A 10-section investor report focused on deal screening. Top 25 acquisition targets ranked by composite score, compliance risk landscape, county-level opportunity rankings, ownership concentration analysis, and payer mix as valuation signal — for any of the 50 U.S. states.
You're entering a new state market or building an acquisition pipeline. The raw data exists in CMS — 14,710 facilities across 50 states, all public. The problem is turning that raw data into a ranked, actionable target list without spending a week on manual analysis.
The report is structured around the acquisition workflow — from initial state screen to deal memo inputs.
Use the Executive Summary and Compliance Landscape to assess whether a state market warrants deeper diligence. High compliance risk concentration in a single county signals a regulatory environment that affects all facilities, not just the target.
The Top 25 Acquisition Targets table gives you a ranked starting pipeline. Sort by composite score, filter by county, or cross-reference against your ownership requirements using the chain portfolio section.
Payer mix by county, revenue quality signals, and ownership concentration data flow directly into deal memo prep. Pull a Facility Intelligence Report on your shortlisted targets to go from state screen to facility dossier.
| Who | The problem they bring to this report | How they use it |
|---|---|---|
| PE Fund Analyst | Mandate to source nursing home acquisitions in 2–3 target states. Needs a ranked pipeline before committing analyst hours to facility-level diligence. | Run one report per target state. Top 25 table gives a starting pipeline. County rankings show geographic concentration. Pull Facility Intelligence Reports on the top 5–8 targets to advance to full diligence. |
| REIT Acquisitions | Evaluating state markets for portfolio expansion. Needs to understand compliance risk concentration, operator quality distribution, and ownership consolidation before entering a new geography. | Compliance Landscape section shows state vs. national risk benchmarks. Ownership Concentration section identifies which chains dominate and where independent operators remain — the primary acquisition opportunity set for REITs. |
| Healthcare Lender | Assessing the regulatory environment in a new state before expanding SNF lending activity. Needs to understand whether the state has elevated compliance risk that affects portfolio-level default probability. | Enforcement Exposure and Compliance Landscape sections provide the state regulatory context. County Market Rankings show which markets have the healthiest operating environments for loan underwriting. |
| Investment Banker | Advising a client on a state-level nursing home roll-up or portfolio sale. Needs market context and comparable acquisition targets to inform valuation and deal structure. | Payer Mix Intelligence and Revenue Quality sections provide the market-level revenue benchmarks. Top 25 targets give comparable acquisition candidates for market sizing. |
| Multi-State Operator | Evaluating adjacent state markets for bolt-on acquisitions. Needs to understand how the target state compares to their existing markets on staffing, compliance, and payer mix. | State-level KPIs in the Executive Summary provide direct comparison points. Staffing Stability Overview shows whether the labor market in the target state is tighter or looser than current operating markets. |
Ten sections built from state-aggregated federal data. All facility-level rows in the Top 25 table are linked — clicking any target launches its full Facility Intelligence Report.
State name, four key stat boxes (total facilities, average star rating, compliance non-compliance rate, median payer mix), and a state vs. national compliance banner showing whether the state is above or below national benchmarks.
The compliance banner is the first triage signal — a state operating 15 points above the national non-compliance rate has a fundamentally different risk environment than one at parity.
Three compliance threshold cards, state vs. national trend chart over 11 quarters, and county-level compliance heat map showing which counties have the highest concentration of non-compliant facilities.
Compliance risk is not evenly distributed within a state. A market with low statewide risk may have one or two counties with severe enforcement concentration — the chart surfaces this before you commit to a geography.
State-level payer mix bar chart (Medicare / Medicaid / Private Pay), county-level private pay concentration bars, and three key stat cards: average private pay %, Medicaid dependency rate, Medicare concentration.
Private pay concentration is the single most important valuation driver in SNF acquisitions. Counties with above-average private pay command premium pricing. This section shows you where to focus before individual facility analysis.
