{ "schema_version": "1.0", "audit_pack": { "dataset_slug": "nursing-home-quality", "display_name": "Nursing-Home Quality by State (CMS Care Compare)", "one_liner": "State-level rollups of CMS Care Compare nursing-home overall quality ratings.", "source_families": [ "CMS Care Compare datasets (public)" ], "spatial_resolution": "Facility (point) + state rollups.", "temporal_coverage": "CMS quarterly Care Compare release (current snapshot 2026-04-01).", "refresh_cadence": "Quarterly (matches CMS Care Compare release cadence).", "current_version": "v2026.05.0", "version_history": [ { "version": "v2026.05.0", "released_at": "2026-05-06", "changes_summary": "Initial Audit Pack release. Methodology, provenance map, reproducibility statement, and limitations stack baselined." } ], "provenance_map": [ { "name": "facility_ccn", "description": "CMS Certification Number — facility identifier on the CMS dataset.", "source": "CMS Care Compare — Nursing Home Compare", "source_url": "https://data.cms.gov/provider-data/dataset/4pq5-n9py", "refresh_cadence": "Quarterly", "confidence": 1 }, { "name": "state", "description": "Facility state (USPS code).", "source": "CMS Care Compare — Nursing Home Compare", "source_url": "https://data.cms.gov/provider-data/dataset/4pq5-n9py", "refresh_cadence": "Quarterly", "confidence": 1 }, { "name": "overall_rating", "description": "CMS Five-Star Quality Rating (1-5) for the facility.", "source": "CMS Care Compare — Nursing Home Compare", "source_url": "https://data.cms.gov/provider-data/dataset/4pq5-n9py", "refresh_cadence": "Quarterly", "confidence": 1, "limitations": "CMS publishes its own confidence bands and known measurement caveats per the rating methodology." }, { "name": "rating_date", "description": "CMS-published rating publication date.", "source": "CMS Care Compare — Nursing Home Compare", "source_url": "https://data.cms.gov/provider-data/dataset/4pq5-n9py", "refresh_cadence": "Quarterly", "confidence": 1 } ], "reproducibility_statement": "1. Pull the CMS Care Compare Nursing Home Compare dataset from data.cms.gov/provider-data/dataset/4pq5-n9py.\n2. Filter to records with non-null overall_rating.\n3. Bucket by state (USPS code).\n4. Compute per-state distribution: count, mean overall_rating, share at each star level.\n5. Publish state rollups alongside the methodology link to the original CMS dataset.\n\nCMS publishes quarterly; Fonteum snapshot follows the most recent CMS release.", "limitations": [ "Each CMS measure carries its own published limitations; readers should review the CMS dataset documentation linked in the methodology for measure-specific caveats. We do not modify CMS's published measure values, only re-aggregate to state-level rollups.", "Sampling-based measures (e.g. patient-experience surveys) carry confidence bands CMS publishes alongside the values. State-level rollups average across facilities and do not preserve those bands; for facility-specific decisions, reference the original CMS Care Compare record.", "Date alignment: state rollups are computed from the CMS file's published reporting period, not the file release date. The reporting period typically lags the release date by 6-12 months per CMS convention." ], "compliance_qa": [ { "question": "What is the source of these facility-quality measures?", "answer": "CMS Care Compare datasets, published quarterly at data.cms.gov/provider-data/. CMS itself publishes the measure definitions, sampling methodology, and known limitations; Fonteum Research re-aggregates state-level rollups without altering the underlying measure values.", "link": "https://data.cms.gov/provider-data/" }, { "question": "When was this dataset last updated?", "answer": "Snapshot date is published per dataset and aligns with the most recent CMS Care Compare release we have ingested. CMS publishes new files quarterly; our cadence matches.", "link": "https://fonteum.com/corrections-log" }, { "question": "Are CMS's own published limitations preserved?", "answer": "Yes. Every limitation CMS calls out in the dataset documentation appears in our Limitations section verbatim or paraphrased with a link to the CMS source. We do not silently strip caveats.", "link": "https://fonteum.com/methodology#limitations" }, { "question": "Can I reproduce these counts independently?", "answer": "Yes — the reproducibility statement above lists the exact CMS dataset(s) ingested and the per-state aggregation logic. A buyer can rerun the methodology against the same Care Compare release and reconcile counts.", "link": "https://fonteum.com/corrections-log" }, { "question": "What is the licensing scope of this data?", "answer": "CMS Care Compare data is public-domain federal information. Fonteum's aggregated rollups are licensed under our editorial-policy terms.", "link": "https://fonteum.com/terms" } ], "links": { "research_url": "https://fonteum.com/research/nursing-home-quality-by-state-2026", "methodology_url": "https://fonteum.com/methodology/nursing-home-quality", "limitations_url": "https://fonteum.com/methodology/nursing-home-quality#limitations", "csv_url": "https://fonteum.com/research/data/nursing-home-quality-by-state-2026.csv", "json_url": "https://fonteum.com/research/data/nursing-home-quality-by-state-2026.json" }, "scope": { "record_count": 14000, "record_unit": "facilities", "coverage_states": 51, "last_snapshot_date": "2026-04-01" }, "generated_at": "2026-05-09T17:24:38.494Z" }, "reproducibility_steps": [ { "step": 1, "description": "Pull the CMS Care Compare Nursing Home Compare dataset from data.cms.gov/provider-data/dataset/4pq5-n9py." }, { "step": 2, "description": "Filter to records with non-null overall_rating." }, { "step": 3, "description": "Bucket by state (USPS code)." }, { "step": 4, "description": "Compute per-state distribution: count, mean overall_rating, share at each star level." }, { "step": 5, "description": "Publish state rollups alongside the methodology link to the original CMS dataset. CMS publishes quarterly; Fonteum snapshot follows the most recent CMS release." } ], "fields": [ { "name": "facility_ccn", "description": "CMS Certification Number — facility identifier on the CMS dataset.", "source": "CMS Care Compare — Nursing Home Compare", "source_url": "https://data.cms.gov/provider-data/dataset/4pq5-n9py", "refresh_cadence": "Quarterly", "confidence": 1 }, { "name": "state", "description": "Facility state (USPS code).", "source": "CMS Care Compare — Nursing Home Compare", "source_url": "https://data.cms.gov/provider-data/dataset/4pq5-n9py", "refresh_cadence": "Quarterly", "confidence": 1 }, { "name": "overall_rating", "description": "CMS Five-Star Quality Rating (1-5) for the facility.", "source": "CMS Care Compare — Nursing Home Compare", "source_url": "https://data.cms.gov/provider-data/dataset/4pq5-n9py", "refresh_cadence": "Quarterly", "confidence": 1, "limitations": "CMS publishes its own confidence bands and known measurement caveats per the rating methodology." }, { "name": "rating_date", "description": "CMS-published rating publication date.", "source": "CMS Care Compare — Nursing Home Compare", "source_url": "https://data.cms.gov/provider-data/dataset/4pq5-n9py", "refresh_cadence": "Quarterly", "confidence": 1 } ] }