How we rank nursing homes
How we rank assisted living communities
Five weighted categories.
Every weight below corresponds to data points visible in our facility comparison tables. Nothing evaluated that families can’t see.
Bar widths reflect weighting. Hover any category below for the full data inventory.
Care Quality
The largest single share of every ranking. These measures come from CMS Care Compare and reflect the actual care delivered to residents.
What’s measured
- Overall CMS Star Rating
- Health Inspection Rating
- Quality Measure (QM) Rating
- Long-Stay QM Rating
- Short-Stay QM Rating
Staffing Adequacy
Staffing is the single strongest predictor of resident outcomes in skilled nursing. We evaluate both volume and stability.
What’s measured
- Staffing Star Rating
- Nurse Hours Per Resident Per Day
- RN Hours vs State Average
- Total Nurse Staff Hours/Resident/Day vs State Average
- Registered Nurse Turnover
- Nurse-to-Resident Ratio
- Staff-to-Resident Ratio
Regulatory & Safety Record
Inspection history reveals patterns that star ratings can mask. We weight per-inspection rates more heavily than raw counts to avoid penalizing facilities inspected more often.
What’s measured
- Total Health Citations
- Citations Per Inspection (vs state average)
- Severe Citations (immediate jeopardy / high-harm)
- Penalties & Fines Received
- Accreditations (Joint Commission, CARF, AAAHC)
Operational & Financial Stability
Stable operations and sound finances are leading indicators of consistent care. Facilities under acute financial pressure cut staff, defer maintenance, and post higher turnover.
What’s measured
- Occupancy Rate (vs state average)
- Average Length of Stay
- Total Revenue (Medicare Cost Report)
- Payroll as % of Revenue
- Revenue Per Bed
- Ownership / Chain Affiliation
- Administrator Tenure
- Years in Operation
Environment & Accessibility
Context that matters to families but doesn’t directly measure clinical care. Weighted lower for nursing homes than for assisted or independent living, since most skilled-nursing residents do not access the surrounding neighborhood independently.
What’s measured
- Walk Score
- Better Business Bureau Rating
Data sources
All inputs are sourced from publicly verifiable datasets. We do not rely on self-reported facility marketing claims.
CMS Care Compare
Provider Information dataset — star ratings, quality measures, and federal inspection results. Updated monthly by CMS.
CMS Payroll-Based Journal (PBJ)
Verified staffing hours and turnover data, submitted by facilities and audited by CMS. The gold standard for nursing home staffing measurement.
CMS Health Deficiencies dataset
Federal inspection citation records, including severity classifications for immediate-jeopardy and high-harm findings.
CMS Medicare Cost Reports (HCRIS)
Audited annual financial reports filed with CMS — revenue, payroll, and other operational financials.
State licensing databases
State-by-state licensing records for administrator tenure, chain affiliation, and operating history.
Accreditation directories
Verified accreditation status from The Joint Commission, CARF, and AAAHC.
Walk Score
Walkability scoring API for the facility address, measuring proximity to amenities and pedestrian access.
Better Business Bureau
BBB business profiles, including accreditation status, complaint history, and customer review patterns.
Six weighted categories.
Every weight below corresponds to data points visible in our facility comparison tables. Nothing evaluated that families can’t see.
Bar widths reflect weighting. Hover any category below for the full data inventory.
Resident & Family Experience
The single largest share of every ranking. We aggregate review data across multiple platforms to capture how families and residents actually experience the community.
What’s measured
- Average Review Sentiment
- Volume of Reviews
Regulatory & Safety Record
State inspection records are the closest equivalent to CMS data for non-skilled-nursing communities. We weight per-inspection rates more heavily than raw counts to avoid penalizing communities inspected more frequently.
What’s measured
- Number of State Inspections
- % of Inspections with Citations
- Total Citations / Violations
- Citations per Inspection
- Number of Complaint Visits
- Awards and Accreditations
- Better Business Bureau Rating
Visual Media & Transparency
Communities that publish high-quality visual media give families a real preview of the environment. Communities with no photos or tours receive a negative transparency signal.
What’s measured
- Presence of Video Tours
- Matterport / Virtual Walkthroughs
- Photo Quantity
- Photo Quality
Website & Operator Transparency
A community’s website is often the first touchpoint for families. We score both the quality of the site and whether the operator publishes basic accountability information.
What’s measured
- Quality of Website Content
- Ease of Navigation & Mobile Usability
- Available Staffing Information
- Owner / Operator Transparency
Community Stability
Operational health indicators that signal whether a community is well-run and meeting demand.
What’s measured
- Occupancy Rate
- Bed Options Offered
Environment & Pricing
Context that supplements care quality. Walk Score is weighted differently across care types — higher for Independent Living, where residents access neighborhoods routinely; lower for Memory Care, where most residents do not leave unaccompanied.
What’s measured
- Walk Score (weighted by care type)
- Pricing Transparency
Data sources
All inputs are sourced from publicly verifiable datasets. We do not rely on self-reported facility marketing claims for scoring.
State health department inspections
Inspection counts, deficiencies, citations, and complaint visits. Sourced state-by-state from official health and human services agencies.
Third-party review platforms
Aggregated review sentiment and volume from Google, Yelp, Caring.com, A Place for Mom, and other major platforms.
Better Business Bureau
BBB business profiles, including accreditation status, complaint history, and customer review patterns.
Accreditation directories
Verified accreditation status from CARF, Joint Commission, and state-specific senior living credentials.
Walk Score
Walkability scoring API for the community address, measuring proximity to amenities and pedestrian access.
Community-published materials
Website content, video tours, virtual walkthroughs, photo galleries, staff directories, and pricing pages — audited by our editorial team.
Editorial independence is non-negotiable
Rankings are produced by our editorial team using the methodology above. Sales and partnership relationships have no influence on a facility’s ranking.
