Methodology

Hospital overall ratings and nursing home overall ratings are different CMS systems and should not be interpreted as directly equivalent. We reproduce reported ratings without creating our own quality score.

Averages exclude missing values and use an arithmetic mean per reporting facility. Hospital 4–5-star shares use only hospitals with an overall rating. Star distributions exclude unrated facilities. Nursing home staffing averages use reported, unadjusted total nurse hours per resident per day.

Top hospital lists require an overall rating of 5. Top nursing home lists require an overall rating of 5 and staffing rating of at least 4. Facilities in those lists appear alphabetically. Most-fines lists show up to 100 facilities per geography ordered by reported total fines, with CMS certification number as a tie breaker. Fines are enforcement amounts in the source release, not lifetime totals.

Every hospital has a detail page. Rated nursing homes receive detail pages within the static hosting file budget, prioritizing higher certified bed counts; ties use certification number. Facilities without pages remain listed, with ratings, on city and state pages. Cities need at least three combined facilities for a separate page. Facilities without ratings and ranking pages with fewer than three facilities are excluded from the sitemap.

Missing values are reported as not reported. Zero amounts are displayed only when the source reports zero. Common hospital rating footnotes are explained in plain language. Other CMS footnotes link to Sources; check Care Compare for current context. The US tile map uses geographic state tiles; gray means no reported hospital average. Averages are printed in the accompanying table.