Methodology
How we grade
Open Care Data turns public federal data into a plain-English read on nursing-home safety. This page explains exactly how our Safety Grade and benchmarks are built, where the data comes from, and how to ask us to fix an error.
The Safety Grade is our independent assessment — an opinion — not an official government rating. It is derived from public data published by the Centers for Medicare & Medicaid Services (CMS), but CMS does not issue letter grades and has not reviewed or endorsed ours. The official CMS measure is the separate Five-Star rating, which we show alongside our grade.
What the Safety Grade measures
The grade starts from a facility's official Medicare (CMS) overall Five-Star rating, then adjusts for a small set of serious, objectively-recorded factors that the star rating can understate. Every adjustment is tied to a specific public data point:
| Start at | The facility's CMS overall Five-Star rating (1–5). |
| −1.0 | An abuse-related finding is flagged on the facility's federal record. |
| −1.0 | The facility is on the federal Special Focus Facility list for persistent quality problems. |
| −0.5 | Staffing rating is in the bottom tier (2 stars or fewer). |
| −0.5 | Registered-nurse turnover above 55%. |
| −0.5 | More than $50,000 in federal fines. |
| −0.5 | One or more serious ("actual harm" or worse) citations in the last 36 months. |
The result is capped to a 1.0–5.0 range and mapped to a letter:
On every facility page we show the specific factors that moved that facility's grade, so the reasoning is never hidden.
How the benchmarks work
The "How it compares" panel ranks a facility against every other Medicare-rated nursing home in the same state, using the most recent federal data. "Better than 80% of Michigan homes" means the facility's value beat 80% of that state's nursing homes on that measure. Percentiles are recomputed as new federal data is released.
Where the data comes from
Everything on the site is drawn from public datasets published by CMS through its Provider Data Catalog and Care Compare program:
- Nursing Home Provider Info — star ratings, staffing, ownership, penalties
- Health Deficiencies — inspection citations, scope and severity
- Enforcement / penalties — fines and payment denials
- MDS Quality Measures — clinical outcome measures
Each facility page notes the federal release date it reflects.
Freshness and accuracy
Federal data updates on CMS's schedule and can lag real-world conditions — a facility may have corrected an issue that hasn't yet cycled into the public record, and datasets occasionally contain errors at the source. We refresh from CMS regularly, but we can't guarantee completeness or timeliness. Always confirm current conditions with the facility and with CMS's Care Compare before making a decision.
Neutrality
The same formula is applied to every nursing home in exactly the same way. There are no sponsored listings, no paid placement, and no referral fees. A facility cannot pay to change, improve, remove, or hide its grade, its ranking, or its record on this site. We don't hand-write or edit individual grades — they are computed automatically from the data above.
Corrections & facility responses
If you believe a data point is wrong, or you operate a facility and want to add context, we want to hear from you. Report a specific error and we'll check it against the source; if a correction is warranted we'll make it.
Spotted an error, or operate this facility?
Not affiliated with the government
Open Care Data is an independent project. It is not affiliated with, endorsed by, or connected to CMS, Medicare, or any government agency or healthcare provider. See our Terms of Use & Disclaimer for more.