Nursing-Home Quality by State (CMS Care Compare)

State-level rollups of CMS Care Compare nursing-home overall quality ratings.

What this methodology is

This page is the public, versioned methodology for the Nursing-Home Quality by State (CMS Care Compare) dataset. It documents how every figure on the matched Fonteum Research study, /api/v1 endpoint, and Audit Pack was constructed — from registered public-source ingest through aggregation rules to the rendered output. It exists so buyers can satisfy auditor questions by linking to a single durable URL.

Every section below is the source of truth. Where the methodology differs from the underlying source's own description (for example: which taxonomies count, how Type-1 vs Type-2 NPIs are treated, how density per 100k is computed), the rule lives here, not in the source. Methodology versions (v2026.05.0 today) increment when those rules change; data refreshes within a methodology version are tracked separately under refresh historyand surface as the “Last refreshed” banner above.

Source provenance

Source families

CMS Care Compare datasets (public)

Spatial resolution

Facility (point) + state rollups.

Temporal coverage

CMS quarterly Care Compare release (current snapshot 2026-04-01).

Refresh cadence

Quarterly (matches CMS Care Compare release cadence).

Snapshot scope

14,000 facilities across 51 states + DC; snapshot dated April 1, 2026.

The Fonteum sources registry holds the canonical entry for each source family — Tier classification, ToS posture, refresh schedule, and live-vs-pending status: /sources.

Reproducibility statement

An independent researcher with access only to the public sources listed above can recreate this dataset by following these steps. Discrepancies between an independent reproduction and the published figures belong in /corrections-log; we publish them when they arise.

Limitations

Limitations are surfaced explicitly, not buried. Each item below is a constraint a buyer’s compliance team should review before relying on the dataset for a specific use case.

• Each CMS measure carries its own published limitations; readers should review the CMS dataset documentation linked in the methodology for measure-specific caveats. We do not modify CMS's published measure values, only re-aggregate to state-level rollups.
• Sampling-based measures (e.g. patient-experience surveys) carry confidence bands CMS publishes alongside the values. State-level rollups average across facilities and do not preserve those bands; for facility-specific decisions, reference the original CMS Care Compare record.
• Date alignment: state rollups are computed from the CMS file's published reporting period, not the file release date. The reporting period typically lags the release date by 6-12 months per CMS convention.

Field schema

Every field surfaced from this dataset on the API and rendered surfaces. Source, refresh cadence, and confidence are recorded per field, not per dataset.

Version history

Every methodology version bump is recorded here with the change rationale. Data-only refreshes (no methodology change) appear as same-version entries with a refresh date.

Cite this methodology

For procurement attachments, audit responses, footer attribution, or academic use. Pick a format and copy.

Fonteum. (2026). Nursing-Home Quality by State (CMS Care Compare) (v2026.05.0) [Dataset]. Fonteum, Inc.. https://fonteum.com/methodology/nursing-home-quality

Downloads & cross-references

• Research study → the editorial findings + charts
• JSON methodology metadata — for programmatic ingestion
• Download per-state CSV
• Download per-state JSON

Methodology questions: methodology@fonteum.com. Data corrections: /corrections-log. B2B inquiries: api@fonteum.com.

This page is the durable URL a buyer’s compliance officer can link from their product. The version pinned at the URL (v2026.05.0) is the active methodology; historical versions remain accessible at the same URL with prior-version content available in the Version history table.