Methodology
Every grade on this site is computed from public CMS data by the formula below. No human adjusts an individual facility's score, and no facility can pay to change one. If you can obtain the same CMS files, you can reproduce every number we publish.
The base score
Each facility starts with a 0–100 composite of four CMS measures, weighted as follows:
| Component | Weight | How it is scored |
|---|---|---|
| Staffing compliance | 35% | Reported RN hours per resident per day divided by 0.55, capped at 150% of the benchmark. A facility at or above 0.55 scores at least 0.67 on this component; one at 0.825 or higher scores the full 1.0. |
| Inspection clean rate | 30% | 1.0 at zero deficiencies, falling linearly to 0.0 at 20 or more. |
| Quality measures | 20% | CMS quality star rating, normalized from 1–5 stars to 0.0–1.0. |
| Staffing consistency | 15% | CMS staffing star rating, normalized from 1–5 stars to 0.0–1.0. |
The weighted components are summed and multiplied by 100. That is the base score.
The 0.55 hour RN standard was repealed effective February 2, 2026 and is not currently enforced. We still grade against it. Why
Penalty terms
The base score is built from averages, which makes it blind to two facts that matter more to a family than any average: whether residents were actually harmed, and whether anything found is still unfixed. Two penalties are subtracted from the base score to correct that.
Uncorrected findings (up to 25 points)
Each deficiency the facility has not resolved costs:
1.5 × severity weight × plan weight × recency weight
- Severity weight — immediate jeopardy (J–L): 4. Actual harm (G–I): 3. Potential for more than minimal harm (D–F): 1.5. Minimal (A–C): 1.
- Plan weight — no plan of correction on file: 2. Plan submitted but not yet verified: 1. A missing plan is a refusal to act; a submitted plan is action awaiting confirmation.
- Recency weight — most recent survey cycle: 1.0. Second cycle: 0.6. Third: 0.35. An open finding from the last inspection is stronger evidence than one from three years ago.
The total is capped at 25 points.
Actual harm (up to 25 points)
Scored on a separate axis from raw deficiency counts, so that harm is not diluted by volume. Each citation at scope and severity G through L costs 8 points for immediate jeopardy (J–L) or 4 points for actual harm (G–I), multiplied by the same recency weight. Capped at 25 points.
The practical consequence is that one J-level citation costs more than three D-level ones. That is deliberate. They are not equivalent events.
The no-plan rule
Independent of the arithmetic above: no facility holding any deficiency in "no plan of correction" status can be graded A. Such a facility is capped at B regardless of its score. An open violation the operator has not committed to fixing is the single most decision-relevant fact on a facility page, and no amount of good staffing should paper over it. This rule only ever lowers a grade — it never raises one.
Grade bands
| Grade | Score |
|---|---|
| A | 80–100 |
| B | 65–79 |
| C | 50–64 |
| D | 35–49 |
| F | 0–34 |
Update cadence
CMS publishes Nursing Home Compare data monthly, and the underlying health inspection surveys on a rolling basis. We re-ingest monthly and recompute all grades on each ingest.
Known gap: the date shown on a facility page is currently the date we loaded the record, not the date CMS published it. Those are different, sometimes by months, and the load date overstates how current the information is. The data sources page carries the dates to rely on until this is fixed.
Grade changelog
| Date | Change |
|---|---|
| 2026-07-27 | Added the uncorrected-findings and actual-harm penalty terms and the no-plan rule described above. Before this change the grade counted deficiencies but ignored both their severity and whether they had been fixed, which allowed facilities with open, unaddressed harm citations to hold an A. Of 14,703 facilities, 3,858 (26%) moved down at least one letter grade and 10,845 were unchanged. The number of A grades fell from 2,677 to 2,184, so 493 facilities lost an A. No facility's grade improved as a result of this change. Every pre-change grade is retained and can be supplied on request. |
If you believe a grade is wrong
We publish a corrections policy and a dispute route. Grades are derived from CMS data, so a grade we compute incorrectly and a CMS record that is itself wrong are different problems with different fixes — the contact page explains both.
Related
The plain-language version, the underlying files, and the staffing benchmark.
How we grade → Data sources → The repealed staffing rule →