CareIndex
CareIndex
Post-Acute Care Intelligence
Refreshed from CMS data · April 2026

Every post-acute care provider in America.
Scored. Benchmarked. Refreshed monthly.

14,710 skilled nursing facilities and 12,251 home health agencies — tracked across staffing, ownership, enforcement, financials, and market structure. Refreshed monthly from primary federal sources.

8,646
Facilities Not Meeting Staffing Benchmarks
CMS PBJ · Q3 2025
$470M
Federal Fines Levied (3yr)
CMS enforcement · active CMPs
10,041
Immediate Jeopardy Citations
Highest-severity · last 3 years
14.5M
Daily Staffing Records
Every shift · every facility
Source: CMS Payroll-Based Journal (PBJ) · CMS Enforcement Actions · CMS Provider Data · CareIndex analysis
State Regulatory Intelligence
The federal floor is gone. What's left varies wildly by state.
With CMS staffing mandates repealed in December 2025, enforcement has shifted entirely to state law and CMS survey findings. The problem: 12 states have no staffing floor at all. Five states actively fine facilities for understaffing. We track every facility against both industry benchmarks and state-specific requirements across all 50 states.
No Staffing Floor
12 states have zero HPRD requirements
Without federal mandates or state minimums, facilities in these states operate with no regulatory staffing floor whatsoever. Our data is the only way to see which ones are dangerously understaffed.
TX — 1,177 facilities → MO — 478 GA — 351 NC — 406 VA — 289 AL HI KY NE NV NH ND SD UT
Texas: 70% below 3.48 HPRD • 80% below 0.55 RN HPRD
Missouri: 76% below RN benchmark • 1.5 avg zero-RN days/quarter
Georgia: 65% below RN benchmark • No state oversight
Active Enforcement
5 states actively penalize understaffing
These states enforce their own HPRD minimums with real financial consequences. Our data shows which facilities are currently exposed to state enforcement action.
NY — 3.5 HPRD — $2K/day fines → CA — 3.5 HPRD — $50K fines → FL — 3.6 HPRD IL — 3.8 HPRD (skilled) MA — 3.58 HPRD
New York: 48% below benchmarks • $2,000/day state penalties active
California: 60% below RN benchmark • Fines up to $50,000
Illinois: 56% below 3.48 • State requires 3.8 for skilled care
We track staffing levels, state law requirements, CMS survey risk, and penalty exposure for every facility in all 50 states.
The Staffing Intelligence Gap
60% of nursing homes fall below staffing benchmarks
CMS established staffing benchmarks in 2024 that remain the industry standard for evaluating quality — used by investors, lenders, and ratings agencies like U.S. News. Though the federal mandate was repealed in December 2025, CMS surveyors still cite understaffing, state laws set their own minimums, and facilities below these benchmarks face real consequences.
3.48
Total HPRD
Total nursing hours per resident per day — RN + LPN + CNA combined
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0.55
RN HPRD
Registered nurse hours per resident per day — the most critical benchmark
——
24/7
RN Presence
A registered nurse on site every day of the year — zero-RN days = staffing gap
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Source: CMS Payroll-Based Journal (PBJ) · Benchmarks from CMS staffing research, adopted industry-wide
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Facilities below at least one benchmark
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Facilities "at risk" — missing one threshold
This bucket is growing quarter over quarter
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Facilities meeting all three benchmarks
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Industry Standard
The quality bar used by investors, lenders, and ratings agencies
Based on CMS research, widely adopted industry-wide
Source: CareIndex analysis of CMS PBJ data
Featured from The Brief
Our latest finding
The CareIndex Brief publishes monthly — one major development in the U.S. senior care industry, data-first, five-minute read.
The April Brief · Volume I · Issue 01
2,285
U.S. nursing homes under QRP reporting penalty in FY2026 — up from 298 two years ago.
Read the full April issue →
Publications
What we publish
Our research reaches readers through three channels: a free monthly brief, a catalog of paid reports, and ongoing coverage of the regulatory landscape.

The CareIndex Brief

A free monthly research brief covering one major development in the U.S. nursing home industry. Five-minute read. Published the first Tuesday of every month. Free with email.

Read the latest issue →

Reports

Paid facility, state, and multi-state intelligence reports for readers who need deeper analysis than our free research provides. Facility profiles, market analysis, staffing opportunity, and acquisition screening.

Browse the catalog →

Regulatory Landscape

Ongoing coverage of the federal and state rules governing post-acute care operations, including enforcement mechanisms, penalty structures, and the current post-repeal environment.

View current landscape →

Contact

14,710 SNFs • 12,251 home health agencies • 14.5M staffing records • 50 states

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