What's That Gold Trophy? CMS Introduces a New High Performing Nursing Home Designation

October 11, 2026 | Ratings & Inspections

If you've recently searched for a nursing home using Medicare's Care Compare website, you may have noticed something new: a small gold trophy beside certain nursing home names.

It's not a decoration. It's a new designation from the Centers for Medicare & Medicaid Services (CMS) recognizing nursing homes that meet specific performance standards.

But what does that trophy actually tell you about a nursing home? And should it influence your decision?

What Does the Gold Trophy Mean?

Beginning October 8, 2026, CMS started displaying a High Performing trophy icon on qualifying nursing home profiles.

The designation identifies facilities that meet additional performance criteria beyond the familiar five-star rating system.

According to CMS, these facilities generally demonstrate fewer serious safety violations, stronger staffing performance, and other indicators of quality.

CMS initially estimated that approximately 12% of nursing homes would qualify for its new program.

How Does a Nursing Home Qualify?

To qualify, a nursing home must meet several requirements, including:

• An overall five-star rating on Medicare Care Compare.

• Meeting CMS staffing performance requirements.

• No citations involving resident harm or substandard quality of care during the applicable survey cycle.

• Compliance with CMS reporting requirements.

• Meeting additional criteria involving inspection history, ownership changes, and other safety indicators.

Eligibility is reviewed periodically. A nursing home can lose the designation if it no longer meets the requirements.

Importantly, not every five-star nursing home will receive a trophy.

Why Did CMS Introduce This Designation?

The trophy is part of a larger change in how nursing homes are inspected.

CMS has introduced a Risk-Based Survey (RBS) process that allows qualifying higher-performing facilities to undergo a more focused routine inspection.

These inspections require fewer survey resources than traditional comprehensive surveys.

The goal is to allow state survey agencies to direct more attention toward facilities with greater risks to resident health and safety.

However, qualifying nursing homes are not exempt from inspections. They remain subject to routine oversight, complaint investigations, and more extensive inspections when concerns arise.

Does a Gold Trophy Mean It's the Best Nursing Home?

Not necessarily.

The designation is a positive indicator, but it doesn't tell you everything about daily life inside a facility.

A nursing home may meet CMS's performance standards while still having challenges that matter to an individual resident.

For example:

• Does the facility have experience caring for someone with your loved one's medical conditions?

• Are staff members available and responsive when residents need assistance?

• Are meals appealing, and can the kitchen accommodate individual preferences and nutritional needs?

• How does the facility communicate with families?

• Are rehabilitation services, activities, and specialized programs appropriate for your loved one?

These questions matter regardless of the number of stars—or trophies—displayed beside a facility's name.

What If a Nursing Home Doesn't Have a Trophy?

The absence of a trophy does not automatically mean a nursing home provides poor care.

Some facilities may have strong performance in important areas without meeting every criterion for the new designation.

Others may be working to improve staffing, inspection outcomes, or quality measures.

That's why families should look beyond any single rating or recognition when comparing nursing homes.

The Bottom Line

CMS's new High Performing designation offers families another useful piece of information when researching nursing homes.

It's a recognition worth understanding, but it shouldn't replace reviewing inspection histories, comparing staffing, asking questions, and visiting facilities whenever possible.

A trophy can help identify a promising nursing home. It cannot tell you whether that nursing home is the right fit for someone you love.

At The Nursing Home Guide, our goal is to make information like this easier to understand so families can make informed decisions without referral fees or sales pressure.

Explore nursing homes and learn what to look for at The Nursing Home Guide.

Sources

• Centers for Medicare & Medicaid Services — Nursing Home Risk-Based Survey National Implementation, QSO-26-14-NH.

• CMS — Five-Star Quality Rating System Technical Users' Guide, September 2026.

• Medicare — Care Compare and Your Guide to Choosing a Nursing Home.

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Important Disclaimer: This website provides educational information only and is not intended as medical, legal, or professional advice. Always consult with healthcare professionals, legal advisors, and facility administrators when making decisions about nursing home care. The information presented here should not be used as a substitute for professional guidance tailored to your specific situation.

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