Methodology

Inspection, staffing, rating and ownership records come from the Centers for Medicare & Medicaid Services (CMS). Historical prices come from separately identified public sources. Budget worksheets use the figures you enter. This page explains the sources, our calculations, and the limits of what these records can tell you.

Data sources

We use the CMS Provider Data Catalog, the same public source behind Medicare's officialCare Compare. CMS refreshes these datasets monthly; we re-import each release in full. Current datasets and versions:

Currently 14,690 certified facilities and 419,479 inspection citations. Facility pages show the CMS processing date for their record. Because CMS publishes monthly, the records can lag real-world changes by weeks; always verify current conditions directly with the facility and Care Compare.

What we add

• Plain-language translations. CMS describes each citation with regulatory language and a code (like F-0600). We maintain a translation for every one of the 643 citation codes in the CMS lookup table: what the failure means, why it matters to residents, and a question a family can ask the facility. Translations are drafted with AI tools from the official CMS description of each code. Every build checks coverage — if CMS adds a code and it has no translation, or a translation is missing any of its three parts, the build fails and nothing ships. That check is for completeness, not accuracy: we do not re-read every translation against its official description before each release. They aim to stay strictly faithful to the official meaning, and the official wording for every code is in the Citation Code Look-up dataset listed above, so you can check any one of them against us — or use our side-by-side list of all 643. If you spot one that drifts, tell us.
• Severity in plain words. The A–L scope/severity letters follow CMS's own grid; our wording for each level is fixed site-wide so a "J" means the same thing on every page.
• Fair staffing comparisons. Staffing hours come from payroll-based records facilities must submit. We display CMS's case-mix adjusted hours — the same basis CMS uses for its staffing star — because raw hours are not comparable between facilities whose residents need different amounts of care. Percentiles ("top 25% in Alabama") are computed within state and nation on that same adjusted basis. Weekend RN hours have no adjusted version, and are labeled accordingly.
• Context. State and national averages, distances to nearby facilities (straight-line, from CMS-published coordinates), chain affiliations, and month-over-month continuity (closed facilities stay visible, marked as no longer certified).

What we deliberately don't do

• We don't compute our own score. No composite rating, no ranking, no "best nursing homes" lists. We show the official ratings and the underlying facts, and leave the judgment to you.
• We don't recommend facilities. No facility can pay to appear, improve, or suppress anything on this site — see money and conflicts of interest. Data display is and will remain fully separate from any commercial content.
• We don't editorialize individual facilities. Pages contain the records and fixed explanatory text — no per-facility opinions.
• We don't invent expertise. Content is published under the site's own name — we never attach fictional experts, credentials, or an editorial body that does not exist to it. Every clinical judgment on this site comes from CMS inspectors, not from us — we don't assess care quality or give medical advice.

How we check the published information

Software joins records using the CMS Certification Number (CCN), checks required fields and formats, and verifies selected calculations against the source data. Plain-language explanations are reused where the same regulatory code has the same meaning. Automated checks are not a clinical review and do not establish that every source record is accurate.

Targeted source checks investigate a specific claim, formula or reported discrepancy. For example, the corrections below were checked against CMS definitions and current Medicare information. We do not claim that every facility has been visited, every explanation reviewed by a clinician, or every record individually checked before each release.

City staffing summaries use the adjusted hours already reported for each facility. Averages give each facility equal weight; they are not weighted by resident count. Comparisons between all-week and weekend hours use only facilities with both values. Missing values are excluded and the sample count is shown. The inspection-age flag reflects the CMS release, not a new inspection by this site.

Material corrections

These are changes to our explanations and calculations, separate from the monthly CMS data release. Report a discrepancy with the page address, CCN where relevant, and the source you are comparing.

• September 4, 2026 — Inspection severity. Corrected wording that confused the scope of a finding with whether it was repeated. Scope describes how widely a problem affected residents; it does not establish recurrence. The A–L wording now follows the CMS citation definitions.
• September 4, 2026 — Rating and coverage guides. Corrected the inspection-cycle and staffing-rating explanations, the skilled-maintenance coverage wording, and the Medicare amounts. The revised ratings guide and coverage guide include their official sources.
• September 4, 2026 — Source descriptions. Updated the site descriptions to distinguish CMS quality records, CT OPM historical prices and calculations from user-entered quotes. A historical price is not a current offer.

Update cycle

Data refreshes monthly, shortly after each CMS release; every page footer shows the dataset version. If you find any number on this site that differs from Medicare Care Compare for the same facility, please report it with the facility's CCN — we check every report against the source data.

The Care File is an independent project and is not affiliated with or endorsed by CMS or medicare.gov. CMS data is in the public domain.

Price evidence and cost worksheets

Quality and price are separate dimensions. CMS inspection records and staffing levels do not tell us a facility’s private-pay price. We do not infer a price from its rating, fines, ownership or staffing, and we do not calculate a combined value-for-money score.

Our initial price sample contains historical private-pay room rates for two Connecticut facilities, transcribed from the Connecticut Office of Policy and Management report (PDF). The rates are effective September 30, 2025, although the report title says 2026. We matched the names, town and bed counts to CMS identifiers and retain the source date. If those identity fields no longer match, the facility price is not shown. The separate Connecticut statewide semi-private average is regional context, not a facility quote.

Published rates may omit services or fees and may have changed. They do not establish availability, insurance coverage or what a particular resident will owe. We reproduce individual factual amounts with attribution, not source logos, seals, report layouts or commercial directory content. Source publication does not itself guarantee permission for every possible reuse. Read Connecticut’s source disclaimer.

The cost worksheet calculates (entered daily rate + entered daily extras) × entered days + entered one-time charges. It does not predict future rates or apply benefits, taxes, deposits or charges you did not enter. Obtain an itemized written quote and confirm coverage with the facility and payer. Report a price or identity error.