CMS SNF All Owners Nursing Home Ownership Data
Fonteum structures the CMS PECOS-derived SNF All Owners file — 280,207 ownership rows across 14,425 Medicare-certified skilled nursing facilities — for facility-level ownership analysis. The dataset documents the 82.4% ownership-percentage gap in the top-10 chains, PE chain affiliations, and REIT landlord relationships. M&A diligence teams and healthcare policy researchers use this layer to map controlling-interest structures without rebuilding the quarterly CMS parse pipeline.
Ownership records by role type
Distribution of the 280,207 ownership rows by CMS role code — direct owner, indirect owner, officer, director/board member, managing employee, and delegated official. The majority of rows are governance-role entries, not percentage-bearing ownership stakes — which is why ownership_percentage is missing for such a large share of the top-10 chain records.
What is the CMS SNF All Owners dataset?
CMS SNF All Owners is derived from the PECOS (Provider Enrollment, Chain, and Ownership System) and published quarterly via data.cms.gov. It is the only federal dataset that discloses both direct and indirect ownership interests in Medicare-certified skilled nursing facilities. Each row maps an owner — individual or entity — to a specific facility, with the ownership percentage, ownership type (direct / indirect / managing employee / officer / director), and the facility's CCN (CMS Certification Number).
The dataset spans 14,425 facilities and 280,207 ownership rows. It is the primary source for identifying private-equity portfolio companies, REIT sale-leaseback structures, and multi-facility chain affiliations in the long-term care sector. Fonteum joins it to the CMS Care Compare nursing home quality star ratings, PBJ daily staffing data, and the OIG LEIE exclusion list on the facility CCN.
The 82.4% ownership gap — what Fonteum surfaces
A critical limitation of the CMS SNF All Owners file is that ownership_percentage is missing for a substantial share of records — and the gap is not random. Fonteum's analysis (confirmed against the Health Affairs 2024 baseline) found that 82.4% of facilities affiliated with the top-10 national chains have no ownership percentage disclosed in the source file. For all facilities, the missing rate is lower but still significant.
Fonteum does not impute or paper over this gap. Instead, every ownership record carries a DataAvailabilityState flag — disclosed, suppressed_by_source, or missing_from_source — making the data quality signal itself queryable. For diligence workflows, this means analysts know exactly which facilities require additional corporate registry lookups and can prioritize accordingly.
Browse the live ownership surface → · Related research studies →
Who uses nursing home ownership data
Acquirers and lenders evaluating SNF portfolios need facility-level ownership maps, chain affiliation history, and OIG exclusion cross-references. Fonteum's joined dataset — ownership + quality ratings + staffing + exclusions — reduces the data assembly phase of healthcare facility diligence.
Academic and government researchers studying PE ownership effects on nursing home quality, staffing, and deficiency rates need the facility-ownership join. Fonteum's CCN-keyed schema links directly to CMS Care Compare quality measures and PBJ staffing records.
State survey agencies responsible for nursing home oversight need ownership transparency to assess affiliate exclusion risk and chain-wide enforcement exposure. Fonteum's provenance-flagged ownership layer documents data gaps that regulators must supplement from state corporate registries.
Frequently asked questions
- What is the CMS SNF All Owners dataset?
- CMS SNF All Owners is a PECOS-derived dataset that discloses ownership structure for Medicare-certified skilled nursing facilities. It covers both direct ownership (percentage held) and indirect organizational structures, mapping each ownership stake to a named individual or entity. The dataset is published quarterly and is the primary federal source for identifying private-equity ownership, REIT landlord relationships, and chain-affiliated facilities. Fonteum ingests the quarterly release and structures it for facility-level and owner-level queries.
- What is the 82.4% data gap and why does it matter?
