Some say that the new Five-Star Quality Rating System for rating nursing homes isn't fair. Designed to help families searching for a nursing home, the Centers for Medicare and Medicaid Services' (CMS) system rates the homes on the basis of health inspections, staffing, and quality measures. The higher the facility is rated, the more stars it receives. But critics claim that the CMS chose measures that may not tell the whole story. For example, self-reported staffing data based on a two-week snapshot once a year don't show the differences between agency and permanent staff, says Lauren Shaham, vice president of communications at the American Association of Homes and Services for the Aging (AAHSA). Shaham called the ranking "a great idea, prematurely implemented" and said that the AAHSA would work with the CMS, hoping for refinement. CMS spokesman Peter Ashkenaz confirmed that some groups considered the rankings "flawed," but noted that the CMS has seen "high consumer interest" and increased Web hits as people access the new information.