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Medicare’s Nursing Home Compare database 

  • Advocacy

In November 2007, the U.S. Medicare Web site released detailed information about every Medicare and Medicaid-certified nursing home in the country. Nursing Home Compare uses data compiled from inspections and compares health and fire safety concerns as well as quality measures and staffing information.

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Detailed list of data for Nursing Home Compare

AHCJ has selected the more serious deficiencies from complaints or routine inspections in the file named DEFICIENCIES.xlsx. There are separate tabs for health deficiencies and fire/safety deficiencies. One row represents a single deficiency, noted as part of a complaint or a survey (see detailed list below). The data are organized according to the following layout:

Health deficiencies

ProvNum – nursing home’s provider identification number

Provname – lists the name of the nursing home

Address – lists the street address of the nursing home

City – lists the city in which the nursing home is located

State – lists the 2-letter State code where the nursing home is located

Zip – lists the 5-digit numeric zip code of the nursing home

Ownership – lists the type of ownership in which the nursing home takes part; includes the following types:

  • For profit – Corporation
  • For profit – Individual
  • For profit – Limited liability company
  • For profit – Partnership
  • Government – City
  • Government – City/county
  • Government – County
  • Government – Federal
  • Government – Hospital district
  • Government – State
  • Non profit – Church related
  • Non profit – Corporation
  • Non profit – Other

Survey_date_output – Survey date

SurveyType – lists the type of deficiency, Health or Fire Safety

Defpref – The alphabetic character that is assigned to a series of data tags that apply to a provider

Tag – lists the numeric code used for each deficiency description

Tag_desc – lists the text of the deficiency for which the nursing home was cited

Scope – lists the alphabetic code for the severity of each deficiency, representing the combination of the scope and the level of harm. Severity codes are as follows:

  • A for Isolated/Potential for minimal harm
  • B for Pattern/Potential for minimal harm
  • C for Widespread/Potential for minimal harm
  • D for Isolated/Minimal harm or potential for actual harm
  • E for Pattern/Minimal harm or potential for actual harm
  • F for Widespread/Minimal harm or potential for actual harm
  • G for Isolated/Actual harm
  • H for Pattern/Actual harm
  • I for Widespread/Actual harm
  • J for Isolated/Immediate jeopardy to resident health or safety
  • K for Pattern/Immediate jeopardy to resident health or safety
  • L for Widespread/Immediate jeopardy to resident health or safety

***The AHCJ version lists only those deficiencies with a severity code of G and above. The original version contains all deficiencies from A to L.

Defstat – Indicates whether the deficiency has been corrected, a plan of correction has been devised, or the deficiency has yet to be corrected.

Statdate – Date the deficiency was corrected

Cycle – How old was the deficiency. Categories are as follows:

  • 1 is the most recent 12 months
  • 2 is 13-24 months
  • 3 is 25-36 months

Standard – Indicates that the deficiency was found on a standard inspection (Y = Yes; N = No)

Complaint – Indicates that the deficiency was found on a complaint inspection  (Y = Yes; N = No)

AHCJ_Date – the last date this data was processed by AHCJ.

Fire/safety deficiencies

ProvNum – nursing home’s provider identification number

Provname – lists the name of the nursing home

Address – lists the street address of the nursing home

City – lists the city in which the nursing home is located

State – lists the 2-letter State code where the nursing home is located

Zip – lists the 5-digit numeric zip code of the nursing home

Ownership – lists the type of ownership in which the nursing home takes part; includes the following types:

  • For profit – Corporation
  • For profit – Individual
  • For profit – Limited liability company
  • For profit – Partnership
  • Government – City
  • Government – City/county
  • Government – County
  • Government – Federal
  • Government – Hospital district
  • Government – State
  • Non profit – Church related
  • Non profit – Corporation
  • Non profit – Other

Survey_date_output – Survey date

SurveyType – lists the type of deficiency, Health or Fire Safety

Defpref – The alphabetic character that is assigned to a series of data tags that apply to a provider

Tag – lists the numeric code used for each deficiency description

New_OldTag – indicates whether tag was cited before (Old) or on/after (New) 7/5/2016; for a small number of life safety deficiencies (K tags), the same tag number has a different description in the two versions.

Tag_desc – lists the text of the deficiency for which the nursing home was cited

Scope – lists the alphabetic code for the severity of each deficiency, representing the combination of the scope and the level of harm. Severity codes are as follows:

  • A for Isolated/Potential for minimal harm
  • B for Pattern/Potential for minimal harm
  • C for Widespread/Potential for minimal harm
  • D for Isolated/Minimal harm or potential for actual harm
  • E for Pattern/Minimal harm or potential for actual harm
  • F for Widespread/Minimal harm or potential for actual harm
  • G for Isolated/Actual harm
  • H for Pattern/Actual harm
  • I for Widespread/Actual harm
  • J for Isolated/Immediate jeopardy to resident health or safety
  • K for Pattern/Immediate jeopardy to resident health or safety
  • L for Widespread/Immediate jeopardy to resident health or safety

***The AHCJ version lists only those deficiencies with a severity code of G and above. The original version contains all deficiencies from A to L.

