This research investigated the connection between the Medicare star rating system and E-tags on emergency preparedness of nursing homes for disasters in Hampton Roads, Virginia. Emergency preparedness in nursing homes has been a topic of growing interest within the past decade. Hampton Roads, Virginia, has a history of natural disasters including hurricanes and flooding, which necessitates a proper and efficient emergency preparedness plan in nursing home facilities. The primary purpose of this research was to review the secondary Centers for Medicare and Medicaid Services (CMS) data regarding the star rating system and E-tag surveys of each of the 37 nursing facilities that were not connected to a hospital or part of a continuing care retirement community to find a correlation, if any, between emergency preparedness and CMS star rating. The theoretical foundation for the research was the diffusions of innovation theory, which addresses innovation that is communicated between members of a team or social group, inclusive of gaining knowledge of an innovation, persuading others to move toward that innovation, team decision making on the innovation, and implementation/confirmation of that innovation. The statistical analysis provided inconclusive answers to research questions. The potential social change from this study is it may inform nursing home administrators of the 4 most frequent E-tag deficiencies found in this research; and their nonlinear relationship to total bed count and variables such as individual Medicare star rating categories so that administrators can apply this new knowledge to their field in general and their facility in particular; to achieve better overall disaster preparedness coordination.