Member ratings and reviews
Our members
Star ratings and written reviews from more than 33,000 members, checked by moderators before they appear.
How member ratings workMethodologyVersion 2.5
Every number, and where it comes from.
The Care Ratings shows the federal record for more than 43,000 providers next to ratings from more than 33,000 members. This page explains where each number comes from, how we calculate the few that are ours, how often they change, and what they can't tell you.
- Medicare- and Medicaid-certified providers, from CMS files
- 43,000+
- provider types: nursing homes, home health, hospice, dialysis and inpatient rehab
- 5
- members in our ratings and reviews community
- 33,000+
- checks for new CMS nursing home data
- Daily
Provider counts as of September 27, 2026, from CMS provider files. Member count as of September 2026.
01Principles
Five rules behind every page
They decide what we show, what we calculate and what we leave out. If you find a page that breaks one, tell us.
Show the federal record as CMS published it
CMS values appear as published. We format them for reading and never adjust them. If a record is wrong, the fix has to come from CMS.
Name the source of every number
Each figure comes from CMS, from our members, from the facility itself or from another public dataset, and this page says which.
Publish the math for anything we calculate
Rankings, badges, report card grades, the Care Quality Index and Compare's suggested pick are ours, not CMS measures. Every formula is on this page.
Keep member opinions apart from the federal record
Member ratings never change a CMS rating. They have their own section on a profile, and they sort lists only where CMS has no rating.
Never let money change a number
The Care Ratings is free for families. Facilities can pay for a few things, each labeled, and none of them changes a facility's data, ratings, reviews, rank, badge or grade.
Payment never changes
- A facility's CMS ratings, inspections, staffing, penalties or ownership record
- Its place in our rankings, its Top Rated badge, its report card grade or the Care Quality Index
- A member review: we don't remove, edit, hide or feature reviews for payment
- Care Advisor recommendations, once the Advisor launches
Facilities can pay for, always labeled
- A Verified profile the facility builds and keeps current, with photos, services, pricing and other details shown alongside the federal record
- Sponsored placement on state and city pages, sold as advertising and marked Sponsored
- Introductions to families who ask to be connected, once the Care Advisor launches
Today, no list or search result on the site is ordered by payment. Read our advertiser disclosure.
02Sources
Where each number comes from
Most of what you see comes from files the Centers for Medicare & Medicaid Services (CMS) publishes about every Medicare- and Medicaid-certified provider. The rest comes from our members, from facilities that claim their profiles and from public data about the community around each provider.
CMS provider files
| Provider type | Providers | What we show | CMS files |
|---|---|---|---|
| Nursing homes | 14,733 | Five-Star ratings (overall, health inspections, staffing, quality measures), Special Focus Facility status and candidate status, the abuse icon, the CMS release date behind each profile, the number of health deficiencies cited in the last three inspection cycles and the most recent citations, short-stay and long-stay quality measures with their reporting periods, nurse staffing hours and turnover, fines and payment denials, CMS ownership type and owners, and certified beds | Provider Information, Health Citations, Penalties, Quality Measures and Ownership |
| Home health agencies | 12,646 | CMS's quality of patient care star rating, services offered, ownership and certification date | Home Health Care Agencies |
| Hospices | 7,076 | Ownership, certification date and location. We don't show CMS hospice quality data yet. | Hospice General Information |
| Dialysis facilities | 7,490 | CMS's star rating, whether hospitalization, readmission and infection rates were better or worse than expected, services and stations | Dialysis Facility files, July 15, 2026 release |
| Inpatient rehabilitation facilities | 1,222 | Five CMS quality measures: recovery at discharge, return to the community, readmissions, falls with major injury, and new or worsened pressure injuries | Inpatient Rehabilitation Facility files, June 24, 2026 release |
All from the CMS Provider Data Catalog, the same files behind Medicare's Care Compare. Provider counts as of September 27, 2026.
Everything else
Facility-provided details
Facilities that claim their profile
Photos, descriptions, services, pricing, languages and whether a facility accepts Medicaid. Facilities add these details; they can't change CMS values.
Google ratings
Google Places
The Google rating and review count for nursing homes, shown as Google's and refreshed each quarter.
Community data
Census Bureau, CDC, HUD
Age, income, poverty, insurance, disability and education for the ZIP code around a provider come from the U.S. Census Bureau, American Community Survey 5-year estimates. Chronic illness and disability prevalence come from CDC, PLACES: Local Data for Better Health, ZCTA estimates. Local rents are HUD, Small Area Fair Market Rents. City, state and national figures are averages across nursing homes, where each home contributes the figure for its ZIP code, so a ZIP code with several homes counts once per home. Every card and tile names its source. State pages add life expectancy (CDC, 2022) and America’s Health Rankings (2024).
