Methodology

State licensing registries are the source of record

Every facility on CareWitness comes from a state licensing registry. These registries are the authoritative public record of what facilities exist, where they are, what they're licensed to do, and who owns them. If a facility isn't in its state's registry, it doesn't appear on CareWitness. We started with Texas (TX HHS) and are expanding state by state.

Starting from state records gives families a ground-truth list of every facility the state has inspected, licensed, and authorized to operate. In Texas, that's 3,588 facilities: 2,011 assisted living residences, 1,176 nursing facilities, 395 adult day care centers, and 6 hospital-based nursing facilities.

CMS quality data is layered on nursing facilities

The Centers for Medicare & Medicaid Services certifies nursing facilities that accept Medicare or Medicaid and publishes star ratings, staffing hours, inspection histories, fines, and abuse flags. We match every state-licensed nursing facility to its CMS record using the Medicare Provider Number (CCN).

CMS data appears on nursing-facility pages under a clearly labeled “Federal Quality Data” section, exactly as CMS publishes it — unaltered, with every abuse flag and Special Focus designation visible. Assisted living, memory care, and adult day care aren't federally regulated, so they don't carry this section. Their quality context comes from state licensing data.

Every fact is labeled with its source and date

On every facility profile, you'll see per-field attribution: “State licensing registry, as of April 2026” or “CMS Care Compare, refreshed April 2026” or “Facility website, last reviewed April 2026.” Your loved one's safety is on the line. You should be able to see where each claim came from and when.

Refresh cadence

• State licensing data: refreshed whenever each state agency publishes new data (cadence varies by state). Every listing shows the snapshot date.
• CMS Care Compare: refreshed monthly when CMS publishes new data.

How listings are ranked

By default, facilities are ordered by CMS overall star rating (highest first) for nursing facilities, then by licensed capacity, then alphabetically. Assisted living and adult day care, which lack CMS ratings, are ordered by capacity and name.

Limitations worth knowing about

• Coverage currently ends at the Texas border. If you're in a state that isn't listed yet, CareWitness won't help you — yet.
• CareWitness doesn't provide medical advice. Care decisions should always involve a qualified professional.