Four state staffing KPIs vs. national averages, county bubble chart showing staffing stability scores with facility count and bed capacity overlay.
Staffing is the most direct operating cost driver in nursing homes. States with below-average staffing stability have higher labor cost profiles — a margin headwind that flows directly into acquisition pricing models.
Four state contract staffing KPIs, county-level contract dependency bar chart showing which markets are most reliant on agency labor vs. employee staff.
High contract dependency at the state or county level signals a structural labor shortage — not just an operator-specific problem. This affects acquisition pricing, operating assumptions, and the business plan post-close.
All counties in the state ranked in an 11-column table: facility count, beds, average star rating, Medicaid %, private pay %, staffing stability score, non-compliant facilities, % below benchmarks, IJ citation count.
County rankings are the core geographic screen for acquisition targeting. Sort by private pay concentration to find premium markets; sort by compliance non-compliance rate to avoid regulatory hotspots.
Scatter plot of all state facilities with composite score on X-axis and acquisition attractiveness on Y-axis, plus ranked table of top 25 targets with CCN, name, county, star rating, composite score, payer mix, and staffing signal.
This is the primary deliverable for deal teams. The scatter plot surfaces the full opportunity landscape visually; the table gives you the ranked pipeline ready for deal memo prep and facility-level follow-up.
County-level violation concentration bar chart, three enforcement stat cards (total citations, IJ citations, SFF-designated facilities), and recent enforcement trend direction.
Violation hotspots show where CMS surveyors are most active and where SFF designation risk is highest. Acquiring into a high-enforcement county requires a different operating plan than a low-enforcement market.
Top chains by facility count in the state, independent vs. chain-operated distribution, and ownership concentration index showing market consolidation level.
Ownership concentration determines deal availability. A state where three chains control 60% of beds has a different acquisition landscape than one with 80% independent operators. This section shows you who you're competing against and where the supply of independent sellers is.
State-level financial aggregates from HCRIS cost reports: average facility revenue, average operating margin, average revenue per patient day, average cost per patient day, unprofitable facility percentage, and facility count with available data.
57% of U.S. nursing homes reported negative operating margins in FY2024. State-level financial health shows whether the target market is above or below that benchmark — a key input to acquisition pricing assumptions and lender underwriting criteria.
Every data point is traceable to a federal government source, aggregated at the state and county level from facility-level records. CareIndex does not model, estimate, or impute data.
Yes. The report generates for any of the 50 U.S. states plus the District of Columbia. State coverage varies in facility count — California has the most with over 1,200 facilities; Wyoming has the fewest. The report adapts to the data available in each state.
Targets are ranked by a composite score that weights quality (star ratings and quality measures), compliance posture (deficiency counts and penalty history), payer mix attractiveness (private pay concentration), and staffing stability. The full formula and weights are documented in the report's Methodology section. The ranking is a starting screen — not a final recommendation.
Yes — each state report is ordered individually at $299. If you need to compare multiple states simultaneously in a single view, the Multi-State Deployment Report covers 2+ states in one document with cross-state comparison tables and a Top 50 deployment target list. For high-volume state screening, IndexIQ provides credit-based access. Contact us to discuss enterprise access.
The State Market Intelligence Report is designed for staffing agencies and operators — it focuses on staffing need scores, contract dependency by county, and workforce deployment opportunities. The State Acquisition Intelligence Report is designed for investors and lenders — it focuses on acquisition target ranking, compliance risk landscape, ownership concentration, and payer mix as a valuation signal. Different products built for different buyers, using overlapping but distinct data layers.
The typical workflow is: State Acquisition Intelligence Report to identify your Top 5–8 targets, then Facility Intelligence Reports on each shortlisted facility for the full 14-section dossier. The state report gives you the pipeline; the facility report gives you the diligence depth. Both are available at $299 each.
Select your target state to generate the report. Available for all 50 states. Most analysts pair this with Facility Intelligence Reports on their shortlisted targets.
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
