About NursingHomeGrade

The dominant nursing home referral services earn commissions from the facilities they recommend — as much as $3,500 per family placed. In May 2024, the Washington Post and a Senate investigation documented how this creates incentives to hide violation records.

NursingHomeGrade does not take payments from nursing facilities. We surface the same CMS data that's publicly available, organized and scored in a way that's actually useful.

How we grade facilities

The NursingHomeGrade Score (0–100) is a weighted composite of four CMS data points:

Staffing compliance (35%) RN hours vs the repealed 2024 benchmark of 0.55
Inspection clean rate (30%) Health inspection deficiencies & severity
Quality measures (20%) CMS quality star rating
Staffing consistency (15%) CMS staffing star rating

The repealed federal staffing standard

The 0.55 RN hours per resident per day figure in our staffing component came from the CMS 2024 minimum staffing rule. That rule was vacated by two federal district courts, blocked by Congress through 2034, and repealed by CMS effective February 2, 2026. It is not currently enforced. We still grade against it, and we say so everywhere we cite it. Read the full explanation →

Data source

All data comes from CMS Nursing Home Compare, a public dataset updated monthly by the Centers for Medicare & Medicaid Services. We apply no editorial adjustments.

Business model

We display contextual advertising and earn small referral fees when users click through to comparison services. We never receive payments from nursing facilities. If that ever changes, we'll disclose it prominently.

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