Nursing home sources and methodology
This page explains which public data are imported, how the care-specific signal is assigned, what is not available, and what families must still confirm directly.
Public data used
The consumer-facing source for official overall, inspection, staffing, short-stay, long-stay, and quality-measure ratings, along with alerts and facility details.
The automated guide uses current provider information, MDS quality measures, Medicare claims-based measures, Skilled Nursing Facility Quality Reporting Program data, and state and national averages.
Official technical information for CMS’s ratings. The guide displays these ratings but does not reproduce or alter the CMS methodology.
Specifications and reporting information for post-acute skilled nursing measures.
Standardized instruments for asking residents and families about experience. CMS does not currently provide a comparable nationwide facility-level experience star for every nursing home.
Optional supplemental verification of Nursing Care Center Accreditation or additional certification for the exact facility.
How the guide-created signal works
The colored shape is separate from the official CMS Five-Star ratings. It is designed to direct attention to findings and questions—not to rank, endorse, or declare a facility safe or unsafe.
| Signal | Rule used by the guide |
|---|---|
| Green circle | At least two selected care-related measures have national benchmarks; none is materially unfavorable; the health inspection and staffing ratings are both at least 3 stars; and no high-priority warning or other specified caution is present. |
| Yellow triangle | One specified caution is present, such as a 2-star inspection rating, 1- or 2-star staffing rating, a reported penalty, an inspection more than two years old, or one materially unfavorable care-related measure. |
| Red octagon | An abuse alert, Special Focus Facility status, a 1-star health inspection rating, or at least two materially unfavorable selected care-related measures are present. |
| Gray square | Too little relevant public information is available, or CMS data cannot verify the selected specialized capability. Missing or suppressed information never supports green. |
Materially unfavorable means the facility value differs from the national value by more than 10% in an unfavorable direction. This is a transparent decision rule created for the guide; it is not a CMS statistical-significance determination.
How measures are matched to care needs
Short-term rehabilitation
Emphasizes rehospitalization, emergency-department use, new antipsychotic use, vaccination measures, staffing, physical-therapy information, and other short-stay results when available.
Long-term nursing care
Emphasizes falls with major injury, pressure injuries, infections, catheter use, weight loss, functional decline, hospital and emergency use, medication measures, staffing, and turnover.
Memory or dementia support
Emphasizes antipsychotic and sedating medication use, falls, restraints, functional change, hospital use, staffing, turnover, and inspections. CMS data do not establish that a facility offers an appropriate secured or specialized dementia program.
Complex skilled nursing
Emphasizes pressure injuries, infections, hospital transfers, staffing, and inspections. Wound, respiratory, dialysis, infusion, and other specialized capabilities must be confirmed directly.
Palliative or hospice-related support
CMS nursing home data do not verify the availability or quality of a particular hospice relationship or palliative program, so this pathway normally receives a gray care-specific signal and provides questions for direct confirmation.
Resident and family experience
The report shows the CMS field indicating whether a resident or family council is reported. A council can support resident voice, but it is not a satisfaction or experience score.
Because a standardized nationwide facility-level CMS experience star is not available for every nursing home, the guide asks each facility for its latest resident and family survey instrument, dates, sample size, response rate, complete results, trends, independent administration, and improvement actions. Facility results should not be compared unless their questions, populations, timing, and methods are sufficiently similar.
How accreditation information is handled
Joint Commission Nursing Care Center Accreditation and related certifications are voluntary and are not universal among nursing homes. The visitor-completed accreditation worksheet is supplemental and does not change the CMS ratings or the guide-created signal. Not finding a facility in the Joint Commission directory is not automatically an adverse quality finding.
CMS inspection findings, staffing, enforcement actions, abuse warnings, Special Focus Facility status, and care-relevant quality measures remain the principal public information used by this guide.
Last methodology review: September 23, 2026.
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