About KnowYourCareHome

Where the records come from

Nursing homes come from CMS Care Compare, which Medicare publishes monthly for every Medicare or Medicaid certified home: the four star ratings, every health deficiency with a plain-English description and a scope-and-severity grade, every fine and payment denial, and the ownership trail with names, roles and percentages. Texas has 1,177 of them.

Assisted living comes from the Texas Health and Human Services Commission, which licenses 2,012 facilities and publishes the licence directory, the owner and management company, Alzheimer certification and every closure in bulk. The inspection findings for each facility are published through HHSC’s provider portal one facility at a time, and we load them facility by facility; where a page says the inspection record is not yet on this site, that is exactly what it means, and it is never shown as clean.

We do not inspect facilities. We do not score them. We do not add findings, adjectives or opinions. What you read is what a state surveyor or inspector recorded, with the date, the grade the government assigned, and the correction where one is recorded.

What the words mean

• Health deficiency. A federal requirement a nursing home was found not to meet on a survey. CMS publishes a plain-English statement of the requirement for every one.
• Scope and severity. CMS grades every deficiency A to L. A to C is no harm, D to F potential for harm, G to I actual harm, J to L immediate jeopardy. We count G to L as serious.
• Star ratings. Medicare’s overall, health inspection, staffing and quality measure ratings, 1 to 5, as published. The health inspection rating is the one built from the deficiencies.
• Abuse icon and special focus. CMS flags a home with its abuse icon after a citation for abuse or neglect; special focus homes are under closer inspection for a persistent record. We show both exactly as CMS does.
• Type A and Type B. Texas licenses assisted living by whether residents can leave the building unassisted in an emergency (Type A) or may need help (Type B).
• Closure. A facility HHSC records as closed. It can mean a sale, a move or a licence surrender as well as an enforcement; the list does not say which, and neither do we.

How the comparison works

Nursing homes are compared by health deficiencies per survey within their county, not by the raw count, because a home surveyed ten times will always have more findings on paper than one surveyed twice. Each home’s page says how many out of 100 homes in the county it does better than. Assisted living facilities are not ranked, because the state publishes no comparable inspection metric for them yet.

How the site is paid for

Two ways, and neither one touches the record.

• The summary on every page is free. The full report, with every finding described, the correction history and the ownership trail, is $12, once.
• Operators can claim their page and pay for a Featured placement and a Book a tour button. Featured placements are always labelled, and a Featured facility’s record appears exactly as every other facility’s does. More for operators.

We take no referral fees and are not paid when a family chooses a facility. That is a deliberate difference from placement services that present themselves as free advice while being paid by the facilities they recommend.

If something is wrong

If a record on this site does not match the government’s file, email chris@securelayerhq.com and we will check it the same day. If the government’s own file is out of date, the correction has to be made with CMS or HHSC; it reaches this site on the next refresh.