The care difference
A nursing home, which CMS also calls a skilled nursing facility, provides round-the-clock care that licensed nurses deliver or supervise, for people with significant medical or care needs. Assisted living generally provides housing plus help with daily activities — meals, bathing, dressing, medication reminders — for people who do not need continuous skilled nursing.
The practical dividing line is usually whether someone needs skilled nursing available at any hour, and that is a clinical determination made with a physician, discharge planner, or care manager rather than something a data site can settle.
The two are also not a one-way sequence. People move between them as needs change, including into a nursing home for rehabilitation after a hospital stay and back to assisted living afterwards.
The oversight difference
Nursing homes that participate in Medicare or Medicaid are certified under federal requirements, inspected by state survey agencies on CMS's behalf, and published on CMS Care Compare with ratings, citations, staffing data, and quality measures.
Assisted living is generally licensed and overseen at the state level instead, under state rules that differ meaningfully from one another — in what the category is even called, what staffing is required, and what health services a community may provide. There is no federal certification and no national rating comparable to the CMS five-star system.
Why that makes the research completely different
Families often read the absence of assisted-living ratings as a gap that will fill in somewhere else on the internet. It will not, because the underlying data is not collected nationally in the first place. Any site presenting national assisted-living rankings is not drawing on an equivalent public record.
So the two require different methods. Researching a nursing home is largely an exercise in reading a rich federal record carefully. Researching assisted living means going to the state: most states publish licensing status and inspection or complaint findings through the agency that regulates the category, and those records — not star ratings — are the substantive public evidence.
Every state also runs a Long-Term Care Ombudsman Program under the Older Americans Act, which advocates for residents of nursing homes and of assisted living and similar settings. It is an established route for questions and concerns about a specific community, and it covers settings CMS does not.
What this site covers, and what it does not
This site organizes the public CMS data on certified nursing homes and Medicare-certified home health agencies. Assisted living communities are outside that dataset, so they do not appear here — not because they are unrated in any judgemental sense, but because no comparable federal record exists to publish.
If the assessment points toward a nursing home, the CMS record here is a substantial place to start. If it points toward assisted living, the state licensing agency and the ombudsman programme are where the comparable evidence lives.