Peregrine Senior Living at Onondaga Hill

Not every facility gets an Inspection Grade. The Inspection Grade is a proprietary Assisted Living Magazine grade, and we publish one only when the public record is strong enough to be fair — to the facility and to the families reading it. A facility has to clear all four of these:

• A real inspection history

  At least two inspections on record. Where a state publishes its own inspection record we hold the facility to two inspections in that record; where we grade from inspection reports we have read ourselves, we require at least three from the past five years, so one old visit can't define a facility.

• Signal in the scored categories

  A grade needs usable data in at least one category — Severity, Violations, Enforcement, or Persistence. CMS-certified nursing homes carry federal records for all four, so we require at least three of them before grading one.

• Data we can actually stand behind

  Each category is weighed by how trustworthy its source is: federal CMS records count fully, a state's own published record counts nearly as much, and reports read by our AI count for less. A facility whose record is essentially empty isn't graded at all.

A missing grade is not a bad grade. It reflects what we can verify — not the facility's quality. Newer providers, and those in states that publish little inspection data, often don't have enough public record yet.

Grades change as the record does. We recalculate as new inspection reports are published and verified, so many of these assisted living residences will earn a grade once there's enough on file.