METHODS / VERSION 2026·08
What the ledger can—and cannot—tell you
Coverage
Facility facts come from the August 2026 CMS Provider Information file. Health and fire citations cover the three most recent standard inspections and qualifying complaint and infection-control inspections in the previous three years. Penalty, survey-summary, chain, staffing, rating, and ownership fields come from the matching release files.
Scope and severity codes
CMS letter codes combine scope and severity: A–C potential for minimal harm; D–F potential for more than minimal harm; G–I actual harm; and J–L immediate jeopardy. Within each band the letters move from isolated to pattern to widespread. The code belongs to a citation row, not to every resident or the facility forever.
Correction intervals
We calculate days only when CMS supplies a survey date and a correction date on or after it, capped at three years to reject impossible values. “Corrected” is a CMS field. Nursing Home Ledger does not independently inspect facilities or certify remediation.
Repeat tags
A repeat means the same tag code appears for one facility on at least two distinct survey dates in the release. It is a retrieval aid, not proof that the underlying facts or scope were identical.
Owners and chains
Owner pages use an exact disclosed name after case and whitespace normalization and require at least 25 distinct facilities. We do not fuzzy-merge names. Chain pages use the CMS chain ID and chain name supplied on provider records. Both can change and both may omit relationships outside their source systems.
No homemade score
CMS ratings remain labeled CMS ratings. We publish separate fields and dates, never a proprietary “safety,” “best,” or “risk” grade. Comparisons should account for inspection timing, facility size, case mix, missing fields, and current conditions.
Decision safeguards
For placement or care decisions, recheck Care Compare, contact the state survey agency and long-term care ombudsman, tour the facility, and ask how cited issues were addressed.