How the site makes the figures
Last reviewed:
Each figure on this site comes from the CMS Care Compare files for nursing homes. CMS processed the files that the site shows now on . This page shows how the site makes each figure from the files.
Sources and update cycle
The site uses seven CMS files. The data sources page lists them. CMS publishes new files about one time each month.
The site requests the files each day and makes the pages again. If a file does not load, the site uses its last complete copy of that file. The ownership file has no copy. If the ownership file does not load, the site keeps the pages of the day before.
How the site calculates each figure
Star ratings
The site shows the four star ratings as CMS publishes them. It does not calculate a rating. The guide What the CMS star ratings measure explains the CMS method.
Citations in a survey cycle
The CMS health deficiencies file has one row for each citation, with a cycle number from 1 to 3. Cycle 1 is the latest. The count for a cycle is the number of rows with that number.
The count includes a citation that the home disputes. The table of citations marks such a citation. CMS adds the surveys of the last months in later updates, so a count can increase.
Citations for each 100 beds
For one home, the site divides the citations of the three cycles by the certified beds, then multiplies by 100. For a county, a state or a chain, it divides the sum of the citations by the sum of the beds.
The figure does not allow for the number of inspections. States inspect and cite in different ways, so a difference between two states can come from the State Survey Agencies.
Medians
For a group of homes, the site puts the values in order and takes the middle value. If the number of homes is even, it takes the higher of the two middle values. A home without a value is not in the calculation.
The groups are the county, the state, the chain and the nation. A column with "(CMS)" in its name holds an average that CMS publishes in its State US Averages file.
Share of homes with 1 or 2 stars
The site divides the number of homes with an overall rating of 1 or 2 stars by the number of all homes in the group. Homes without a rating are in the total.
Fines and payment denials
The CMS penalties file holds the fines and payment denials of three years. The total of fines is the sum of the fine amounts in that file. The date of a penalty is the date of the inspection that caused it.
A table of fines by year shows the first year and the last year in part only.
Staffing
The hours per resident per day are the reported figures in the CMS provider file, for the quarter that CMS uses. The turnover figures are the CMS figures for 12 months. The site shows hours with two decimal places.
Quality measures
The site shows the average of four quarters for 8 measures from the CMS quality measures file. CMS uses these measures in the quality measure rating. The site calculates the state median and the national median.
What "since the last CMS update" compares
At each CMS update, the site compares ten values of each home with the values in the update before it:
- the overall rating, the health inspection rating, the staffing rating and the quality measure rating
- the Special Focus status
- the abuse icon
- the number of penalties
- the total amount of fines
- the number of health citations in the latest survey cycle
- the chain
The site records each value that is different. For the total amount of fines, it records a change of $1,000 or more. For each state, it also compares the number of certified homes.
The lists of changes and the feeds do not name a home for a change of the abuse icon. The page of the home shows that change, and the log gives the count.
Pages that search engines do not list
The site asks search engines not to list some pages. Each of these pages stays on the site, and its address does not change.
- The page of a home that has no rating, no citation and no penalty. The page has too little data to be a useful search result.
- The page of a city with fewer than five homes, and the page of an owner organisation with fewer than five homes. The county page and the pages of the homes have the same data.
- A month page of a state that is older than 24 months, or that has fewer than three entries.
- The search page, the compare tool and the watch list. Their content comes from the reader.
A chain has a page when the CMS provider file lists 3 or more homes with its name. An owner organisation has a page with 3 or more homes. A city has a page with 2 or more homes, and an F-tag with 20 or more citations.
Known gaps
- Persons in the ownership file. The site does not show an owner, an officer or a manager who is a person. It also removes an organisation name that reads as the name of a person, for example a personal trust or an estate.
- Chains with the name of a person. For such a chain, the site shows "Chain name not shown" and makes no chain page.
- Staffing. The staffing figures come from the provider file only. The site does not use the daily Payroll-Based Journal file.
- Names. CMS cuts the name of a home at 50 characters, so a long name can stop in the middle of a word. CMS writes names in capitals, and the site changes them to title case.
- Survey dates. The provider file gives the date of the standard survey for cycles 1 and 2 only.
- Fire safety. The site does not show citations from fire safety inspections.
- Inspection reports. The CMS data files do not contain the report of the surveyor.
Why a figure can differ from Care Compare
- Care Compare can show a newer update for some days before the site has it.
- The site counts a citation that is in dispute and marks it.
- The site rounds the citations for each 100 beds and the medians to one decimal place.
If the two records differ, the Care Compare record is the official one.
Editorial policy
- CMS terms. The site uses the terms of CMS. Each term has one meaning, and the glossary gives it.
- No ranking. The site does not put homes in order of quality. A comparison is a figure beside a median.
- No advice. The site gives records and statistics. It does not give medical, legal or financial advice.
- The CMS caveat. Each page of a home quotes three sentences of the CMS Technical Users' Guide about changes of a rating. The page names the guide and gives the date of the data.
- Organisations only. No page, title or table row is about a person.
- Corrections. The site corrects an error in its processing at the next edition and records it in the corrections log. A dispute about a CMS record goes to CMS.