Finding Care18 mins
Open data
Data license
A release mixes public-domain federal data with work by The Care Ratings. The terms differ by layer, and every column in a release is tagged with its layer in the codebook (cms or tcr).
Terms by layer
| Layer | What it covers | Terms |
|---|---|---|
| CMS source values | Every value taken from a CMS file (columns tagged cms in the codebook): ratings, staffing hours, fines, owner names, disclosure flags. | U.S. government work, public domain. No attribution to The Care Ratings is required to reuse these values. Full text. |
| Derived data | Columns computed or curated by The Care Ratings (tagged tcr) and the selection and arrangement of each release: harmonized identifiers, ownership and staffing flags, state summaries, the Care Quality Index. | Creative Commons Attribution 4.0 (CC BY 4.0), applying only to those contributions. Facts are not copyrightable; this is an attribution request for our work, never a claim over federal data. Full text. |
| Identifier crosswalk | The crosswalk table (CCN, PECOS enrollment id, NPI, affiliation entity id, chain id). | CC0 1.0 Universal, so it can be reused in public knowledge bases without attribution. Full text. |
| Documentation | The codebook, methodology, release notes, and the reports built on the data. | CC BY 4.0. Full text. |
| Code | The build scripts, schema and tests in the public repository. | MIT. Full text. |
Attribution
When you reuse tcr columns or a release as a whole, please cite the release you used:
The Care Ratings. Open Nursing Home Data, release vYYYY.MM. Built from Centers for Medicare & Medicaid Services public files. https://thecareratings.com/data/
Each release carries a manifest.json with checksums and the exact CMS files it was built from; cite the release name so readers can retrieve the same files. Ready-made formats are on the citation page.
Reusing only CMS values? Cite CMS. The public-domain layer is theirs, and no attribution to The Care Ratings is required.
What the data is not
The disclosure flags in owners_pecos and the has_* columns in facilities are the facility's own answers on Form CMS-855A. A facility that does not disclose a private-equity or REIT owner has not reported one; that is not a finding that it has none. The Government Accountability Office (2023) and Chen and colleagues (Health Affairs, 2024) documented that CMS ownership data captures only part of private-equity and REIT investment.
The Care Quality Index in state_summary is a descriptive composite with weights chosen by The Care Ratings. Its three components are published beside it so anyone can reweight it.
The full notice, as shipped inside every release, is LICENSE-DATA.md in the public repository.
