Editorial policy — how we count

This page exists so you can check us. Every figure on this site should be traceable to a named public dataset with a date on it. If you find one that is not, tell us and we will either source it or remove it.

Where the numbers come from

Nursing homes. The Centers for Medicare & Medicaid Services publish two files we rely on: the Provider Information file (one row per home — certified beds, staffing hours, star ratings, ownership changes) and the Health Deficiencies file (one row per citation — the home, the survey date, the tag, and the scope-and-severity grade). Both are free to download at the CMS Provider Data Catalog. We pull them quarterly and date-stamp what we publish.

Assisted living. There is no federal equivalent. Assisted living has no federal star rating and no national inspection database, so those counts come from each state’s own licensing data — the Department of Social Services in California, the Department of Health Services in Arizona, and the Division of Public and Behavioral Health in Nevada.

What “actually harmed” means

Federal inspectors grade every finding on a letter scale from A to L. It matters enormously and almost nobody explains it.

• A–C — no harm, minimal potential for harm.
• D–F — no actual harm, but more than minimal potential. About 93 of every 100 findings nationally sit here.
• G–I — actual harm to a resident.
• J–L — immediate jeopardy: residents were in danger of serious injury or death.

When we say a home was cited for something that actually hurt a resident, we mean a finding graded G or above. When we give a total number of findings alongside it, that is every grade including the D–F band. This is why a raw violation count tells you very little on its own, and why we always show both.

What the star ratings do and don’t tell you

We use Medicare’s five-star ratings, and we think you should too — with three caveats we will keep repeating. They are graded on a curve within each state, so a three-star home in one state is not equivalent to a three-star home in another. Part of what feeds them is reported by the facility itself. And in 2023 the federal government’s own inspector general found that Medicare had failed to publish at least one deficiency for an estimated two-thirds of nursing homes.

The star is a way of deciding which inspection reports are worth reading. It is not the finding.

How we treat findings against a named facility

A citation means a government inspector looked into something and agreed with it. It is not a court ruling, it is not a criminal conviction, and facilities are entitled to challenge findings. Where we name a home, we say what the record says and when we checked it, and we link to the government’s own page for that home so you can read it yourself.

We do not name a home on the basis of a single complaint, an anonymous account, or a lawsuit that has been filed but not resolved.

Corrections

We publish corrections rather than quietly editing. If something here is wrong — whether you are a family, a facility, or a regulator — the route is on our corrections page, and it goes to a person.