A 14-section facility dossier covering quality, compliance, staffing, payer mix, ownership, violations, fire safety, and financial health for any of 14,710 U.S. nursing homes — built from nine federal data sources.
You're evaluating a nursing facility — for acquisition, due diligence, underwriting, or operational benchmarking. CMS publishes the raw data. What it doesn't do is assemble it. Nine separate datasets, different refresh cadences, different identifiers — each one telling part of a story that only makes sense together.
Five buyer types use this report for fundamentally different workflows. Each finds something different in the same data.
| Who | The problem they bring to this report | How they use it |
|---|---|---|
| PE Analyst | Screening a potential acquisition target. Needs quality, compliance risk, payer mix, ownership history, and financial performance before committing diligence resources. | Run the report on target CCNs at the first screen. Compliance risk score, operating margin trend, and ownership chain flag which facilities warrant deeper review and which to pass on immediately. |
| Healthcare Lender | Underwriting a loan secured by a nursing facility. Needs evidence of operational stability, revenue quality, and compliance exposure beyond what's in the borrower's financials. | Financial Health section shows multi-year operating margins and revenue per patient day. Penalty History and Compliance Risk score quantify regulatory exposure. Payer mix shows Medicare/Medicaid concentration risk. |
| REIT Acquisitions | Assessing the operating quality of a nursing home tenant or potential portfolio addition. Needs a third-party view of operator performance independent of what the operator reports. | Quality Ratings, Staffing Levels, and Investment Intelligence sections provide a clean operator scorecard. Chain Affiliation shows how the facility compares to the operator's other locations. |
| Plaintiff Attorney | Building a negligence, wrongful death, or regulatory violation case. Needs documented quality history, violation records, penalty history, and staffing patterns as evidentiary foundation. | Violation History section provides full citation records with severity coding. Penalty History documents fines and payment denials. Staffing Levels show whether the facility met industry benchmarks during the relevant period. |
| Multi-Facility Operator | Benchmarking an acquired facility, preparing for an inspection, or evaluating a competitor's operational posture. | Nearby Facilities section compares 20 facilities within 15 miles on key metrics. Compliance Projection shows where the facility stands against regulatory thresholds. Quality Measures show outcomes against state and national averages. |
Fourteen sections assembled from nine federal data sources, delivered as an interactive HTML file. Every data point cited to its source — no black-box estimates, no modeled projections.
Facility name, CCN, address, bed count, ownership type, chain affiliation, certification date, overall star rating, and four KPI cards: compliance risk score, payer mix summary, staffing benchmark, and investment attractiveness signal.
Designed for rapid triage — the investment score and KPI cards give you the full picture before reading a single section.
CMS 5-star overall rating and component stars for health inspections, staffing, and quality measures. State and national average comparisons for each component.
Star ratings are the first screen for most institutional buyers. Component breakdown shows whether a low overall score is driven by inspections, staffing, or outcomes — which points toward different remediation paths.
Compliance risk score (0–100), three threshold cards showing staffing gap vs. industry benchmarks, stability score with sub-metrics, and RN/total staffing hours per resident day vs. state and national averages.
Compliance risk is the single most important metric for lenders and buyers post-mandate repeal. A score above 70 signals active regulatory exposure that affects valuation.
Payer mix breakdown (Medicare / Medicaid / Private Pay / Other) with visual donut chart, county and state average comparisons, and private pay concentration score.
Payer mix is a primary valuation driver. High Medicare concentration signals short-stay rehabilitation focus; high private pay is a margin premium. Medicaid dependence above 70% is a cash-flow risk flag.
RN, LPN, CNA, and total hours per resident day vs. national averages. Weekend staffing differential. Staffing rating component breakdown.
Staffing is both a quality indicator and an operating cost driver. The weekend differential reveals whether reported averages mask weekend understaffing — a common pattern in facilities gaming the rating system.
Agency/contract staff percentage of total hours, employee vs. contract split by discipline, contract dependency tier (LOW / MODERATE / HIGH / URGENT), and workforce signals.
High contract dependency inflates operating costs and signals recruiting failure. Facilities above 15% contract utilization typically face 20–40% higher labor costs than peers — a direct margin drag.
11-quarter trend chart of citation counts, violation table with tag number, description, severity code (A–L), date, and correction status. IJ (Immediate Jeopardy) citations highlighted.
