Transparency is fundamental to our mission. This page explains exactly how we collect, process, and present nursing home data to ensure you can trust the information we provide.
Data Collection Process
We employ a sophisticated multi-channel approach to ensure comprehensive coverage:
Primary Government Sources
- CMS Provider Data Catalog: Direct access to Medicare's official nursing home database
- Nursing Home Compare: Real-time updates from CMS's public reporting system
- State Survey Agencies: Individual state inspection reports and enforcement actions
- CDC NHSN: COVID-19 data and infection control metrics
- CASPER Reports: Certification and survey provider enhanced reports
Data Processing Pipeline
Our automated systems process millions of data points daily through a rigorous pipeline:
1. Extraction
Automated retrieval from government APIs and databases every 4-6 hours
2. Validation
Cross-reference multiple sources to ensure accuracy and completeness
3. Normalization
Standardize formats across different state and federal systems
4. Analysis
Apply algorithms to identify patterns, trends, and newsworthy events
5. Verification
Quality checks against historical data to flag anomalies
6. Publication
Generate articles with proper context and severity assessments
Understanding Violation Severity
We use CMS's official scope and severity matrix to classify violations:
🔴 Immediate Jeopardy (Most Severe)
- Situation where facility noncompliance has caused or is likely to cause serious injury, harm, or death
- Requires immediate corrective action
- May result in termination from Medicare/Medicaid
🟠 Actual Harm
- Deficiency that resulted in actual physical or psychological harm to residents
- Requires prompt corrective action plan
- Often results in financial penalties
🟡 Potential for Harm
- No actual harm occurred but potential exists for more than minimal harm
- Most common type of violation
- Requires corrective action within specified timeframe
⚪ Minimal Harm
- Potential for causing no more than minor negative impact
- Still requires correction but lower priority
Quality Rating System
We present CMS's Five-Star Quality Rating System with added context:
Overall Star Rating Components:
- Health Inspections (Most Weighted): Based on last 3 years of onsite inspections, complaint investigations, and infection control surveys
- Staffing Levels: Total nursing hours and RN hours per resident day from payroll data
- Quality Measures: 15+ clinical indicators including falls, pressure ulcers, and medication management
Update Frequency
Different data types are updated on varying schedules:
Real-Time
Breaking news, closures, immediate jeopardy situations
Daily
New inspection reports, enforcement actions, complaint investigations
Weekly
Staffing updates, quality measure changes, ownership transfers
Monthly
Star rating updates, comprehensive facility profiles, trend analysis
Important Limitations
Transparency requires acknowledging what our data cannot tell you:
- Time Lag: Government data typically reflects inspections from 2-3 months ago
- Snapshot Nature: Inspections capture specific moments, not continuous monitoring
- State Variations: Inspection frequency and rigor varies significantly by state
- Self-Reported Elements: Some staffing and quality data relies on facility self-reporting
- Unannounced vs Announced: Not all inspections are surprise visits
- COVID Impact: Pandemic disrupted normal inspection schedules 2020-2022
Ethical Standards
Our methodology is guided by strict ethical principles:
- No Sensationalism: We report facts without exaggeration
- Context Matters: Always provide severity and scope information
- Corrections Transparency: Promptly correct errors and note updates
- Source Attribution: Always cite official government sources
- No Pay-for-Play: Coverage cannot be influenced by payment
- Public Interest: Focus on violations affecting resident safety
Using Our Data Responsibly
We strongly recommend:
- Review multiple data points, not single incidents
- Consider trends over time rather than snapshots
- Visit facilities in person before making decisions
- Speak with current residents and families
- Consult healthcare professionals for medical advice
- Contact facilities directly for current information
Questions About Our Methods?
We welcome inquiries about our methodology. Please visit our contact page to reach our data team.