Where our numbers come from, and how we use them.

One source: Medicare’s own data

All facility data comes from the Centers for Medicare & Medicaid Services (CMS), the federal agency that certifies and inspects nursing homes. It is the same data behind Medicare’s Care Compare website. We use these CMS files:

• 1
  Provider informationStar ratings, certified beds, ownership type, Special Focus status, the abuse icon, staffing hours and staff turnover.
• 2
  Health and fire safety inspectionsEvery citation from the home’s most recent inspection cycle, with how serious inspectors judged it and when it was corrected, plus problem counts from the last three inspection cycles.
• 3
  PenaltiesFederal fines and Medicare payment denials from the last three years.
• 4
  Quality measuresResident outcomes such as falls with injury, pressure sores, antipsychotic use, and returns to the hospital, reported separately for short-term and long-term residents.
• 5
  OwnershipThe people and companies CMS lists as owners, operators and managers.
• 6
  State and national averagesCMS’s own averages, which we use for every comparison on the site.

How often it updates

CMS publishes new nursing home data about once a month. Our site checks for a new release every week and, when one appears, updates every home’s ratings and report automatically. Each facility page says which month’s Medicare data it shows.

Medicare data always runs behind real life: inspections can be a year or more old, and staffing and quality figures cover earlier months. A home may have fixed a problem since, or developed a new one. Use the data to choose which homes to visit and what to ask, not as the final word.

What we never change

Star ratings are calculated by CMS, not by us. We show every rating, citation, fine and measure exactly as CMS publishes it. Paying for a listing never changes a home’s data, ratings, findings or summary, and homes cannot edit or remove any of it. A home can add a short, clearly labeled response beside a finding, and every home can do that for free. How we make money →

What Medicare found

Each facility page lists the home’s strengths first, then items that are about average, then things to ask about. We list something as worth asking about when:

• 1
  The home is a Special Focus Facility or candidateCMS’s short list of homes with a history of serious quality problems, which are inspected more often.
• 2
  The home carries Medicare’s abuse iconCMS shows it for a recent citation related to abuse, neglect or exploitation.
• 3
  Inspectors found harm or immediate jeopardyAny citation in the most recent inspection cycle rated as actual harm (levels G–I) or immediate jeopardy (levels J–L).
• 4
  Serious penaltiesFines in the last three years that total more than the national average per home, or any Medicare payment denial. Smaller fines are shown as below the state average.

We also compare the home’s problem count at its last inspection, nurse staffing time, registered nurse time and staff turnover with its state’s average. Where a home has responded to an item, its response is shown right beside it, labeled as written by the home.

How we compare a home with the average

A home is better or worse than average only when it differs from its state’s average by a meaningful margin; otherwise we call it about average, because small differences are mostly noise. The margins are:

• 1
  Staffing time per resident: 10%For both total nursing time and registered nurse time.
• 2
  Staff turnover: 15%The share of nursing staff who left in the past year.
• 3
  Resident outcomes: 20%Rates such as falls, pressure sores and hospital returns, which swing more from year to year in small homes.
• 4
  Problems found at inspection: 25%Inspection counts vary a lot between inspectors and visits.

The plain-English summary

The “In plain English” paragraph on each facility page is written automatically from the same Medicare figures, using fixed rules, so every home is described the same way. It covers the home’s size and ownership, its overall star rating against the state average, Special Focus status, its last inspection, any citations for harm, staffing and turnover, fines, and whether its quality ratings are stronger for short-term rehab or long-term care. Nobody, including the home, can edit it.

Short-term rehab or long-term care

Medicare rates the quality of short-stay care (rehab for a few weeks after a hospital stay) separately from long-stay care (residents who live at the home). We show both ratings next to each other, with the outcomes that matter most for each kind of stay, because many homes are noticeably better at one than the other.

Ratings over time

Each facility page charts the home’s four Medicare star ratings and its nurse staffing hours every month since January 2019, taken from Medicare’s own monthly releases. Medicare skipped a few months (usually December), and it has changed how some ratings are calculated over the years and paused most inspections in 2020, so a sudden jump can reflect a rule change rather than a change at the home.

The labels on each home’s page

Every label comes from the same fixed rules for every home. Nobody picks them by hand, and no home can pay to change them.

• Strength: better than the state average by the margins above, or no citations for actual harm or immediate jeopardy, or no federal fines in the last three years.
• About average: within those margins of the state average.
• Worse than state average: past those margins on the worse side.
• Ask about this: a Special Focus listing or candidacy, Medicare’s abuse icon, citations for actual harm or immediate jeopardy, Medicare payment denials, or fines above the national average per home.
• Worth asking about: fines in the last three years that are below the national average.

Best-rated lists

Each list ranks homes by Medicare’s overall star rating, then its health inspection, staffing and quality ratings, then fewer serious citations and fines. Homes on Medicare’s Special Focus list or with its abuse icon are left out, and so are children’s facilities. Sponsored listings never change the order.

Top Rated recognition

Top Rated for Short-Term Rehab goes to homes with Medicare’s short-stay quality rating of 5 stars, an overall rating of 4 or 5, and a health inspection rating of 3 or more. Top Rated for Long-Term Care needs Medicare’s long-stay quality rating of 5 stars, an overall rating of 4 or 5, and health inspection and staffing ratings of 3 or more. Homes on the Special Focus list or candidates for it, homes with the abuse icon and children’s facilities are never included. The bar is fixed, so any number of homes of any size can win. Recognition is free, can’t be bought, and is redone with each month’s Medicare data. See every Top Rated home.

Spotted a mistake?

If something on a facility page doesn’t match Medicare’s Care Compare, let us know and we will check it against the CMS files. If the CMS data itself is wrong, the home can ask its state survey agency or CMS to correct it; the fix will reach this site with the next monthly update.