Our Methodology

Data Source

All facility data is sourced exclusively from the CMS Provider Data Catalog at data.cms.gov/provider-data. We download six datasets monthly:

• provider_info — Core table: name, address, star ratings, staffing, ownership
• health_deficiencies — Every inspection citation, tag, and severity code
• penalties — Civil money penalties and payment denials
• quality_measures — 30+ clinical quality metrics per facility
• mds_quality_measures — Resident-level clinical assessment rollups
• state_us_averages — State and national benchmarks

Star Ratings

CMS calculates the Five-Star ratings using a complex methodology. We display the ratings as-is from CMS — we do not modify, interpolate, or adjust them. The four components are:

• Overall Rating — Weighted composite of the three below
• Health Inspections — Based on standard surveys, complaint investigations, and focused infection control surveys over the last 3 years
• Staffing — RN and total nurse staffing hours per resident per day, adjusted for case mix
• Quality Measures — 15 short-stay and 15 long-stay measures from MDS assessments

Abuse Alert Flag

The Abuse Alert flag is set when abuse_icon = 'Y' in the CMS provider_info dataset. CMS sets this flag when a facility has an active citation for resident abuse, neglect, or exploitation from a standard survey within the past year that has not been corrected to CMS satisfaction.

We display this as a prominent red banner on every flagged facility page. We do not hide or downplay this information.

Special Focus Facility (SFF)

The Special Focus Facility program identifies nursing homes with a pattern of serious deficiencies. CMS sets special_focus_status = 'SFF' for these facilities. We display an orange warning banner on all SFF facilities.

Severity Codes (A–L)

CMS uses a letter code to indicate the scope and severity of each deficiency citation:

• A–C — Isolated, no actual harm
• D–F — No actual harm with potential for minimal harm
• G–I — Actual harm (G = isolated, H = pattern, I = widespread)
• J–L — Immediate jeopardy to resident health or safety

We flag severity G and above as "Harm" in our display.

Update Frequency

CMS updates the Provider Data Catalog on the first Wednesday of each month. We import the new data within 48 hours of each release. Facility pages show the date of the most recent CMS update.

What We Do Not Do

• We do not rank facilities by anything other than their CMS rating
• We do not accept payment to alter a facility's ranking or appearance
• We do not suppress negative information for any reason
• We do not generate or infer ratings — only display what CMS publishes