CMS inaccurately reported deficiencies for two-thirds of nursing homes on Care Compare, the tool families use to choose facilities

An HHS Office of Inspector General audit found that CMS did not accurately report deficiency data on Care Compare — the federal government's primary nursing home comparison tool — for 67 out of 100 sampled nursing homes. The inaccuracies included health deficiencies for 34 facilities, fire safety deficiencies for 52 facilities, and emergency preparedness deficiencies for 2 facilities. Care Compare is the website families, hospital discharge planners, and ombudsmen use to evaluate and compare nursing homes. It is the authoritative federal source. And for an estimated two-thirds of facilities, it is wrong. This matters because families making nursing home placement decisions are operating under extreme time pressure and emotional stress. Their parent has been hospitalized, the discharge planner says they cannot go home, and the family has 48-72 hours to choose a facility. They go to Care Compare, look at star ratings and deficiency histories, and choose the facility that appears safest. If Care Compare says a facility has no fire safety deficiencies when it actually has three, that family is making a life-and-death decision based on false information. They cannot independently verify deficiency data — they would need to request state survey records and read hundreds of pages of inspection reports, which is not feasible in a 48-hour placement window. The entire value proposition of Care Compare is that it provides an accessible, accurate summary. When it fails at accuracy, it fails at its only job. This inaccuracy persists because of a fragmented data pipeline. State survey agencies conduct inspections and enter findings into the federal ASPEN system. CMS then extracts and processes this data for display on Care Compare. The OIG found errors at multiple points in this pipeline: surveyor data entry errors, extraction errors, and processing errors. There is no automated reconciliation between what surveyors documented and what Care Compare displays. CMS does not audit the accuracy of its own public-facing data. The system was designed decades ago and has been patched rather than rebuilt. Meanwhile, 107,000 complaints were filed about nursing homes in fiscal year 2024 alone — complaints that generate inspection findings that may or may not make it accurately into the system families rely on.