How we work
CareFull Review puts the public record on nursing homes and assisted living in one place, in plain English, and keeps watch on it. Here is where the information comes from, how we handle it, and how we pay for it.
No home pays us
Most "senior living advisors" are free to families because the homes pay them — often a fee worth thousands of dollars when a family moves in. That gives the advisor a reason to send families to the homes that pay.
We work the other way round:
- No nursing home or assisted living home pays us, for anything.
- Homes can't pay to be listed, ranked, featured or left out. There is no "claim your listing".
- We carry no advertising.
- Searching and reading every home's page is free, with no account.
We plan to charge for things that take ongoing work: alerts that watch a home over time, and documented comparison reports for families and the professionals who advise them. We will never charge for the safety information itself.
Where the information comes from
- Medicare (CMS) Care Compare data for every nursing home that takes Medicare or Medicaid: inspections and their grades, fines and payment denials, staffing from payroll records, quality measures, and ownership. CMS updates it monthly, with some parts quarterly, and the schedule sometimes slips.
- North Carolina Division of Health Service Regulation (DHSR): licence lists for nursing homes, adult care homes and family care homes; state inspection reports; adult care star ratings; and the state penalty list. We check these every night.
- NC Medicaid daily rates paid to nursing homes.
- South Carolina: homes in South Carolina within 25 miles of Charlotte are covered through the federal data. South Carolina doesn't publish its own inspection reports online.
We keep a dated copy of everything we collect, so we can show how a home's record has changed — including after a sale, when the name on the sign often stays the same.
How we compare homes
We compare a home only with other homes of the same kind in the same state, because states inspect and rate differently. A star in North Carolina is not the same as a star in South Carolina.
"Worse than most" means the home is among the worst quarter of homes in its state on that measure; "better than most", the best quarter; anything in between is "about typical". Where most homes share the same result — for example, no harm findings at all — we say so rather than calling any of them better or worse.
We show the official grade every time — Medicare's letters A to L, or North Carolina's Type A1, A2 and B — and say in plain words what it means. We don't invent our own scores or rankings.
What we can't tell you
No public record shows prices, whether a bed is free, or what daily life is like — the food, activities, or how kind the staff are. For adult care homes, there are no public staffing figures or quality measures at all. We say plainly what is missing on each page. Please visit, more than once and at different times of day.
Our tone
We report what the record says, with the date and a link to the source, and we don't call any home good or bad. A finding is a reason to ask questions. If your family member already lives in a home with a worrying record, moving is not the only option — and moving a frail person carries risks of its own. Each page explains who can help.
Mistakes
We copy government records automatically, and some are scanned documents. If you think something is wrong, tell us. We check every report against the original record and fix errors quickly.
Not advice
CareFull Review is information from public records. It is not medical, legal or financial advice. Records can be incomplete or out of date, and a home may have changed since an inspection.