Cost of care
CareScout (formerly Genworth)
National median monthly costs by type of care, used in our cost calculator and on care-type pages.
Map locations
Census Bureau geocoder, Mapbox
Coordinates that place each provider on our maps and measure distance when you search near a place.
03CMS ratings
How CMS builds the nursing home stars
The star ratings on nursing home profiles are CMS's, shown unchanged. This is how CMS calculates them, from the September 2026 edition of its Five-Star technical guide.
- Step 1
Start with health inspections
Findings from the two most recent annual inspections, plus three years of complaint and infection-control inspections, weighted by how serious and widespread each problem was.
- Step 2
Adjust for staffing
One star added for a 5-star staffing rating, one taken away for 1 star. Staffing combines nurse hours, adjusted for how sick residents are, with staff turnover, all from payroll data.
- Step 3
Adjust for quality measures
One star added for a 5-star quality rating, one taken away for 1 star. The rating uses 15 measures from resident assessments and Medicare claims.
- Result
Overall rating, 1 to 5 stars
A nursing home with a 1-star inspection rating can rise by one star at most, because CMS weights what inspectors found on site most heavily.
Inspection stars are graded on a curve, state by state
CMS compares each nursing home's inspection score with the others in its state. It recalculates the cut points every month, so each state's share of each star level stays about the same.
When a rating is capped or missing
- Abuse citations
- A nursing home cited for abuse that harmed a resident, or cited repeatedly for abuse that put residents at risk, has its inspection rating capped at 2 stars, so its overall rating cannot exceed 4. Its profile shows an abuse warning above the stars.
- Special Focus Facilities
- Nursing homes in CMS's program for persistently poor performers get no star ratings while they are in it. Profiles show a warning for nursing homes in the program and for the candidates on CMS's list, and say when a home is not rated for this reason.
- New nursing homes
- With only one standard inspection on record, a nursing home gets no ratings until its second. Its profile says it is not rated yet, and why.
Other provider types
- Home health agencies
- CMS's quality of patient care star rating, 1 to 5 stars, built from a set of home health quality measures.
- Dialysis facilities
- CMS's star rating for dialysis facilities, plus whether hospitalization, readmission and infection rates were better than, as or worse than expected.
- Inpatient rehabilitation
- CMS doesn't star-rate these facilities. We show five of its quality measures instead.
- Hospices
- CMS publishes hospice quality and family survey results. We don't show them yet.
04Our calculations
The numbers we calculate ourselves
None of these is a CMS measure. Each applies one rule to every provider, uses CMS data (and, where noted, member or Google ratings), and is published here so you can check it.
Local nursing home rankings
See the rankings- Who's included
- Nursing homes with a CMS overall rating that appear in CMS's latest file.
- Order
- CMS overall rating, highest first
- Fewer penalties (a missing count ranks last)
- Health inspection rating
- Staffing rating
- Name
- Limits
- Up to 25 per page. A state ranking needs at least 10 eligible nursing homes.
- Filters
- 5-star only, no penalties, government-owned and accepts Medicaid. The Medicaid filter uses what facilities tell us, not CMS data.
- Updated
- Calculated when the page loads, from the latest CMS data we hold.
Top Rated badge
About the badgeA nursing home earns the badge when all four are true:
- A 5-star CMS overall rating, or a rating higher than at least 90% of the other rated nursing homes in its state
- No fines or payment denials in CMS's penalty window, about three years
- Not a Special Focus Facility or candidate
- No CMS abuse icon
Awarded and withdrawn automatically after each automatic CMS load and every Monday. It can't be bought or applied for.
Report card and scorecard grades
Open a report cardThe report card shows CMS's stars as they are and places each measure among peer nursing homes once there are at least five.
The scorecard grade combines six percentiles among the rated nursing homes in the same state:
Then it takes off 30 points for a Special Focus Facility, 20 for an abuse icon, 15 for a Special Focus candidate and 5 for an overdue standard inspection. Grades: A 80 and up, B 65 to 79, C 50 to 64, D 35 to 49, F below 35. A nursing home without a CMS overall rating isn't graded.
In both, citations at severity G through L count as harm to residents, and J through L as immediate jeopardy.
