Methodology
Every number, date, and citation on Find That Nursing Home comes from the Centers for Medicare & Medicaid Services’ public Provider Data Catalog (data.cms.gov) — the same data behind medicare.gov’s Care Compare. We never invent, estimate, or “fix” a value. When CMS doesn’t report something, we say “Not reported” — or show CMS’s own stated reason for the blank.
The datasets
- Provider Information (4pq5-n9py): Ratings, staffing, ownership type, chain, penalties summary — one row per facility.
- Health Deficiencies (r5ix-sfxw): Every federal health-survey citation from the last 3 inspection cycles.
- Penalties (g6vv-u9sr): Fines and payment denials, rolling ~3-year window.
- Ownership (y2hd-n93e): Owners, managers, roles, and percentage stakes.
CMS refreshes these roughly monthly; this site rebuilds from the latest files. Current data processing date: June 1, 2026. CMS data itself lags reality — inspections take time to process, and staffing reflects past quarters.
What each rating means
The 5-star system
Medicare inspects and measures every certified nursing home, then rolls the results into a 1–5 star overall rating. It combines three parts: health inspections, staffing, and quality measures. Five stars means much better than average — it does not mean perfect. One star means much worse than average — it does not mean every shift is bad. Stars are a screening tool, not a verdict. They can lag reality by months, and they can't see things like how kind the aides are or how the building smells at 7am.
What to do with this: use stars to build a shortlist, then visit in person. Nothing on this site replaces walking the halls.
Stars are graded within each state
CMS sets health-inspection star cutoffs separately for each state: roughly the top 10% of homes in a state get 5 stars, the bottom 20% get 1 star, no matter how the state compares to others. That means a 4-star home in one state and a 4-star home in another state may have very different inspection records. The stars tell you how a home compares to its neighbors, not to the whole country. That's why this site shows your state's median next to each star rating — and never a national star comparison.
What to do with this: compare stars only between homes in the same state. To compare across states, use staffing hours — those are real numbers, not curves.
Which numbers to trust most
The three sub-ratings come from different sources. Health inspections are done on-site by trained state surveyors who show up mostly unannounced — the most objective signal. Staffing comes from payroll records that facilities must submit and CMS audits — quite reliable. Quality measures are partly self-reported by the facility from its own resident assessments — useful, but the facility grades some of its own homework.
What to do with this: when sub-ratings disagree, weigh the inspection star most and the quality-measure star least.
Health inspections
State surveyors inspect every nursing home on a roughly yearly cycle, plus extra visits when someone files a complaint. They watch care being delivered, review charts, and talk to residents. Every problem they cite becomes a deficiency with a severity grade. CMS scores the last three inspection cycles (recent ones count more) and turns that into the health-inspection star, graded on a curve within the state.
What to do with this: read the actual deficiency list below the stars — the specifics matter more than the count.
Staffing
Facilities must submit payroll records showing exactly how many RN, LPN, and nurse-aide hours they staffed each day. CMS divides those hours by the number of residents to get hours per resident per day, adjusts for how much care the residents need, and assigns a star. Staffing is the single strongest lever a facility controls: more hands means call lights answered, people turned on schedule, meals not rushed.
What to do with this: look at the actual hours below, especially RN hours and weekend hours — averages can hide thin shifts.
Quality measures
Quality measures track resident outcomes: pressure ulcers, falls with injury, urinary tract infections, unplanned weight loss, hospital readmissions, and more. Some come from claims data, but many come from assessments the facility itself fills out. Most homes report honestly; the incentive to look good is still real. CMS splits these into short-stay (rehab) and long-stay (residential) measures.
What to do with this: treat a low QM star as a real signal and a high one as a soft signal — confirm it with the inspection record.
Staffing hours per resident per day
If a home reports 3.5 total nursing hours per resident per day, that's all nursing staff time across 24 hours — roughly one caregiver-hour every 7 hours per resident, spread across day, evening, and night shifts. On a real floor it decides whether call lights get answered in 5 minutes or 25, whether someone has time to help with dinner, and whether night shift is one aide for a hall or two. Unlike star ratings, hours are actual numbers, so they CAN be compared across state lines.
What to do with this: compare a home's hours to the state and national medians shown, and ask the facility how the hours split across day, evening, and night shifts.
Case-mix adjustment
A home full of short-term rehab patients needs different staffing than a home caring for people with advanced dementia or ventilators. Case-mix adjustment estimates how many hours a home's particular residents need, then scales the reported hours so homes can be compared fairly. A home with sicker residents needs more staff for the same star. This page shows reported (raw payroll) numbers and compares them only to other reported numbers — like with like.
What to do with this: if a home's reported hours look low, check whether its residents may simply need less care — and ask the facility directly.
Staff turnover
Total nursing staff turnover is the percentage of the home's nurses and aides who stopped working there during the year. Around half of nursing-home staff leaving annually is sadly common in this industry. High turnover means residents are cared for by people who don't know them — which matters enormously for dementia care, pain management, and noticing the small changes that catch problems early. Low turnover usually means staff are treated well enough to stay.
What to do with this: when you visit, ask aides how long they've worked there. Long-tenured aides are the best sign a building has.
Survey types
A standard survey is the routine top-to-bottom inspection every home gets on a recurring cycle. A complaint survey happens because a resident, family member, or staff member reported something to the state — surveyors come specifically to investigate it. Infection-control surveys focus on practices like hand hygiene and isolation procedures. A deficiency found during a complaint survey means someone cared enough to report it and a surveyor confirmed enough to cite it.
