Aged Care Star Ratings: How to Improve Your Rating in Every Domain

The aged care star ratings system is one of the most visible measures of quality in Australian aged care. Published on the My Aged Care website, star ratings give consumers and their families a way to compare residential aged care services at a glance — and they give providers a powerful incentive to invest in quality improvement.

For providers, star ratings are not just a marketing concern. A low star rating can affect occupancy, staff recruitment, and regulatory scrutiny. Understanding how the system works, what you can influence, and where to focus your improvement efforts is essential for any compliance manager or CEO in residential aged care.

The star ratings system assigns each residential aged care service an overall rating from 1 to 5 stars, based on performance across 4 domains. Each domain is rated individually, and the overall star rating is a weighted composite of those domain ratings.

The 4 domains are: Residents' Experience (based on consumer experience interviews), Compliance (based on regulatory compliance history), Quality Measures (based on clinical quality indicators), and Staffing (based on care minutes and staffing data). Each domain contributes to the overall rating, but the weighting is not simply an average — the system includes safeguards to ensure that very poor performance in any single domain pulls down the overall rating.

The Residents' Experience domain is based on interviews conducted with residents by independent assessors. These interviews use a structured questionnaire that covers areas such as food quality, personal care, social activities, dignity and respect, choice and control, and the physical environment.

This domain is arguably the hardest to influence through compliance activity alone, because it reflects the lived experience of residents rather than documented processes. However, providers can improve performance by genuinely embedding person-centred care into daily operations, training staff in communication and empathy, and acting on resident feedback in real time rather than waiting for formal surveys.

It is worth noting that this domain captures a snapshot in time. A single bad experience on the day of the interview can affect the rating. Consistency in care delivery is therefore critical.

The Compliance domain reflects the service's regulatory history with the ACQSC. It considers the outcomes of assessment contacts, any non-compliance findings, sanctions, notices to agree, and compliance actions over a rolling period.

Providers with a clean compliance history will score well in this domain. Those with recent non-compliance findings — particularly unresolved findings or findings against core standards — will be marked down. The key to performing well here is maintaining continuous compliance readiness rather than preparing for assessments in bursts.

This is one of the more controllable domains for providers. By investing in systematic compliance tracking, maintaining up-to-date evidence against the Strengthened Aged Care Quality Standards, and addressing any identified gaps before they become findings, providers can protect their compliance rating.

The Quality Measures domain is based on clinical quality indicator data that providers submit quarterly to the Department of Health and Aged Care. The National Aged Care Mandatory Quality Indicator Program has been expanded in stages — from 3 indicators in 2019 to 5 in 2021, 11 in 2023, and 14 from 1 April 2025. The 14 indicators are: pressure injuries, restrictive practices, unplanned weight loss, falls and major injury, medication management, activities of daily living, incontinence care, hospitalisation, workforce, consumer experience, quality of life, enrolled nursing, allied health, and lifestyle. Of these, 5 (pressure injuries, restrictive practices, unplanned weight loss, falls and major injury, and medication management) feed into the Star Ratings Quality Measures sub-rating.

Performance is benchmarked against national averages, so a provider's rating depends not just on their own performance but on how they compare with the rest of the sector. Improving quality indicator performance requires robust clinical governance, regular clinical auditing, staff training in prevention strategies, and accurate data collection and reporting.

Data integrity is critical in this domain. If your quality indicator data is inaccurate — either because of poor data capture or inconsistent definitions — your rating may not reflect your actual clinical performance. Ensure that the staff responsible for data submission understand the indicator definitions and that the data is validated before lodgement.

Star ratings in the Quality Measures domain are driven by your performance relative to national benchmarks. The 5 quality indicators that feed into star ratings are:

1. Pressure injuries (Stage 2+): National average approximately 5-7% of residents. Providers below 3% perform well; above 10% triggers concern. Prevention strategies include regular skin assessments, repositioning schedules, pressure-relieving mattresses, and nutritional support.