Trend direction matters as much as count. A facility with declining citations over 8 quarters tells a different story than one with stable high counts or a sudden spike — which often signals a management change or regulatory intervention.
20 facilities within 15 miles ranked by overall star rating, with bed count, payer mix, staffing benchmark, and compliance risk scores shown for each.
Competitive context is essential for valuation and market entry decisions. A 2-star facility looks different when it's the best option in a 15-mile radius versus when it's surrounded by 4-star competitors.
Special Focus Facility (SFF) designation status, active enforcement actions, recent ownership changes, and CareIndex-generated threshold alerts for staffing, compliance, and payer mix.
SFF designation is the single most important negative signal in the database — it triggers enhanced CMS scrutiny and can precede termination of Medicare/Medicaid participation.
8 long-stay MDS/Claims outcome measures and 6 short-stay measures with facility rate, state average, and national average shown for each. Better/Worse Than Expected ratings.
Quality measures are the clinical outcomes behind the star rating. Pressure ulcer rates, fall rates, and rehospitalization rates are the metrics plaintiff attorneys and lenders request most frequently.
Full penalty record including civil monetary penalties, payment denials, and formal enforcement actions. Penalty amounts, dates, citation links, and cumulative fine total.
Penalty history is a leading indicator of systemic compliance failure, not a lagging one. A facility with $500K in cumulative fines over three years has a fundamentally different risk profile than one with no history.
Organizational and individual owners with ownership percentages, association dates, and role types. Management company identification. Historical ownership changes.
Ownership transparency is the central demand from regulators, lenders, and investors alike. Shell company structures and frequent CHOW activity are the most reliable predictors of below-average care outcomes in the literature.
Compliance risk score (0–100), acquisition attractiveness score, turnaround potential rating, and component-level breakdown bars showing which factors drive each score.
The Investment Intelligence section synthesizes the entire report into a single investment signal — not a replacement for analysis, but a structured starting point that frames which sections to read first.
Total fire safety citations, immediate jeopardy count, top deficiency categories, and 10 most recent citations with date, category, severity, and correction status.
95% of U.S. nursing homes have fire safety citations. The question is severity and recurrence — uncorrected IJ-level fire citations are an insurance and licensing risk that most buyers don't screen for.
Multi-year trend table of total revenue, total expenses, net income, operating margin, revenue per patient day, and cost per patient day from HCRIS cost reports.
57% of U.S. nursing homes reported negative operating margins in FY2024. Financial Health shows whether a facility is structurally unprofitable or temporarily distressed — a critical distinction for acquisition pricing and loan underwriting.
Every data point is traceable to a federal government source. CareIndex does not model, estimate, or impute data — if a metric is unavailable for a given facility, it is noted rather than filled with an estimate.
Yes. The database covers all 14,710 CMS-certified skilled nursing facilities currently active in the Provider Data Catalog. If the facility participates in Medicare or Medicaid, it is in the database.
HCRIS cost reports are not filed by every facility every year. When financial data is unavailable, the Financial Health section notes the gap rather than showing estimated figures. Similarly, ownership records that are incomplete in CMS enrollment files are shown as partial — the report never invents data to fill a gap.
Staffing data comes from CMS Payroll-Based Journal (PBJ) submissions, which are collected quarterly. The current vintage covers Q3 2025. The report header displays the data vintage for each section so you always know the age of what you're reading.
The compliance risk score (0–100) is a CareIndex-computed metric that weights staffing gap vs. industry benchmarks, health deficiency count and severity, penalty history, and Special Focus Facility status. The full formula and component weights are documented in the Methodology section of the report. A score above 70 indicates active regulatory exposure; below 30 indicates low risk.
Yes — each report is ordered individually at $299. For portfolio-level screening across multiple facilities or states, the State Acquisition Intelligence Report surfaces the top 25 acquisition targets in any state ranked by composite score — a more efficient starting point before committing to individual facility reports. IndexIQ also provides credit-based access for high-volume diligence workflows. Contact us to discuss enterprise access.
Enter the facility name or Medicare CCN to generate your report. Not sure which facility you need? Use the Research Desk to search by name, state, county, or ZIP code.
Live facility-level screening, multi-state filtering, and on-demand report generation billed in credits. Built for analysts running repeat diligence workflows.
14,710 SNFs • 12,251 home health agencies • 14.5M staffing records • 50 states
