Reading the CMS record
Guides
These pages explain the measures CMS publishes for certified nursing homes. They describe the rating method and the files. They do not rank homes, and a star rating is not a recommendation.
How to read star ratingsHealth inspections set the base. Staffing and quality measures can move the overall rating by a star or two. The rules are the September 2026 Technical Users' Guide.Staffing hours explainedHours per resident per day, weekend coverage, case-mix adjustment, and turnover, plus what remains of the federal staffing rules after the 2025 repeal.How to choose a nursing homeWhat to read in the CMS record, what to ask on a visit, and where the long-term care ombudsman and the state survey agency fit.How to read a deficiency tagWhat an F-tag cites under 42 CFR Part 483, how scope and severity letters A through L differ, and how complaint surveys differ from standard surveys.What a Special Focus Facility meansWhy CMS selects some homes for extra surveys, how that status suppresses star ratings, and how the candidate list differs from the SFF list.Fines and payment denialsCivil money penalties and denials of payment for new admissions, what the days and dollars mean, and how summary totals differ from individual penalty rows.