Every nursing home in our database has a Safety Report Card ??? a structured summary of its public federal record. This guide walks through each section so you know exactly what you are reading and what to do with it.
The safety score (0???100)
The top of every report card shows a single safety score between 0 and 100. This is our translation of the facility’s overall federal record into one number. Higher is better. The score is divided into five bands:
- 85???100: Low Risk ??? Above-average record across all five dimensions. A reasonable starting point.
- 70???84: Generally Favorable ??? Solid record with minor issues worth reviewing.
- 55???69: Use Caution ??? Mixed record. Some areas need a closer look before deciding.
- 35???54: Serious Concerns ??? Notable issues in the public record. Direct conversations with the facility are essential.
- 0???34: Critical Issues ??? Among the lowest-scoring facilities in our coverage area. Significant problems on record.
The score combines five sub-scores, each representing a different dimension of the facility’s record. You can see the sub-score breakdown on every report card.
Why one score instead of five stars
The federal government uses a five-star system with five separate ratings. Families consistently find it confusing ??? a facility can have one star for inspections and four overall, with no plain-English bridge between them. Our single 0???100 score is designed to give you one clear answer to the most important question: relative to other nursing homes, how does this facility’s public record look?
The five sub-scores
Inspections. Based on results from state health inspection surveys ??? independent, on-site observations of actual care delivery. This is the sub-score we weight most heavily, because it is the hardest for facilities to manipulate. Looks at the number of deficiencies, their severity, and whether serious findings appear in the record.
Staffing. Compares the facility’s registered nurse (RN), licensed practical nurse (LPN), and certified nursing assistant (CNA) hours per resident per day against state and national averages. Understaffing is the strongest single predictor of poor inspection outcomes.
Violations & Penalties. Tracks civil money penalties ??? fines the federal government has levied against the facility for regulatory violations. A facility with a significant penalty history has had documented, serious problems that the government acted on.
Complaint History. Volume of complaint-triggered inspections and the share that were substantiated by investigators. Substantiated complaints mean a resident or family reported a problem and an independent investigator confirmed it.
Quality Outcomes. Based on CMS clinical quality measures ??? resident-level data on outcomes like falls with injury, pressure ulcers, and unnecessary antipsychotic medication use. These come from clinical assessments of every resident, not just inspection reports.
Deficiency citations ??? explained in plain English
Each inspection citation on a report card shows:
- The regulatory area that was cited (e.g., “Infection Control,” “Resident Rights,” “Fall Prevention”)
- The severity level ??? explained in plain English, not just a code letter
- Whether the citation is a Repeat ??? meaning the same problem appeared in the previous inspection and was not corrected
- The plain-English description of what the inspector found
Repeat citations are the most important thing to look for. A single citation might be an isolated incident. A repeat citation means the problem persisted across two inspection cycles ??? a materially different situation that warrants specific questions during your visit.
The Questions to Ask section
Every report card includes a list of questions generated from that specific facility’s record. If their inspection history includes repeat citations, the questions ask about that. If staffing is below the state average, the questions target RN coverage on weekends and evenings. These are not generic questions ??? they are tailored to what the data actually shows about this facility.
Print or bookmark this section before your tour. The questions are designed to elicit specific, operational answers ??? not marketing language.
Staying current: how the data updates
CMS publishes new inspection data on a monthly cycle. We sync with that update every month, so the report card you are reading reflects the facility’s current federal record. A facility that had problems a year ago may have improved ??? or may have added new citations since. Check back before making a final decision, and check periodically after placement.
Senior Care Report Card summarizes publicly available CMS data and is updated monthly. Data may have a publication lag. Always verify directly with CMS Care Compare and the facility before making placement decisions.