Some ways to potentially gauge the health of the starfish that may be useful:
1 - Visual: is anything visually wrong with the specimen? (From what I know of starfish, these cues are generally pretty obvious if they're there at all - if the starfish is disintegrating, there's something wrong).
2 - Weight: is the specimen putting on or maintaining weight (generally healthy), or is it losing weight (under most circumstances, this would be unhealthy)?
3 - Size/Length: if it's not already full size, is the specimen growing? Is it shrinking (either from weight loss, disease, limb loss, etc.)?
4 - Reproduction: is the specimen engaging in reproductive behaviors/activities (i.e. courting, nesting, spawning, etc.)? (I recognize this one is not as common of an indicator in captive starfish at this point, but there are a few instances of starfish attempting to spawn in captivity).
5 - Longevity: is the specimen relatively close to meeting, actually meeting, or exceeding their expected wild lifespan (or at least surviving for a few years - healthy), or is the specimen dead/dying prior to doing so (unhealthy)?
6 - Speed: how quickly can the specimen right itself when it's flipped over?
7 - Level of activity: how much is the specimen moving around? (Generally speaking, low activity indicates poor health; moderate activity indicates good health; and high activity indicates good health but probable stress - it could be searching for food, oxygen, etc., but it's probably not in terrible health when moving a lot).
8 - Grip strength: does the specimen have a strong hold/grip with its tube feet? (A strong grip indicates good health, a weak grip indicates poor health).
9 - Willingness to eat: is the specimen eating? (Seems obvious, but can be really hard to tell with some stars - some stars leave little trails called feeding scars through the things they're eating; sometimes you can see their everted stomachs; other times, like if they're feeding on biofilm, you may not be able to tell at all - them crawling onto visible food is a good sign they're willing to eat, but - as mentioned above - the food may or may not meet their nutritional needs).
