Methodology & sources

Where the data comes from

Quality & staffing: CMS Care Compare (Nursing Homes), dataset 4pq5-n9py, a public-domain dataset the U.S. Centers for Medicare & Medicaid Services (CMS) publishes for every certified nursing home. Retrieved 2026-08-09; CMS refreshes it roughly monthly. Star ratings shown are CMS's own five-star ratings — we do not create our own ratings.

Cost figures: national median monthly costs from the CareScout 2025 Cost of Care Survey, cited as published. We do not republish CareScout's compiled tables; costs vary significantly by metro area.

The report-card grade

The letter grade is a plain-English relabel of the facility's CMS overall star rating: 5★ = A, 4★ = B, 3★ = C, 2★ = D, 1★ = F. It adds no hidden judgment — the underlying CMS ratings and flags are always shown alongside it.

Staffing benchmark

“Nurse hours per resident per day” is CMS's payroll-based total nurse staffing measure. We compare each facility to the Texas median of 3.27 hours, computed across the 1,135 rated facilities.

Inspection findings (deficiencies)

Each report card's “recent inspection findings” come from CMS's Health Deficiencies dataset — the specific citations state inspectors issued. We label each by its scope-and-severity code: minimal harm (A–C), potential for harm (D–F), actual harm (G–I), and immediate jeopardy (J–L). We show the most recent and most severe findings, mark those CMS records as corrected, and link to the full inspection history on Medicare.gov. These are the government's findings, presented factually — not our judgment.

What we publish — and suppress

Of 1,177 certified Texas nursing homes, we publish a page only for the 1,135 with both a real CMS overall rating and real staffing data. The other 42 are counted but not given a page — we would rather show fewer, complete pages than many thin ones.

Study exclusions (credibility filter)

For the worst-staffed study, we exclude reporting artifacts that would distort a “lowest staffing” ranking: continuing-care retirement communities, facilities with fewer than 25 average residents, and any facility reporting below 1.5 nurse hours per resident per day (below any real operating level — a sign of an incomplete payroll submission, not genuine staffing).

Corrections

CMS data can contain errors, and facilities change. If something looks wrong, tell us and we'll check it against the source. This site is educational information, not medical, legal, or financial advice.