.
Who rates nursing homes?
CMS, on Medicare Care Compare. Virginia does not rate assisted living at all.
What is the most important CMS rating?
The health inspection rating carries the most weight; read it alongside staffing.
Who licenses nursing homes in Virginia?
The Virginia Department of Health; CMS certifies them for Medicare and Medicaid.