Compare's suggested pick
Compare facilitiesWhen you compare nursing homes, we suggest one with a fixed formula:
3 × overall + 2 × inspections + 2 × staffing
+ 2 × quality measures + 0.5 × Google rating
− 0.35 per penalty (at most 3)
− 1 per 50 miles from your location (at most 2)Missing ratings count as zero. It is arithmetic on the numbers you can see, not advice.
Care Quality Index
See the indexA 0-to-100 score for nursing home quality in each state, built from three CMS measures. Our homepage map calls it the Care Ratings Index.
CQI = round( 0.40 × Rating + 0.35 × NoPenalty + 0.25 × Staffing )
Rating = (average CMS overall rating − 1) ÷ 4 × 100
NoPenalty = % of nursing homes with no fine or payment denial
in CMS's penalty window (a missing count counts as none)
Staffing = % of staffing-rated nursing homes with 4 or 5 staffing stars- It covers the 50 states. A state needs at least 10 nursing homes, and states with fewer than 30 are marked † as small samples.
- The weights are our judgment, not a measure of how well each part predicts outcomes. The components ship in our open data so anyone can reweight them.
- The index page recalculates it from the latest CMS data when it loads; the homepage copy updates when the site is rebuilt.
- In the open dataset, D.C. and the territories also get an index when they have at least 10 nursing homes.
How lists are ordered
- Nursing home lists and directories
- CMS overall rating, then fewer penalties
- Home health lists
- CMS's quality of patient care star rating
- Dialysis directories
- CMS's star rating
- Hospice and inpatient rehabilitation lists
- Name, or the member rating on lists labeled highest rated
- Highest rated near you
- CMS stars, or the member average where CMS has none, then distance within 100 miles
- Site search
- Exact name matches first, then rating, then name
- Any list sorted by closest
- Distance from the place you searched
No list or search result is ordered by payment.
05Member reviews
How member ratings work
More than 33,000 members rate and review providers here. Their ratings add what federal data can't: how a place felt to the people who lived there or visited.
- members rate and review providers
- 33,000+
- review per member, per provider
- 1
- of reviews checked by a moderator before they appear
- 100%
The rules
- Only signed-in members can review, and only once per provider.
- Accounts that own or are claiming a facility can't post reviews.
- A review needs a 1-to-5-star rating and 20 to 2,000 characters.
- Moderators check every review before it appears.
- Three flags from members send a review back to moderation.
- We don't remove, edit, hide or feature reviews for payment.
How ratings are shown
- The community rating is the average of approved member ratings, shown with the number of reviews. It appears once a provider has one approved review.
- It sits in its own section on the profile and never changes a CMS rating.
- Where CMS has no rating (hospices, inpatient rehabilitation facilities and listings outside CMS), lists labeled highest rated use the member average, so a single review can place a provider on them.
- Averages update when a moderator approves or removes a review.
Reviews come from people who chose to write them, and a few can swing an average. Read them next to the federal record, not instead of it.
06Updates
How often each source changes
CMS publishes on its own schedule, and we load different files in different ways. Here is how each source reaches the site today.
| Data | How it reaches us | When it updates |
|---|---|---|
| Nursing home ratings, staffing hours, nurse turnover, penalty totals, chain and ownership-change flags | Automatic | We check CMS every day and load each new release when it appears, usually monthly |
| Nursing home inspection citations, penalty details, quality measures and owner records | By our data team, from CMS downloads | Not yet on a fixed schedule |
| Home health agencies and hospices | Automatic | We check CMS every day and load each new release when it appears, usually quarterly |
| Dialysis and inpatient rehabilitation | By our data team, one CMS release at a time | Dialysis: July 15, 2026 release. Rehabilitation: June 24, 2026 release. Each profile names its release. |
| Google ratings for nursing homes | Automatic | Each quarter, on January, April, July and October 15 |
| Member reviews | After moderation | Shown once a moderator approves them |
| Community data | By our data team, with our loader scripts | Once a year, after each release: Census ACS 5-year estimates in December, CDC PLACES in December, HUD Small Area Fair Market Rents in October. Now showing Census ACS, CDC PLACES and HUD SAFMR. State and city population and median age come from the Census API at page load. |
| Rankings, badges, grades and the Care Quality Index | Calculated by us | Rankings and the index are recalculated when a page loads. Badges, peer percentiles and state summaries are recalculated after each automatic CMS load and every Monday. |
| Open Nursing Home Data | Automatic build from CMS files | A new release each month |
CMS data describes the recent past. Inspection results reach CMS once a state finishes its paperwork, staffing and quality measures cover an earlier quarter, and fines typically take six to eight months to appear in CMS's files.
07Limits
What the data can't tell you
Ratings are where your questions start, not where they end. These are the caveats we would want to know.
