Data Methodology

Editorial Workflow

PlainElderCare has two kinds of pages, and we are transparent about how each is produced. Data pages (individual facility profiles, county pages, and state pages) are generated programmatically from the official CareScout and CMS source files by our ETL pipeline; the numbers on them are loaded directly from official agencies, never invented or interpolated. Editorial content (the guides, rankings commentary, and this methodology) is written and reviewed by the PlainElderCare editorial team. We follow rigorous standards: source data is loaded directly from official agencies, and we do not accept payment for coverage, placement, or rankings; "cheapest," "highest-rated," and cost comparison figures are computed directly from CareScout and CMS source data. PlainElderCare is an informational resource and is not medical, legal, or care advice, always consult licensed healthcare professionals and visit facilities in person before making care decisions.

Data Sources

PlainElderCare combines two primary data sources:

• CareScout 2025 Cost of Care Survey - State-level median costs for five elder care service types across all 50 states and D.C. CareScout (formerly Genworth Financial) has conducted this survey annually since 2004, making it the longest-running and most widely cited source for U.S. elder care cost data. Source: CareScout Cost of Care.
• CMS Nursing Home Compare and Home Health Compare - Facility-level quality ratings published by the Centers for Medicare and Medicaid Services. Nursing home ratings are updated monthly and reflect health inspection results, staffing levels, and quality measures. Home health agency ratings follow a similar framework. Sources: Medicare Care Compare (medicare.gov), CMS Nursing Home Provider Data, CMS Home Health Provider Data, and CMS Nursing Home Quality Resources.

Data Vintage

CareScout cost data reflects the 2025 survey. CMS facility ratings are updated monthly, PlainElderCare's database reflects the most recent available CMS release at time of build. County-level data aggregates state cost context with CMS facility data for facilities in that county.

Processing Pipeline

1. CareScout state-level median costs are loaded for all five care types: home care, adult day services, assisted living, nursing home (semi-private), and nursing home (private).
2. CMS Nursing Home Compare data is downloaded and processed to extract facility name, address, CMS overall star rating, and sub-ratings (health inspection, staffing, quality measures) for all 14,700+ certified nursing facilities.
3. CMS Home Health Compare data is loaded for 12,200+ Medicare-certified home health agencies.
4. Facilities are linked to counties using address data, creating county-level facility inventories.
5. All data is loaded into a structured SQLite database serving state cost pages, county pages, and facility profiles.

Coverage

• State cost data: 50 states + D.C., 5 care types each
• Nursing homes: 14,700+ CMS-certified facilities
• Home health agencies: 12,200+ Medicare-certified agencies
• Counties: 2,800+ U.S. counties with facility and cost data

CMS Star Rating Methodology

CMS assigns nursing homes an overall star rating (1–5 stars) based on three components:

• Health Inspections: Results from state inspection agency surveys, with more recent inspections weighted more heavily.
• Staffing: Nurse staffing hours per resident per day (RN, total nurse aide, total nurse aide + RN).
• Quality Measures: 15 measures derived from resident assessment data, reflecting outcomes such as pressure ulcers, falls, and use of antipsychotic medications.

We display the official CMS 5-star ratings exactly as published, we do not alter or recompute them.

PlainElderCare Quality & Compliance Index

On individual facility pages, alongside the official CMS rating, we show a supplementary PlainElderCare Quality & Compliance Index (0–100, with a letter grade). This is a transparent composite we compute from the same official CMS components, presented as a single at-a-glance figure. It complements and never replaces the official CMS star rating, and it adds no new data, it only re-weights what CMS already publishes. The weighting is:

• Health inspections: 30% (the CMS health-inspection star)
• Staffing: 25% (the CMS staffing star)
• Quality measures: 25% (the CMS quality-measures star)
• Deficiency record: 20%, benchmarked against the national distribution of recorded deficiencies (fewer deficiencies score higher)

When a component is not rated for a facility, its weight is redistributed across the available components so the Index stays comparable. Because it is derived purely from published CMS data, the Index is fully reproducible, and like the CMS rating it is a regulatory-data signal, not a substitute for visiting a facility in person.

How the Source Organizations Collect Data

CareScout (formerly Genworth Financial) conducts its annual Cost of Care Survey by collecting pricing data from licensed care providers across the United States. Surveyors contact assisted living facilities, home care agencies, nursing homes, and adult day care centers to obtain current pricing for standard care packages. The resulting data represents median costs, the midpoint where half of providers charge more and half charge less.

CMS collects nursing home quality data through state survey agencies that conduct unannounced health inspections of every Medicare- and Medicaid-certified nursing facility at least once every 15 months. Staffing data is submitted by facilities through the Payroll-Based Journal (PBJ) system, which tracks actual staff hours worked from payroll records. Quality measures are computed from standardized resident assessments (Minimum Data Set) that facilities are required to complete for every resident.

Data Accuracy Commitment

Cost figures, official CMS star ratings, and facility details are displayed exactly as published by the source organizations, we do not interpolate costs for areas where survey data is unavailable, nor alter the official ratings. The one figure we derive ourselves is the PlainElderCare Quality & Compliance Index described above, which is computed transparently from the published CMS components and clearly labeled as ours. If you find any data that appears incorrect, please contact us at hello@plaineldercare.com and we will verify against the source data.

Limitations

• State cost data reflects medians, actual costs vary significantly by location, facility type, and individual care needs.
• CMS ratings reflect regulatory data points; they do not capture subjective quality or staff-resident relationships that matter most to families.
• Facility data may lag slightly behind real-world conditions due to CMS update cycles.
• PlainElderCare is not affiliated with CareScout, CMS, or any government agency.

What do families ask most?

Where does PlainElderCare's cost and quality data come from?

State-level elder care cost figures come from the CareScout Cost of Care Survey (formerly Genworth), a long-running annual survey of licensed care providers in the United States. Facility quality ratings come from the Centers for Medicare & Medicaid Services (CMS) Nursing Home Compare and Home Health Compare programs, which publish star ratings derived from federal health inspections, staffing data, and quality measures.

How often is the data updated?

CareScout releases new cost-of-care survey data annually. CMS publishes updates to Nursing Home Compare monthly as new inspections, staffing submissions, and quality measures are processed; Home Health Compare is refreshed on a similar cadence. PlainElderCare periodically re-pulls the latest CMS and CareScout files and rebuilds its database, though there can be a lag of weeks to a few months between a CMS refresh and our next rebuild, rapidly evolving facility conditions may not be reflected until our next update cycle, for urgent care decisions, verify directly with the facility and your state survey agency.

How accurate are the CMS 5-star ratings?

CMS star ratings are the official federal quality signal for Medicare- and Medicaid-certified facilities and combine inspection results, payroll-based staffing, and resident-outcome quality measures. They are the best standardized indicator available, but they do not capture every dimension of care quality, interpersonal relationships, culture, and facility-specific resident experiences are not measured. Treat star ratings as a starting point, not a substitute for a visit and conversations with staff, residents, and families.

Is PlainElderCare medical advice or a recommendation?

No. PlainElderCare is an informational resource built on public federal and survey data. Nothing on this site is medical advice, legal advice, or a recommendation for any specific facility or care plan. Always consult licensed healthcare professionals, care navigators, and your state long-term care ombudsman, and visit facilities in person before making elder care decisions.