This page explains how NursingHomesNearMe.org calculates composite quality scores and rankings for 14,703 U.S. nursing facilities. All underlying data comes from the official CMS Nursing Home Compare dataset.
Why Rankings Matter
CMS star ratings place hundreds of facilities in the same 5-star or 4-star bucket. In California alone, over 300 nursing homes share a 5-star overall rating. Our composite score breaks these ties by using the raw continuous numbers that CMS uses to calculate stars — not just the star category itself. This lets families compare facilities that would otherwise appear identical.
Composite Score (0–100)
Each facility receives a composite score from 0 to 100, calculated as a weighted sum of five components:
| Component | Data Used | Weight | Direction |
|---|---|---|---|
| Health Inspection | Total Weighted Health Survey Score (continuous) | 30 pts | Lower score = better |
| Quality of Care | QM Rating (1-5, continuous) | 25 pts | Higher = better |
| Staffing Hours | Total nurse staffing hours per resident per day | 20 pts | Higher = better |
| Compliance Record | 5-year fines, complaints, abuse flag | 15 pts | Fewer = better |
| Staff Stability | Total nursing staff turnover rate | 10 pts | Lower = better |
| 5-Year Trend Bonus | Overall rating trajectory 2022-2026 | +5 pts max | Improving = bonus |
Each component is normalized to a 0-1 scale relative to all 14,703 facilities before weighting, so no single metric can dominate unfairly.
Five Geography Levels
Every facility is ranked within five geographic scopes using the same composite score:
- National — among all 14,703 CMS-certified nursing facilities in the U.S.
- State — among all facilities in the same state
- County — among facilities in the same state and county
- City — among facilities in the same city
- ZIP Code — among facilities sharing the same ZIP code
Rank #1 in each geography is the highest-scoring facility. Ties are broken by the national rank.
Staffing Hour Rankings
Separate from the composite score, we rank each facility’s staffing hours per resident per day year by year (2022-2026) across all five geographies. This produces 100 individual staffing rank columns (4 metrics x 5 years x 5 geographies).
The four staffing metrics ranked are: Total Nurse Hours, Registered Nurse (RN) Hours, Licensed Practical Nurse (LPN) Hours, and Nurse Aide Hours — all measured per resident per day.
Data Source and Limitations
All data is sourced from the CMS Nursing Home Compare public dataset. We use annual snapshots from 2022, 2023, 2024, 2025, and 2026 (processing date: March 1, 2026 for the most recent). Rankings are recalculated each time new CMS data is released.
Important limitations to be aware of:
- Rankings reflect historical CMS data and may not reflect current facility conditions
- Facilities that opened recently may have incomplete 5-year data
- The composite score is our own methodology and is not endorsed by CMS
- Staffing data is self-reported by facilities to CMS
- Rankings should be one factor in your decision — not the only one
Always verify current ratings and inspection reports directly at medicare.gov/care-compare before making care decisions.
Last updated: March 2026 · Data source: CMS Nursing Home Compare (public dataset) · 14,703 facilities ranked