Stars are graded on a curve
CMS compares inspection results within each state, so three stars in one state isn't the same bar as three stars in another.
Facilities report much of it
Staffing comes from payroll data facilities submit, and most quality measures from assessments their own staff complete. CMS audits both, but neither is an independent observation.
A fine isn't a count of harm
Penalties cover about three years, recent ones may not appear yet, and CMS's file doesn't say whether a fine was charged per day or per instance.
Ownership is as disclosed
Owner and operator names are what facilities report to CMS, not what we have verified.
Some providers have no rating
New nursing homes and Special Focus Facilities have no CMS rating, and their profiles say why. CMS doesn't star-rate rehabilitation facilities, and we don't show hospice quality data yet.
Area data isn't about the building
Community figures describe the people who live in a ZIP code or city, not a provider's residents or the care they get.
Reviews are individual
They come from people who chose to write them, and a few reviews can swing an average.
Our weights are judgment calls
The weights and thresholds in our rankings, grades and index are choices. We publish them so you can disagree.
Before you decide
Visit, more than once and at different times of day. Ask to see the latest inspection report, which nursing homes must make available, and talk with residents and their families.
What we don't use
- Crime, sex-offender, food access, health workforce, education, wage or cost-of-living data. Earlier versions of this page listed these datasets; we don’t use them.
- Changes to CMS data from facilities. Facilities can add details alongside the record; a correction to a CMS value has to go through CMS.
- Payment of any kind for a rating, rank, badge, grade or review.
- Reviews copied from other sites. Google’s rating appears on nursing home profiles as Google’s, apart from member ratings.
08Open data
Check our work
Our nursing home research runs on Open Nursing Home Data: monthly, versioned releases of the CMS files behind it, published with the code that builds them. Anyone can download a release, rerun the code and get the same numbers.
- Download the dataEach release is named for its CMS vintage, like v2026.08, and ships with checksums, a codebook and a validation report.
- Read the codeThe build code, methodology and codebook are public on GitHub. The code is MIT-licensed.
- LicensesCMS values are public domain. Our derived data, including the Care Quality Index, is CC BY 4.0.
- Permanent archiveAn open copy of every release at Zenodo, under DOI 10.5281/zenodo.22780104.
- Editorial standardsWhat our research will and won't claim, and how we check it before publishing.
- Corrections logEvery correction to our research, with what changed and when.
How to cite
For a dataset release, use the formats on our cite page, which include the DOI. For a figure on a provider profile, cite CMS as the source and The Care Ratings as where you found it, with the date you viewed it. For this page:
The Care Ratings. (2026, September 25). Methodology (Version 2.5). https://thecareratings.com/methodology/
09Changelog
Changes to this page
When we change a source, a formula or a rule, we record it here with the date.
The daily CMS check now carries more of the nursing home record.
- Nurse turnover, the overdue-inspection flag, chain names and the ownership-change flag now load with each automatic CMS release. Before this they reached the site only when our data team loaded CMS files by hand, which the schedule in version 2.0 did not make clear.
- State summaries, the figures on each state page, are recalculated after each automatic CMS load, alongside badges and peer percentiles.
- The daily check now compares the processing date CMS serves with the one we have loaded, so a change to CMS catalog metadata alone cannot trigger a reload.
Home health agencies and hospices joined the daily CMS check.
- The update schedule now lists home health agencies and hospices as automatic: we check CMS every day and load each new release of the Home Health Care Agencies and Hospice General Information files when it appears. Version 2.0 said our data team loaded them by hand.
- An automatic load refreshes every field we show for these providers, including the home health quality of patient care star rating, services offered, ownership and certification date.
- An automatic load never changes a profile’s web address or map position. When CMS lists a provider at a new address, its page, address and map stay as they were until our data team reviews and re-maps the change.
Nursing home profiles show more of the CMS files.
- Profiles count every health deficiency cited in the last three inspection cycles. The figure had been capped at the five citations the page lists; the report card lists them all.
- Profiles show the ownership type CMS records (for-profit, non-profit or government, with the legal form) beside any ownership type the facility entered.
- Quality measures are grouped by short-stay and long-stay residents, show their reporting periods, and mark the 12 star-rating measures that CMS publishes in the files we load. Counts per 1,000 resident days are no longer shown as percentages.
- Payment denials show their start date and length instead of a $0 fine.
Community data rebuilt from the official files, with the source and vintage shown wherever it appears.
