Data Methodology
Data Sources
All data on Nursing Home News comes from official government sources, primarily the Centers for Medicare & Medicaid Services (CMS). We use the following datasets:
Primary Datasets
- Provider Information: Basic facility information including location, ownership, and certification
- Health Deficiencies: Detailed health inspection violations and deficiency citations
- Survey Summary: Inspection summaries and weighted scores
- Penalties: Financial penalties and enforcement actions
- Quality Measures: Clinical quality indicators and resident outcomes
- Staffing Data: Nurse staffing levels and hours per resident day
- Ownership Information: Current and historical ownership data
- Special Focus Facilities: Identification of poor-performing facilities under special oversight
Update Frequency
Our data is updated on the following schedule:
- Monthly: Provider information, quality measures, and staffing data
- Quarterly: Health inspection results and deficiency data
- As Available: Special Focus Facility designations and ownership changes
Note: There is typically a 2-3 month lag between inspections and data availability from CMS.
Star Rating System
The CMS Five-Star Quality Rating System assigns each nursing home ratings between 1 and 5 stars based on:
Overall Rating
A composite score based on the three component ratings below, with health inspections weighted most heavily.
Health Inspection Rating
- Based on outcomes from the last 3 years of onsite inspections
- Includes both standard surveys and complaint investigations
- More recent surveys are weighted more heavily
- Considers number, scope, and severity of deficiencies
Staffing Rating
- Based on staffing levels reported through Payroll-Based Journal (PBJ) system
- Measures total nursing hours and RN hours per resident day
- Adjusted for resident acuity using case-mix
Quality Measures Rating
- Based on 15 different physical and clinical measures
- Includes both long-stay and short-stay measures
- Risk-adjusted for resident characteristics
Deficiency Scope and Severity
Health deficiencies are categorized by scope and severity:
Severity Levels
- Level 1: No actual harm with potential for minimal harm
- Level 2: No actual harm with potential for more than minimal harm
- Level 3: Actual harm that is not immediate jeopardy
- Level 4: Immediate jeopardy to resident health or safety
Scope Levels
- Isolated: One or very limited number of residents affected
- Pattern: More than limited number but not widespread
- Widespread: Pervasive throughout the facility
Special Focus Facilities
The Special Focus Facility (SFF) program identifies nursing homes with:
- Persistent record of poor quality
- History of serious quality issues not improving over time
- More frequent surveys (twice per year instead of annually)
Data Limitations
Users should be aware of the following limitations:
- Data reflects past performance and may not represent current conditions
- Self-reported data elements may contain inaccuracies
- Inspection frequency and intensity can vary by state
- Not all quality aspects can be captured in quantitative measures
- Facilities may improve or decline between inspection cycles
How to Use This Data
We recommend:
- Using multiple data points when evaluating facilities
- Looking at trends over time, not just current ratings
- Visiting facilities in person before making decisions
- Consulting with healthcare professionals
- Contacting facilities directly for current information
Questions?
For questions about our methodology or data, please contact us.