Grandmother’s Crib

The Inspection Grade is a proprietary Assisted Living Magazine score — a 0–100 score (shown as a letter) of a facility's regulatory inspection record, compared with other assisted living residences in Nevada. Each category below contributes a weighted share — ranking better than the typical facility in your state raises the grade, worse lowers it. Serious problems weigh more than clean marks, so one severe issue costs more than a good record earns.

It is not a government rating. CMS and state health agencies publish the underlying inspection records; the grade is our own calculation from them, and no regulator endorses or reviews it.

• Severity 34%

  The most serious problems — immediate-jeopardy findings and deficiencies that caused actual harm. Weighted highest, because one severe problem matters more than many minor ones.

• Deficiencies 26%

  How often inspectors cite the facility for deficiencies — measured per inspection and relative to its size, and including problems found through complaint investigations.

• Enforcement 24%

  Fines and formal enforcement actions regulators have taken — a strong signal of serious or repeated problems.

• Persistence 16%

  How quickly the facility corrects cited problems — slow-to-fix issues weigh against the grade.

Not every facility is graded on all four categories. A facility is scored only on the categories we have verified data for. CMS-certified nursing homes carry federal records for all four. State-regulated facilities — assisted living and adult care — are graded on fewer, usually just severity and how often they're cited, because fines and problem-resolution data are collected only at the federal level. A grade can even rest on a single category when that's the only inspection data on record; it reflects what we actually know, and a facility is never penalized for data that simply doesn't exist for it.

The period we look at. For facilities graded from state inspection reports, the grade covers the last five years — every category, the same five years. CMS-certified nursing homes are graded on the current records CMS publishes. Either way, old findings age out: a facility isn't judged forever on a problem it has long since fixed.

Data quality. We weigh every category by how much verified data we actually have — federal CMS inspection records count fully, while state and AI-read records count less. When a record is thin, we grade more cautiously and won't publish a damaging grade we can't stand behind.

Severe events. A recent, verified severe event — immediate jeopardy, substantiated abuse, or a license / Medicare termination — can cap the grade regardless of the rest.

The scale. It's set so a typical facility lands around a B+. Most homes are fine; C, D, or F is a genuine warning flag worth a closer look.