- Reloaded the three community tables with published loader scripts: U.S. Census Bureau, American Community Survey 5-year estimates (ZIP Code Tabulation Areas), CDC, PLACES: Local Data for Better Health, ZCTA estimates, and HUD, Small Area Fair Market Rents. Each load records its source, vintage and date, and the Community Health card and dashboard tiles now show them.
- Provider ZIP codes that have no tabulation area of their own (PO-box and retired ZIPs) now take the figures of the area containing the provider, resolved with the Census geocoder.
- A missing community figure is now shown as a dash. Before, a city or state with no data for a measure was averaged as 0%, which pulled averages down.
- Relabeled the poverty figure on city and national dashboards as an all-ages rate; it had been called a senior poverty rate.
- The national "housing cost burdened" tile is now calculated from the Census data (owner and renter households paying 30% or more of income for housing) instead of a fixed 44.3%.
- State-versus-national comparisons for rent, income and the 65+ share now use national averages computed from the same ZIP tables instead of fixed figures.
- Set the update schedule for community data to once a year after each release; version 2.0 said these tables were loaded once with no refresh planned.
Nursing home profiles now show CMS warnings and the CMS release date.
- Added warnings to nursing home profiles for Special Focus Facility status, the Special Focus candidate list and the abuse icon, from the CMS Provider Information file, each with one line on what it means and a link to the CMS ratings section of this page.
- Added "CMS data as of" to nursing home profiles, from the Processing Date of the CMS file each nursing home was last loaded from. Rankings pages already showed it.
- A nursing home with no CMS overall rating, a new home or a Special Focus Facility, now says it is not rated and why, instead of showing an empty rating.
- Listed these items in the sources table.
Rewritten to match how the site works today.
- Added member reviews, which launched on April 18, 2026. Version 1.0 said we used no user reviews.
- Replaced the update schedule. Version 1.0 said data updated quarterly, with fixed delays that did not describe our pipeline.
- Removed datasets we do not use: FBI crime, sex-offender, USDA food access, HRSA shortage area, NCES education, BLS wage, BEA price, HUD housing burden, CMS hospital, COVID-19 and Medicaid rate data.
- Added sources version 1.0 left out: Google ratings, facility-provided details, America’s Health Rankings and CareScout costs.
- Corrected the Care Quality Index: it covers the 50 states, not every state and territory; its staffing part is the share of nursing homes with 4- or 5-star staffing ratings; and its weights are our choice, not a measure of how well each part predicts outcomes.
- Corrected two descriptions of CMS data: payroll staffing data is reported by facilities, and penalties are not limited to cases of actual harm.
- Added the methods for local rankings, the Top Rated badge, report card grades, Compare's suggested pick and list order.
- Pointed citations, data requests and corrections to our open data pages.
First published at launch.
Written by the Care Ratings Team and reviewed by the TCR Editorial Team. Every statement on this page was checked against the code and data behind the site on .
10FAQ
Questions we hear
Why doesn't a rating here match Medicare's Care Compare?
Both come from the same CMS files, so a mismatch usually means one site has loaded a newer release. We check for new nursing home, home health and hospice data every day; dialysis and inpatient rehabilitation data are loaded by our data team and can lag. Tell us through our contact page and we will check.
Can a facility pay to improve its rating or rank?
No. Payment doesn't change CMS data, star ratings, member reviews, rankings, badges or grades, and today no list on the site is ordered by payment. Facilities can pay for a Verified profile, sponsored placement marked Sponsored and, once our Care Advisor launches, introductions to families who ask. Our advertiser disclosure has the details.
Do member reviews change CMS star ratings?
No. Member ratings have their own section on a profile. They sort lists labeled highest rated only for providers CMS doesn't rate.
How does a nursing home earn the Top Rated badge?
Automatically, with a 5-star CMS rating or one in the top 10% of its state, no fines or payment denials in CMS's penalty window, no Special Focus status and no abuse icon. It is rechecked after every automatic CMS load and every Monday. See the badge program.
Is the Care Quality Index a CMS measure?
No. It is our state-level composite of CMS data. We publish its formula, its components and its weights so anyone can check it or reweight it.
Why is a provider missing from the rankings?
Rankings include only nursing homes with a CMS overall rating that appear in the latest CMS file. New nursing homes and Special Focus Facilities join once CMS rates them.
How do I report an error?
Use our contact page and name the page and the figure. If a CMS value is wrong, the facility has to correct it with CMS, and the fix reaches us with the next release. Corrections to our research are logged in our corrections log.
Corrections
Found something wrong? Tell us.
Name the page and the figure. We reply within five business days, and corrections to our research are logged publicly.