2. Physical restraint use: National average approximately 3-5%. The ACQSC and the Act strongly discourage restrictive practices. Providers should aim for zero where possible, with any use documented through behaviour support plans.

3. Unplanned weight loss: National average approximately 6-8%. Track weight monthly for all residents, investigate any loss exceeding 5% in 1 month or 10% in 6 months, and involve dietitians early.

4. Falls and major injury from falls: National average for falls with major injury approximately 1-2%. Implement comprehensive falls prevention programs including risk assessment on admission, environmental modifications, medication reviews (falls-risk medications), and post-fall analysis.

5. Medication management incidents: Track medication errors, omissions, and adverse events. National benchmarks vary by incident type. Key prevention strategies include S8 register compliance, polypharmacy reviews, and nurse-led medication reconciliation on admission and after hospital transfers.

Your QI data is compared against the sector, so improvement means performing better than your peers — not just better than your own history.

Improving your star rating requires a coordinated effort across clinical care, operations, workforce management, and governance. Here are practical, data-driven strategies that target each domain:

Residents' Experience: Implement real-time feedback mechanisms — don't wait for the annual interview. Act on complaints quickly (5-day acknowledgement, 30-day resolution). Invest in staff training around dignity, choice, and communication. Ensure food quality is consistently high — it is one of the most commonly cited concerns in resident interviews. Conduct mock resident experience interviews quarterly to identify areas for improvement before the formal assessment.

Compliance: Move to continuous compliance readiness. Conduct regular internal audits against the quality standards self-assessment checklist. Address gaps proactively rather than reactively. Ensure your SIRS reporting processes are watertight — late SIRS notifications are one of the most common compliance findings.

Quality Measures: Establish clinical indicator dashboards that are reviewed monthly at a minimum. For each indicator above the national average, create a targeted improvement plan with measurable goals and assigned clinical leads. Review your data collection methodology — inaccurate data entry is a common reason for poor QI scores that don't reflect actual care quality.

Staffing: Meet or exceed the 215 care minutes target. Ensure 24/7 RN coverage is documented and verifiable. Invest in staff retention to reduce agency reliance. Track staffing data daily, not quarterly — by the time you see a shortfall in quarterly data, it's already affected your rating.

Focusing on one domain and ignoring others. A provider that invests heavily in clinical quality but neglects workforce compliance may see quality indicator improvements offset by a poor staffing rating. All 4 domains contribute to the overall rating.

Inaccurate data submission. Quality indicator data submitted to the Department must be accurate. Under-reporting incidents to improve QI scores is both a compliance risk and an ethical failure. Over-reporting due to poor data definitions also distorts your rating. Invest in training for the staff who collect and submit QI data.

Reactive compliance. Preparing for ACQSC assessment contacts in bursts rather than maintaining continuous compliance readiness results in gaps that assessors identify. The compliance domain rewards consistency.

Ignoring consumer feedback between formal assessments. The Residents' Experience domain captures a point-in-time snapshot. Providers who only focus on quality when they know an interview is coming will have inconsistent ratings.

Not benchmarking. Star ratings are relative. If the sector improves and you stay the same, your rating drops. Regular benchmarking against national QI data is essential to understand your competitive position.

Statura Care's Quality Standards module provides continuous self-assessment tracking against all 7 Strengthened Aged Care Quality Standards, giving you real-time visibility into compliance gaps that could affect your star rating. The Quality Indicators module tracks your QI rates against national benchmarks, identifies trends, and generates improvement recommendations.

The SIRS and Incidents module ensures your compliance history stays clean by tracking all reportable incidents within regulatory deadlines. Workforce compliance tracking helps you monitor care minutes performance against the 215-minute target, while clinical governance tools support quality indicator improvement programs.

All of this data is consolidated into board-ready dashboards through the Reporting Hub that your governing body can use for strategic oversight. The Analytics module provides trend analysis across all star rating domains, helping you identify which improvements will have the greatest impact on your overall rating.

Explore how Statura Care's aged care compliance software can help you improve and maintain your star rating.