Original reporting on U.S. nursing homes, built entirely from public CMS data. Every figure is reproducible from the source files, every method is documented, and every dataset is free to reuse with credit.
3 reportsSource: CMS Provider Data Catalog & Payroll-Based JournalFree to reuse (CC BY 4.0)
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Analysis of the CMS Provider Data Catalog (May 2026 release)·Updated 2026-06-21
All 50 states and the District of Columbia ranked on the quality of their Medicare- and Medicaid-certified nursing homes. Each state's facilities are scored with the SunsetWell v2.3 composite of CMS inspections, staffing, and clinical quality measures, then averaged. South Carolina posts the highest average score (67.4 of 100) and District of Columbia the lowest (27.0); the table also breaks out immediate-jeopardy rates, health citations per facility, and federal fines across 14,690 certified facilities. Because citation and fine counts partly reflect how aggressively each state inspects, the report reads these as facility-quality comparisons, not verdicts on any one state.
A frozen-model trend analysis that scores two CMS data vintages — October 2025 and June 2026 — with the exact same SunsetWell v2.3 weights, so a facility only moves when its underlying data changed, not because the model did. Of 14,700 facilities present in both vintages, 1,376 improved by at least 10 percentile points with same-direction gains in their MDS harm measures, while 1,000 declined. Complaint and incident features whose definitions shifted between vintages are excluded so the comparison stays stable. It is a screening signal from public data, not proof of causality — families should still read current inspection reports and visit.
CMS reports nursing-home staffing every single day through its Payroll-Based Journal, and this report uses that daily data to measure how dependable a facility's care actually is. Across 14,358 homes with at least 60 valid days, total nurse staffing averages 3.71 hours per resident day, weekend staffing runs 15.2% below weekdays on average, and contract or agency labor accounts for 5.3% of all measured nursing hours nationally. The report ranks the largest weekend drops and the most reliable staffing patterns. It measures staffing inputs, not clinical outcomes, and should be read alongside inspection findings.
Every report on this page starts from public data published by the Centers for Medicare & Medicaid Services — the CMS Provider Data Catalog and the CMS Payroll-Based Journal. The aggregation and scoring steps are deterministic, so the numbers can be reproduced from the source files. You can read the full SunsetWell scoring methodology or download the underlying facility-level records from the data downloads page.
Journalists and researchers: these analyses and datasets are free to reuse under CC BY 4.0 — just credit “SunsetWell” with a link back to the report.
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These reports show the national and state picture. To find and compare specific facilities near you, start with a state or metro overview or search directly.