Nursing homes

Medicare- and Medicaid-certified nursing homes from CMS Care Compare: facility profile and star ratings from dim_nursing_home, MDS- and claims-based quality measures from fct_nursing_home_quality, and health-inspection deficiencies and penalties from fct_nursing_home_enforcement. Every view below reads a pre-aggregated source query — the raw grains (14.7k homes, 308k measure rows, 435k enforcement rows) never leave the warehouse.

Star ratings

Each home carries four 1–5 star ratings: the overall rating plus its three components (health inspections, quality measures, staffing). The overall distribution centers on

Ownership

For-profit homes — the large majority — average materially lower overall ratings than non-profit and government homes, with lower nurse staffing hours and higher staff turnover.

States

Average ratings vary widely by state, and the gap tracks the for-profit share — the biggest for-profit-heavy systems (Texas, Illinois) sit at the bottom of the ratings table while averaging some of the largest fine totals.

Quality measures

National averages for the resident-assessment (MDS) and Medicare-claims measures. Scores are only comparable within a measure: MDS scores are percentages of residents, while the two claims long-stay measures are rates per 1,000 resident-days — so the table never aggregates across measures, and the chart below is limited to the MDS percentage measures used in the five-star quality rating.

Enforcement

Health-inspection deficiency citations and the penalties that follow them. The two histories have different windows: the deficiency file covers roughly the last three survey cycles (counts thin out before 2022), while penalties reach back only to

Most-cited deficiencies

Infection prevention and control tops the list — cited at four out of five homes at least once in the current survey window.

Caveats

• Snapshot vintage. All three marts come from the same Care Compare release, as_of August 1, 2026 . There is no facility-level history — every figure above is a point-in-time snapshot except the enforcement dates.
• Unrated homes. The 14,690 − 14,563 homes without an overall rating drop out of every rating average above (but still count in facility totals).
• Special focus. The headline counts CMS's Special Focus Facility program participants ( 84 ); another 441 homes are SFF candidates, and 1,426 carry the abuse icon. The "SFF + candidates" columns in the ownership and state tables count participants *and* candidates together, so they sum to more than the headline figure.
• Enforcement windows differ. Fine totals cover only penalties since August 19, 2023 and reflect fines *imposed*, not necessarily collected; deficiency counts cover a longer (but still truncated) survey history. Neither is a complete history, so year-over-year changes partly reflect the window edges.
• Suppressed scores. Quality-measure scores CMS suppresses are NULL and excluded from averages; facilities_reporting counts only non-null scores.
• Unweighted averages. All rating and score averages weight each facility equally, regardless of bed count or resident volume.