The federal Centers for Medicaid and Medicare Services issued Thursday ratings for nursing homes across the country, including three in Polk County.

The new 5-star rating system gave two stars to Autumn Care of Saluda, three stars to White Oak Manor of Tryon and five stars to Willowbrooke Court at Tryon Estates.

According to the rating system, two stars represents below average quality, three stars represents average quality and five stars represents much above average quality.

According to the report, more than one in four nursing homes in North Carolina are rated one star or &dquo;much below average.&dquo; The federal agency gave a one-star rating to 119 of the state&squo;s 419 nursing homes, and it gave a two-star, or &dquo;below average,&dquo; rating to 68 nursing homes.

The report cites high staff turnover, excessive restraints, patient bedsores, unrelieved pain and lost patient mobility as reasons for some of the low ratings. The ratings are based on health inspections, nursing home staffing and other quality measures.

The new report was created to provide more information to consumers when they are evaluating the quality of nursing homes. Some industry representative have critized the report.

&dquo;It is based on significantly flawed and inadequate information that has stacked the public relations deck against nursing homes,&dquo; said William Minnix Jr. of the American association of Homes and Services for the Aging.

North Carolina is planning next month to start its own five-star rating system for adult-care homes, assisted living centers, rest homes and group homes that offer a lower level of medical care than nursing homes.