What realrating.care adds
Medicare publishes star ratings, inspection citations, staffing files, and quality measures for every certified nursing home. realrating.care ranks and summarizes those public records so families can compare homes side by side.
- Star ratings — the same overall, health, staffing, and quality scores shown on Medicare.gov.
- Eight quality checks — seven feed the composite rank; an eighth staffing gap check adds context on each home page.
- Composite risk rank — one national percentile (0–100) combining all seven checks. Lower is better.
- Trust gap flag — when stars look strong but broader checks suggest elevated risk.
Eight quality checks
Each check is scored and compared to every other Medicare-certified nursing home in the country. Seven are combined into the composite rank; staffing gap is shown separately for context.
Serious violations
How often health inspection citations involve actual harm or immediate jeopardy — not minor paperwork issues.
Repeat violations
Whether the same types of problems keep showing up on survey after survey, a sign of chronic enforcement issues.
Staffing record problems
When inspectors cite a home for unreliable or false staffing reports — a red flag for transparency.
Fire & life safety
Fire and emergency safety citations from separate life-safety inspections.
Weekend staffing drop
Whether nurse coverage falls sharply on weekends compared with weekdays.
Agency / temp staff
How much of daily nursing care is delivered by temporary agency staff instead of regular employees.
Declining outcomes
Key resident outcome measures — falls, pressure ulcers, infections, and similar — getting worse over the past year.
Staffing gap
Reported nurse hours vs. what Medicare expects for that home’s residents.
Composite risk rank
The composite score blends all seven checks into a single national percentile from 0 to 100. A home at the 20th percentile ranks better than roughly 80% of nursing homes nationwide.
Weight of each check in the composite (staffing gap shown for context):
Serious and repeat violations receive the most weight because they reflect sustained enforcement problems. Staffing-pattern checks matter when daily nurse data is available for a home.
Trust gap flag
Some homes earn 3★ or higheron Medicare's overall rating while still showing warning signs in inspection history or quality trends. We flag a trust gap when:
- Overall Medicare rating is 3★+, and
- Repeat violations rank in the top 10% nationally or
- Composite risk rank is 75th percentile or higher.
Trust gap highlights when star ratings and broader quality signals diverge — use it alongside the full inspection history on each profile.
Financial information on facility pages
Where available, we show occupancy rate and revenue figures from Medicare cost reports — the financial filings operators submit to the government. They reflect Medicare business data, not private-pay room rates.
Official data sources
realrating.care is rebuilt from Medicare's public nursing home files, including provider profiles, health and fire-safety deficiencies, daily staffing records, quality measures, and cost reports. Figures update after Medicare releases new quarterly data.