Methodology & Data Sources

Primary Data Source

All data on PlainNursing comes from CMS Nursing Home Compare, a public dataset published by the Centers for Medicare & Medicaid Services. This is the same data that powers Medicare's official nursing home comparison tool. The dataset is updated monthly for most measures.

What We Download and Process

We download CMS Nursing Home Compare datasets, including provider information, star ratings, staffing metrics, health inspection results, and penalty records, and join them into a unified facility profile. Our pipeline:

• Joins provider information, ratings, and deficiency data on CMS certification number (CCN)
• Preserves deficiency descriptions, scope codes (A–L), and severity levels exactly as published by CMS
• Calculates state-level aggregate benchmarks from individual facility metrics
• Reports staffing hours per resident day using CMS Payroll-Based Journal (PBJ) data submitted by facilities

Five-Star Rating System

CMS assigns each nursing home an overall rating from 1 to 5 stars based on three components, each also rated separately:

• Health Inspections: Results from the three most recent on-site surveys and complaint investigations. More recent surveys are weighted more heavily.
• Staffing: RN and total nurse hours per resident day from PBJ payroll data, adjusted for resident acuity (case-mix). CMS targets higher-acuity residents requiring more care.
• Quality Measures: Clinical outcome metrics for long-stay residents (falls, pressure ulcers, infections, functional decline) and short-stay residents (re-hospitalizations, ER visits, functional improvement).

The overall rating is determined by the health inspection rating, then adjusted up or down based on staffing and quality measure ratings. Full technical methodology is in the CMS Five-Star Technical Users' Guide.

Inspection Deficiencies

Deficiency codes use a letter-based scope and severity grid where A–C are isolated/minimal harm, D–F are isolated/potential harm, G–I are actual harm, and J–L are immediate jeopardy (the most serious category). We display deficiency descriptions and scope/severity codes as published in the CMS dataset without modification.

Data Vintage and Update Frequency

CMS updates the Nursing Home Compare dataset monthly for most measures, with health inspection data reflecting the three most recent on-site surveys (typically spanning a 3-year window) and staffing data reflecting the most recent PBJ quarterly submission. Quality measures are updated quarterly as CMS processes the underlying clinical data reported by facilities through the Minimum Data Set (MDS). PlainNursing refreshes its database periodically as CMS publishes updated Nursing Home Compare files; the refresh is not on a fixed automated schedule, so the data on file may lag the most recent CMS release. The vintage date shown alongside published figures reflects the most recent refresh. Source datasets are available at CMS Provider Data, Nursing Homes and inspection lookups at Medicare Care Compare.

Accuracy Commitment

PlainNursing reproduces CMS Nursing Home Compare data exactly as published. Star ratings, staffing hours, deficiency descriptions, scope and severity codes, and penalty records are presented without editorial modification or proprietary reweighting. Deficiency details are displayed verbatim as published by CMS, including the specific regulatory tag number, scope code (A through L), and deficiency description text. Where CMS reports a rating or metric as unavailable, due to new ownership, data gaps, or insufficient survey history, PlainNursing displays it as unavailable rather than estimating or interpolating a value.

If a figure looks wrong, follow the corrections process. Material shipped fixes and CMS-refresh landings are listed on the data changelog.

Limitations

• Star ratings are one data point among many that matter in a care decision. They do not capture staff culture, leadership quality, resident satisfaction, visitor policies, dining quality, or the overall warmth and attentiveness of day-to-day care.
• Health inspection frequency and rigor varies by state. Some states survey facilities more frequently than others, and some facilities may have longer gaps between surveys due to scheduling and resource constraints.
• Staffing data reflects what facilities self-report to CMS through the Payroll-Based Journal (PBJ) system. PBJ data is subject to CMS audit but may contain errors, and reported staffing levels may not reflect the actual care experience on every shift.
• Quality measures are based on clinical data from the Minimum Data Set (MDS), which is completed by facility staff. The accuracy of quality measure scores depends on the completeness and accuracy of MDS assessments.
• Where CMS reports a rating as unavailable (new ownership, recent change of management, insufficient data), PlainNursing displays it as such rather than estimating a score.
• Always visit facilities in person, observe care delivery firsthand, and consult healthcare professionals and the long-term care ombudsman before making a placement decision. PlainNursing is not affiliated with CMS or any government agency.

Revenue & data-reuse readiness

This section documents what is productized today and what would require an explicit operator decision to activate. Nothing here turns on new monetization by itself.

Downloadable today

• nursing-home-quality-statistics.csv (/data/nursing-home-quality-statistics.csv): national aggregates also wired into Dataset JSON-LD on methodology and statistics. Underlying CMS Nursing Home Compare fields are U.S. government works (government works). PlainNursing's compiled table and derived rollups follow Terms of Use (attribution + link back; no bulk competing redistribution without written permission).
• CiteThis blocks on hub and policy pages: copy-ready attribution text. No separate embed script is published.

Not productized (operator-gated)

• Paid CSV/API tiers, bulk dumps beyond the public aggregates CSV, and white-label embeds.
• Any affiliate units or alternative ad networks beyond labeled Google AdSense (when approved).

YMYL-safe affiliate rules (if the operator ever activates)

PlainNursing is a CMS registry reference, not care-placement advice. If facility-finder or insurance comparison affiliates are ever enabled, permitted slots are limited to /tools and /rankings hubs, never adjacent to facility star ratings, deficiency narratives, staffing tables, or guide sections that discuss choosing a nursing home. Units must be clearly labeled as advertising and respect the same density ceiling as display ads (Module 36). Any activation is [operator].

Alternative network eligibility (paperwork only)

Mediavine Journey readiness now includes traffic and engagement floors (Tier-1 sessions, engagement rate, session duration, bounce, pages/session; see the portals north star). PlainNursing is still under the Google AdSense GETTING_READY state with thin Google organic traffic; session volume and engagement are the gates that have not been crossed. Alternative-network application is not paperwork-blocked by the policy stack (privacy, terms, editorial policy, and the data changelog are present). No alternative ad code ships without operator sign-off.