Independent ratings built from government data
Check a nursing home or assisted living facility before you visit.
Our 0 to 100 Scorecard score rates nursing homes on staffing, inspections, resident outcomes, fines and stability, using government data only. Compare 14,680 Medicare-certified homes nationwide by star rating, inspections and fines.
The Scorecard score
One number from 0 to 100, built only from government data.
We score each nursing home against the other homes in its state, using Medicare's own inspection, staffing, quality and penalty data. No facility pays us, and online reviews aren't part of the math.
Serious problems can't hide in an average. A harm-level citation in the past 18 months caps a home at 74, so it can't reach the top tier. An immediate jeopardy citation in the past 24 months caps it at 59.
Why it differs from Medicare's stars. Medicare's overall rating leans heavily on inspections. Ours gives staffing and resident outcomes equal footing, so a home with a clean inspection record but average staffing can have 5 stars and still score in the 70s. We show both side by side.
What goes into it
- Staffing25 pts
Nurse and RN hours per resident, weekend coverage, staff turnover
- Inspections25 pts
Severity of citations at the last three inspections; harm and complaint findings weigh most
- Resident outcomes20 pts
Hospital and ER visits, falls with injury, pressure sores, antipsychotic use
- Fines and payment holds10 pts
Federal fines and Medicare payment denials, past three years
- Stability5 pts
Ownership changes, administrator turnover, troubled-home status
The five parts total 85 points and are scaled to 0 to 100. Each part compares a home with the other homes in its state.
Score bands
Medicare star average by state
Average Medicare overall star rating (1 to 5) of nursing homes in each state, A to Z by state name. These are Medicare's ratings, not our score. We'll switch this map to Scorecard scores as we add states.
under 2.62.6 to 2.842.85 to 3.143.15 to 3.393.4 and up
Nursing home or assisted living?
They are licensed, inspected and paid for differently, so we show them separately on each city page.
| Nursing home | Assisted living | |
|---|---|---|
| Who it's for | Rehab after a hospital stay, or long-term care for serious conditions | People who are mostly independent but need help with bathing, dressing, meals or medications |
| Medical care | Licensed nurses on site 24 hours | Staff on site; limited nursing |
| Inspected by | State surveyors under federal rules | State only |
| Our rating | Scorecard score, 0 to 100, shown next to Medicare's 1 to 5 stars | A to F grade from state inspections; no government rating |
| Who pays | Medicare for short rehab stays; Medicaid for long-term care if eligible | Mostly private pay |
| National median cost, 2025 | $9,581/month, semi-private room | $6,200/month |
Cost source: CareScout 2025 Cost of Care Survey.
Common questions
Still deciding? Start here.
Where does the data come from?
Nursing home ratings, inspections and fines come from the Centers for Medicare & Medicaid Services (CMS), updated monthly. Assisted living and residential care licenses and inspection reports come from the Missouri Department of Health and Senior Services.
Do you make your own scores?
Yes. Nursing homes in the states we cover get our Scorecard score from 0 to 100, calculated by us from Medicare (CMS) data on staffing, inspections, resident outcomes, fines and stability, with caps for recent serious citations. Assisted living facilities get an A to F grade from state inspection results. Scores are available for Missouri today, with more states coming. We also show Medicare's own 1 to 5 star rating so you can compare. The full method is on our methodology page.
What's the difference between a nursing home and assisted living?
A nursing home provides 24-hour care from licensed nurses, often after a hospital stay or for serious health needs. Assisted living is housing with help for daily tasks like bathing, dressing, meals and medications, without round-the-clock nursing.
Who pays for senior care?
Medicare covers short-term skilled nursing after a qualifying hospital stay. Medicaid can cover long-term nursing home care for people who qualify. Assisted living is usually paid privately, sometimes with long-term care insurance or veterans benefits.
Can facilities pay to rank higher?
No. Scores and lists come from government data only, and no facility can pay to change them. If the site ever has sponsors, they will be clearly labeled and won't change ratings or order.
How do I write a review?
Use the Write a Review page. Family reviews will be shown separately from government data so you can tell them apart.