Original research on CMS senior-care data

CMS's top overall rating is far more common in some states than others. This report measures the state-to-state spread in five-star share — and explains why CMS itself cautions against reading it as a state quality ranking.

The national distribution of CMS overall star ratings, how the overall rating diverges from the health-inspection domain that drives it, and how often the CMS abuse icon appears.

Whether a home health agency carries a CMS quality star depends heavily on its state. This report measures star coverage state by state — the gap between the best- and worst-covered states, and why the public record is thinner in some places than others.

How CMS quality-of-patient-care star ratings are distributed across the nation's Medicare-certified home health agencies — and how many agencies CMS cannot rate at all, and why that matters.

The ownership structure of the nation's nursing homes: how many operators there are, how concentrated the sector is, and what share of facilities belong to large multi-state chains versus single-facility operators.

The two CMS five-star systems are not the same. A side-by-side explainer of what each rating measures, how coverage differs, and why a family cannot compare a nursing home's stars to an agency's one-for-one.

How common federal enforcement is in the CMS record: the share of nursing homes with federal fines, payment denials, high-severity deficiencies, and the CMS abuse icon — and how to read an enforcement history.