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I highly recommend to play the story until you unlock teleporters and the second consultant (they are unlocked at the same time, and I believe it's chapter 3 from memory). Both of them make the game a LOT easier and make 5 stars in every level a much less daunting task.
So, all these people going 'It's not hard', yes it is due to how patients are coded and how the game loop occurs. There is very little you can do to stop Congestion (a single person next to a KB will make them have an orange debuff and two is red), yes, even with teleporters galore you will still get it and that will keep people down ON TOP of the default 'never goes happier than 80%' patients. Once again, I have done all of the story missions to 5* and currently stuck on one optional hospital (fourth one) with the other three also 5*. Again, it is down to timing and getting 5* in middle game, rather than end game, as end will not do it.
tl;dr it is bugged imo, patients will be stuck at 80% mood even with all positive mood modifiers and don't seem to get affected by doctor buffs. There are several other bugs such as patients having 'Messy Area' debuff even though it is clean. Even doctors get this and it is impossible to get rid of, so you have to fire them. They will likely get it again, regardless. Or Consultant skills not working. Or artefacts not seeming to work. Or loads of things. It's buggy.
Edit: I managed to get the 5 Star Rating despite not actually getting it on the screen. I assume this is a display bug as I have in several missions gotten 5 Star Rating on the objective screen display but it isn't and I guess I got 4.9 on objective screen display but didn't.... Or it is another bug and I shouldn't have gotten it. Not going to complain though.
Edit (again): It did eventually say so, the trick worked btw. I just hired Charismastic doctors to wander the halls without any rooms to man, combined with phereomones they give a decent boost (but the 'forever 80%' patients often don't improve or if they do start to go back down to 80%).
If you do this with spacious rooms, wide corridors lined with decorations and keep your queue times down to a minimum it's pretty easy to 5* stuff... So far anyway.
I had to restart the sandbox on the first one to get that to 5* purely because I couldn't be bothered rearranging everything after the learning curve. The two story missions after that and the side sandbox mission I got 5* without trying.
I was struggling to get to 85% on the patient mood before but now I'm over 90% so that extra boost from charisma isn't essential but it sure makes things run a lot smoother.
Ps. Oh, and later don't build too many rooms. I almost ran out of space only in one mission and all my rooms have been spacious throughout the campaign.
Cheers. This is sorely needed, it seems near impossible to get five stars on the first level (and likely others) because of the Patient Mood requirement which is, to a distressing extent, kept entirely beyond our control due to the gantry issue.
I got five on the second one naturally enough while just playing the game as best I could; seems difficulty in getting to five stars is currently very dependant on layout, grateful it's being addressed.
You're welcome
The progress counter on the right hand side of the screen also doesn't show the mission to improve the hospital to five stars. But the stars counter on the lower left side of the screen does working.