What to do with this: note which deficiencies came from complaints — they show you what residents and families actually experienced.
F-tags
Every federal nursing-home requirement has a tag number. F0686, for example, is the pressure-ulcer requirement; F0600 is freedom from abuse. The tag tells you exactly which rule was broken, and the description next to it is CMS's own plain-language summary of that rule. The same tag appearing across multiple inspections is a pattern worth noticing.
What to do with this: if the same tag repeats across surveys, ask the facility what changed since the last citation.
Fines and payment denials
When deficiencies are serious or aren't fixed, CMS can impose a fine (a civil money penalty) or a payment denial — refusing to pay for new Medicare/Medicaid admissions until the home fixes the problem. Payment denials hit harder than most fines because they stop revenue. CMS's public dataset covers a rolling window of roughly the last three years, so the totals here are recent history, not an all-time record. Many facilities have no penalties in the window — that's common, not remarkable.
What to do with this: a recent large fine deserves a direct question on your visit — what happened, and what changed?
Ownership and chains
Nursing homes are often owned through layers: an operating company, a property company, management companies, and individual investors with percentage stakes. CMS publishes who holds 5%-or-greater interests and who has operational control. Ownership matters because it sets the budget: research has linked some ownership structures, especially certain chains and investment vehicles, to lower staffing. That's a pattern across the industry, not a verdict on any one building.
What to do with this: know who owns the home before you sign anything, and ask the administrator who actually sets the staffing budget.
The abuse icon
CMS flags a facility with its abuse icon when inspectors cited it for abuse that harmed a resident within the past year, or for abuse that could have harmed a resident in each of the last two years. CMS shows this same icon on its own Care Compare site, and caps the facility's ratings while it's flagged. The icon is removed when newer inspections come back clean. The deficiency list below will contain the underlying citations — read them.
What to do with this: read the abuse-related citations below, and ask the facility directly what happened and what changed. Verify the current status at medicare.gov/care-compare.
Special Focus Facilities
CMS keeps a short national list of nursing homes with the most persistent serious problems — the Special Focus Facility (SFF) program. SFF homes get inspected about twice as often and must improve or face termination from Medicare/Medicaid. 'SFF candidate' means the home qualifies for the list but isn't on it yet (the list has limited slots per state). Some SFF homes do graduate and improve; the designation means CMS is watching closely right now.
What to do with this: ask the administrator where the home is in the SFF process and what the improvement plan is. Verify status at medicare.gov/care-compare.
The scope & severity grid (A–L)
Every deficiency gets one letter: how severe the finding was, crossed with how widespread it was.
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| No actual harm, potential for minimal harm | A | B | C |
| No actual harm, potential for more than minimal harm | D | E | F |
| Actual harm | G | H | I |
| Immediate jeopardy to resident health or safety | J | K | L |
Why a rating can be blank (CMS footnote codes)
When CMS suppresses or omits a value, it publishes a footnote code. We show the meaning in place of the blank. From the official CMS Nursing Home Data Dictionary:
| Code | Meaning |
|---|---|
| 1 | This nursing home is newly certified and doesn't have enough months of data yet for this measure. |
| 2 | Not enough data available to calculate a star rating. |
| 6 | The facility submitted staffing data that didn't meet CMS's criteria for calculating this measure. |
| 7 | CMS determined this value was not accurate, or suppressed the data for one or more quarters. |
| 9 | Too few residents or resident stays to report this measure. CMS suggests calling the facility to discuss it. |
| 10 | Data for this measure is missing or was not submitted. CMS suggests calling the facility to discuss it. |
| 13 | Results are based on a shorter time period than CMS normally requires. |
| 14 | This nursing home is not required to submit data for the Skilled Nursing Facility Quality Reporting Program. |
| 18 | CMS does not rate this facility because of a history of serious quality issues — it is in the Special Focus Facility program. |
| 20 | CMS could not validate the accuracy of the data behind this rating. |
| 21 | CMS could not validate the accuracy of the data behind this measure. |
| 22 | The street address couldn't be matched to map coordinates, so the location shown is based on the facility's ZIP code. |
| 23 | This facility did not submit staffing data. |
| 24 | This facility reported a high number of days without a registered nurse on site. |
| 25 | CMS could not validate the accuracy of the staffing data behind this measure. |
| 26 | The facility's staffing data was missing or invalid for calculating turnover, so this measure receives the minimum staffing points. |
| 27 | The facility's staffing data didn't meet the criteria for a turnover measure, so it's excluded and the staffing score is rescaled. |
| 28 | This is an annual measure — data for individual quarters isn't available. |
What this data can’t tell you
- The deficiency file covers federal health surveys only. State-only citations and fire-safety (Life Safety Code) surveys are not in it. An empty deficiency section means no federal health-survey deficiencies in this file — never “no violations.”
- The penalties data is a rolling window, not all-time history. Totals shown are per CMS data (roughly the last 3 years). A facility may have older penalties that no longer appear.
- Quality measures are partly self-reported by facilities from their own resident assessments.
- Data lags reality. A new owner, a staffing change, or a recent inspection may not be reflected yet. Verify anything important directly with the facility and at medicare.gov/care-compare.
- Numbers can’t see kindness. Nothing here replaces visiting, asking questions, and trusting what you observe.
Attribution
Data: Centers for Medicare & Medicaid Services (data.cms.gov), public domain, processing date June 1, 2026. Find That Nursing Home is not affiliated with CMS, Medicare, or any government agency. Found an error? Suggest a correction.