The facts
We are a lens on the federal record, not the record. Here is exactly what we hold (five CMS dataset families and one we compile ourselves, each with what it answers, how often it refreshes, and where it falls short), assembled, dated, and archived month over month, which is worth more than the raw feeds anyone can download.
PBJ CY2025Q4, published 2026-04-29
Nothing here is exclusive: every dataset below is free on data.cms.gov, and we will tell anyone who asks exactly where to download it. What you pay us for is the computation, the joining, the dating, and the monitoring, never the data itself.
A growing system, a growing caseload. The families go to the firm that wins.
The country is aging faster than the care system can keep up. That reshapes your practice for the next twenty years, and it is why this record matters.
Every one of those numbers is a family that may one day need a lawyer, and the caseload isn't shrinking, it is compounding, for two decades. The firms that win the hard cases become the firms families are referred to. Winning starts with the facts: ElderFacts hands you the entire federal record on every one of the 14,700 certified homes, worked up and ready. As the system grows, the firm that's equipped grows with it.
Sources: U.S. Census Bureau (Vintage 2024 estimates; 2023 population projections via ACL/AoA Profile of Older Americans) · CDC/NCHS National Post-acute and Long-term Care Study · PHI. Nursing-home coverage computed from the CMS Nursing Home Care Compare file (May 2026 release).
So what data do you actually hold?
Every card carries the same five fields, and its limit is set beside what it answers, at equal weight. The concession is the credibility.
Health Deficienciesnursing homes incl. rehab services
Every health citation from a facility’s last three standard inspection cycles plus complaint inspections (about three years): the F-tag, CMS’s deficiency category, the scope/severity letter A–L, the survey date and type, and the correction record. This is the dataset behind every citation ledger on the site, with a deep link to the CMS-2567 for each survey.
Has this facility been cited under the same F-tag before? At what scope and severity, and how many citations sit at G or above, CMS’s actual-harm band? What does the survey-by-survey history look like, standard and complaint?
Monthly CMS release
Three inspection cycles of depth, no more; and the record moves: citations get disputed and can change on IDR/IIDR appeal, so disputed citations carry an inline flag and outcomes post at the following release. Survey rigor also varies by state.
FLAGGED every disputed citation, until its appeal postsHealth Deficiencies · 2026-06 release · published 2026-06-24Penalties
Federal civil money penalties (CMPs) and denials of payment for new admissions (DPNA) over the past three years: the amount and the imposition date.
Which penalty traces to which survey; what a facility has paid in federal penalties over the trailing 36 months; whether any remedy lands inside a date window you care about, a residency, for instance.
Monthly CMS release
Federal remedies only. State-only enforcement actions appear only where CMS posts them. A clean penalty record here is not a clean record everywhere.
Penalties · 2026-06 releasePBJ Daily Nurse Staffing
Payroll-based staffing: paid hours per day per category (RN, LPN, CNA, administrative), split employee versus contract, with a daily resident census derived from MDS assessments.
What staffing actually looked like on specific days: the days a resident was in the building, weekends included. We compute the share of days below the facility’s case-mix-expected RN staffing (Care Compare expected values), by quarter, against a statewide median. This is the analysis neither ProPublica nor Care Compare produces.
Quarterly file, on a lag of a quarter+
Self-reported payroll data, subject to CMS audit but not pre-verified, and the lag means the newest days you can see are months behind the calendar. We show the file date on every chart.
PBJ Daily Nurse Staffing · CY2025Q4 file · published 2026-04-29Provider Information
The facility profile as CMS publishes it: overall, health-inspection, and staffing star ratings; certified beds and census; ownership type; Special Focus Facility status and candidacy; the abuse-citation flag; certification date.
The at-a-glance read on any facility, and, because we archive every release, what changed: rating moves, SFF entries and exits, flag changes, snapshot to snapshot.
Monthly CMS release
The ratings are CMS’s composites: we display them verbatim and never re-score them, which means they inherit whatever the underlying survey and staffing data inherit, including state-to-state survey variance.
Provider Information · 2026-06 releaseSNF All Owners + PECOS enrollment
Every disclosed owner with 5% or more direct or indirect ownership, or managing control (roles, percentages, association dates), plus change-of-ownership records, cross-checked against PECOS enrollment.
Who is behind the license: the operating company, the property holder, the management company, the parent, and which sibling facilities sit under the same ownership or management, each with its own citation and penalty record.
Monthly CMS release
As-disclosed only, at the 5% threshold, and investors can structure below it, so private-equity and REIT involvement is materially under-captured, and our PE/REIT flags are a starting point to corroborate against SEC filings and state records, never a finding on their own.
SNF All Owners · 2026-06 release · PECOS cross-check 2026-06-24Medicare Advantage plan acceptance
Plan-acceptance data compiled per facility: which Medicare Advantage plans a facility accepts.
The discharge-planner’s first cut: which facilities in a radius accept this patient’s plan, before quality screening even starts.
With our monthly snapshot cycle
Compiled data, not a CMS certification. Networks change mid-year. Confirm acceptance with the plan or the facility before anyone relies on it for a placement.
MA acceptance · 2026-06 snapshotHow far back does your data go?
Every month, CMS replaces its published files with a new release. Most of the old release simply disappears from public view. We archive every monthly release from the day we started, so where CMS shows you now, we can show you now versus then: new citations, new penalties, rating moves, ownership changes, dispute outcomes, release over release. Here is the honest part: the time series starts on our start date and accumulates from there. Today it is exactly as long as we have been archiving, no longer, and it gets more valuable every month in a way nobody can backfill, including us. We will never present the archive as deeper than it is; the earliest snapshot date is printed right on it.
The archive gets more valuable every month in a way nobody can backfill, including us.
Supersession. The live page is always canonical. Snapshots, PDFs, and exports carry the release they were built from and are superseded when the next release applies. If you are citing us, cite the live page and its stamp.
What we never do
We never fabricate a number.
Every figure on this site traces to a named dataset and a dated release, and the methodology specifies every computation we run on top. If we can’t source it, we don’t publish it.
We never editorialize beyond published criteria.
We recount the record in CMS’s own vocabulary and characterize no one’s conduct. Every label we compute carries exact, versioned, dated criteria, published before the label appears anywhere.
We never change quietly.
Corrections go on a public, dated log with a stated clock. Methodology changes get a version number. The record of what we said, and when, is part of the product.
Before you trust any of this, read the methodology.
The computations behind everything above (definitions, label criteria, limitations, version history) are specified in one place, and it’s the page we’d want you to read before you trust any of this.