Comparing Nursing Homes: A Step-by-Step Method

A repeatable way to compare nursing homes using CMS ratings, staffing, inspections, cost, location, and the care needs of your family member.

Updated 2026

This guide is informational and is not medical advice.

Category: staffing-and-quality · Updated 2026

Comparing nursing homes gets easier once you apply a fixed set of criteria, and harder when every facility tells its own story. CMS data hands you a common yardstick for ratings, staffing, inspections, and penalties, while the person's care needs and your family's practical limits set the priorities. A structured comparison stops a persuasive tour from drowning out the numbers.

This guide offers a repeatable method plus a table you can fill in for each facility on your shortlist.

Step 1: Pin down the care need

Before you compare anything, write out the specific need: skilled nursing, dementia care, rehabilitation, ventilator care, bariatric care, behavioral support, or long-term custodial care. A facility that excels at one need may be unable to serve another. This narrows the list faster than any rating.

Step 2: Assemble the comparison table

Criterion	Where to find it
Overall and domain star ratings	Care Compare facility page
Inspection deficiencies and severity	Inspection results on Care Compare
Adjusted nurse and RN hours	Staffing section on Care Compare
Turnover rates	Staffing section on Care Compare
Quality measures	Quality measure section on Care Compare
Fines, denials, abuse icon, SFF status	Care Compare and CMS SFF page
Cost and rate structure	Facility rate sheet
Distance from family	Your own measure
Specialty services and culture	Tour and family feedback

Step 3: Weight what matters to you

No two criteria carry equal weight. For someone with complex nursing needs, staffing and clinical capability may come first. For someone pursuing rehabilitation, short-stay quality measures and therapy staffing may lead. For a family visiting daily, distance may decide it. Put your weights in writing so the process stays honest when one facility just feels friendlier.

Step 4: Dig into anything that stands out

Read the actual inspection reports behind any serious or repeated deficiency
Ask about any immediate jeopardy history and the plan of correction
Ask the director of nursing about staffing and turnover numbers
Check whether the facility will keep a resident who transitions to Medicaid
Visit on an evening or weekend, when staffing is often thinnest

See Spotting Red Flags in CMS Data for what to look for.

Step 5: Decide with the person, not for them

Whenever possible, include the person who will live there. Their read on the building, the staff, and the other residents counts. If time pressure forces the decision, as at a hospital discharge, lean on the practical criteria first, then plan to revisit the choice. For the move itself, see Hospital to Nursing Home Discharge and Planning a Move to a Care Facility.

Sources: Medicare Care Compare; CMS Provider Data Catalog; CMS Nursing Home Quality.

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Frequently asked questions

How many facilities should I compare?

Three to five is usually manageable. After filtering by care need and distance, a shortlist that size lets you weigh the data and visit each one without getting overwhelmed.

Which counts more, the ratings or the tour?

Both. Ratings cut the field down and reveal patterns you cannot spot in an hour, while the tour shows daily life. Let ratings guide where to look hardest, then trust what you observe and hear.

How do I compare cost fairly?

Ask each facility for an all-in monthly figure at the care level you need, including ancillaries. Then ask about annual increases and the policy if the resident transitions to Medicaid.

Where can I get help comparing?

Hospital discharge planners, Area Agencies on Aging, and state long-term care ombudsman programs help families understand options. Our guides and the CMS Care Compare tool supply the data.

Should I lean toward a newer building?

A newer building may offer private rooms and better design, but care quality depends more on staffing, leadership, and systems than on the building's age. Weight the data accordingly.

Data sources

CMS Provider Data Catalog · CMS Care Compare. This guide is informational and is not medical advice. Data as of 2026-10-06.

Required disclosures

For general information only, not medical advice. This website shares public data and general information. It does not offer medical advice, diagnosis, or treatment guidance, and it cannot replace a consultation with a qualified health care professional or with Medicare.

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