Defstat – Indicates whether the deficiency has been corrected, a plan of correction has been devised, or the deficiency has yet to be corrected.

Statdate – Date the deficiency was corrected

Cycle – How old was the deficiency. Categories are as follows:

  • 1 is the most recent 12 months
  • 2 is 13-24 months
  • 3 is 25-36 months

Standard – Indicates that the deficiency was found on a standard inspection (Y = Yes; N = No)

Complaint – Indicates that the deficiency was found on a complaint inspection  (Y = Yes; N = No)

AHCJ_Date – the last date this data was processed by AHCJ.

Documentation to help understand the data:

Design for Nursing Home Compare Five-Star Quality Rating System: Technical Users’ Guide

Guidance for Laws and Regulations for Nursing Homes

State Operations Manual Chapter 7 (PDF, 1.60 MB)

For the star ratings:

ProvNum – nursing home’s provider identification number

ProvName – lists the name of the nursing home

Address – lists the street address of the nursing home

City – lists the city in which the nursing home is located

State – lists the 2-letter state code in which the nursing home is located

Zip – lists the 5-digit numeric zip code of the nursing home

Ownership – lists the type of ownership in which the nursing home takes part; includes the following types:

  • For profit – Corporation
  • For profit – Individual
  • For profit – Limited liability company
  • For profit – Partnership
  • Government – City
  • Government – City/county
  • Government – County
  • Government – Federal
  • Government – Hospital district
  • Government – State
  • Non profit – Church related
  • Non profit – Corporation
  • Non profit – Other

One of the following column names, depending on which file you have opened. AHCJ has broken down the five  parameters for rating the nursing home, each contained in a separate file. Overall Rating, Health Inspections, Quality Measures, Staffing, and RN Only:

Overall_rating

Quality_rating

Survey_rating

Staffing_rating

RN_staffing_rating

The values represent the number of stars given for the category (out of five). If blank, check the following column(s), which contain footnotes:

Overall_rating_fn

Quality_rating_fn

Survey_rating_fn

Staffing_rating_fn

RN_staffing_rating_fn

Filedate – the last date this data updated by CMS 

AHCJ_date – the last date this data processed by AHCJ.

Documentation to help understand the data:

Design for Nursing Home Compare Five-Star Quality Rating System: Technical Users’ Guide

Consumer Fact Sheet (PDF, 35 KB)

Summary of Public Comments (PDF, 73 KB)

 To get a picture of nursing home deficiencies that are most severe (codes G through L), AHCJ has merged records of deficiencies from complaints and routine nursing home inspections. Each deficiency is marked showing whether it came from the survey or a complaint.

DEFICIENCIES.xlsDownload

This file includes the most recent overall ratings provided by the Medicare Web site.

STARS_OVERALL.xlsDownload

This file includes the most recent quality ratings provided by the Medicare Web site.

STARS_QUALITY.xlsDownload

This file includes the most recent inspection-based ratings provided by the Medicare Web site.

STARS_INSPECT.xlsDownload

This file includes the most recent ratings based on nursing home staffing provided by the Medicare Web site.

STARS_NURSE.xlsDownload

This file includes the most recent government ratings based on staffing with registered nurses.

STARS_RN.xlsDownload

Nursing Home Compare, according to the Medicare Web site, is meant to provide information to help individuals, family members, caregivers, and those who assist them find and compare nursing homes and make informed decisions about nursing home care.

While the government Web site is useful in comparing a small number of nursing homes, the Association of Health Care Journalists has compiled the information as a series of spreadsheets, allowing the user to filter, sort and use other analysis tools to compare more nursing homes in a more sophisticated way. Obtained from a series of government databases, the spreadsheet files include only more serious nursing home deficiencies and star ratings for nursing homes in a format to easily sort and compare.

How to read the data

The nursing home information is composed of two parts: (1) inspections that find “deficiencies” in the home and (2) ratings out of five stars for each nursing home in a number of parameters.

Deficiency data are a result of both routine inspection and individual complaints, contained in different tables. The data here are composed of the current and previous two health and fire safety inspections for each nursing home. Results are collected by the state survey agencies and occur at least once during a 15-month period. Within that period, investigations are also made on the basis of registered complaints; when a complaint results in a health or safety citation, it is reported in the data separately. The information ranges from 2004 to the present.

Deficiencies are characterized by their severity, “A” being the least severe and “L” being the most severe. AHCJ has included the most severe of the deficiencies, letters “G” through “L.” These range from an “isolated incident of actual harm” to “widespread immediate jeopardy to resident health or safety.”

In the second part, nursing homes are given between one and five stars. According to the Medicare ratings Web site “nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average.” Each nursing home is given an overall rating, as well as three specific ratings: health inspections, staffing, and quality measures. The Medicare ratings Web site has specific information regarding each of the parameters, including overview and technical documentation that explains the rating system. More information regarding the rating system is located here.

More resources

Need help in analyzing Excel files? Check out the AHCJ tutorial about investigating health data using spreadsheets.

If you write a story based on these data, we’d love to see a copy. Please send an e-mail to jeff@healthjournalism.org.

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