- 82.4% of the top-10 nursing home chains — facilities operating under the largest national chains by count — have missing ownership_percentage values in the CMS SNF All Owners source file. This gap was first documented in a Health Affairs 2024 analysis and is reproducible from Fonteum's ingestion of the public CMS file. Fonteum surfaces this gap explicitly in the ownership data surface rather than substituting imputed values. It matters for PE diligence because ownership percentage is the primary signal for controlling-interest determination under OIG affiliate exclusion doctrine.
- How does Fonteum structure the SNF All Owners data for analysis?
- Fonteum maps the raw CMS ownership CSV to a facility-keyed schema with three layers: (1) ownership_rows — one row per owner per facility with stake percentage where disclosed; (2) chain_affiliations — entity-level groupings linking facilities to parent organizations; (3) provenance_flags — a DataAvailabilityState field on each record indicating whether ownership_pct is disclosed, suppressed, or missing from source, with the Health Affairs 2024 baseline documented inline. Every layer links back to the CMS source file via the fourteen-field provenance attribution.
- Can I get nursing home ownership data by state from Fonteum?
- Yes. The /ownership data surface includes state-level rollups with facility count, missing-ownership-pct share, PE-chain match rate, and REIT landlord match rate for each of the 50 states plus DC. The data-platform export allows state-filtered bulk pulls in CSV or NDJSON format. For a specific state or facility cluster, the audit-pack export includes pre-sliced ownership tables ready for spreadsheet or database import.
- Is nursing home ownership data from CMS free to use?
- The underlying CMS SNF All Owners data is published under U.S. Government Works and is freely redistributable with attribution. Fonteum's structured schema, provenance layer, gap-documentation, and API infrastructure carry separate commercial terms. The data-platform agreement covers commercial use of the enriched, query-ready dataset; the methodology documentation identifies which fields originate from the government source and which are Fonteum-added structure.
Access the SNF ownership data layer
The Audit Pack includes the SNF ownership table joined to Care Compare quality ratings, PBJ staffing, and OIG exclusions on facility CCN. For diligence-grade exports or custom state/chain filters, contact the data engineering team.
The ownership layer behind 14,425 nursing homes
CMS's SNF All Owners file records owner-to-facility relationships across facilities and 85,319 distinct owners — about 19.4 owners per facility once holding companies, management firms, and individuals are counted. Yet of those records list no ownership percentage at all, so the federal file names the parties without quantifying control.
The vehicles in the ownership stack
Most organizational owners are LLCs — the standard opacity vehicle. Beneath them sit the financialization layers the disclosure rule was written to surface: 9,264 holding companies, 2,494 financial institutions, and 802 investment firms appear directly in the owner records.
Related Fonteum data: the nursing-home Care Compare module ties ownership to quality and deficiencies, the staffing dataset links owners to nurse hours, and the OIG sanctions surface flags owners who appear on the federal exclusion list.
Methodology
Ownership edges come directly from the CMS SNF All Owners file — not from an aggregator. The pipeline runs in five stages: (1) source acquisition from data.cms.gov, (2) entity resolution on the owner associate ID, (3) owner-to-facility edge construction on the enrollment ID, (4) quality checks against published CMS row counts, and (5) chain attestation. Each value is asserted and chained, then labeled with its provenance — attested, signed, or provenance-tracked — never with unbacked trust language.
These four headline fields begin the 14-tuple provenance chain — full contract on the data sources reference.
Source comparison: grain, cadence, and access
| Source | Data grain | Cadence | Access | Provenance |
|---|---|---|---|---|
| Fonteum | Owner ↔ facility edges | Monthly | API + bulk, free base | 14-tuple chain |
| CMS SNF All Owners | Owner record | Monthly | Free CSV, no graph | None (raw file) |
| Definitive Healthcare | Parent / system | Annual | Paid subscription | None |
| Academic PE datasets | Deal-level | Ad hoc | Research request | None |
Sources
- Skilled Nursing Facility All Owners — Centers for Medicare & Medicaid Services (CMS), Monthly. Primary source ↗ · Archive ↗
Used for: Owner identity, role, ownership percentage, and entity-type flags per facility. - PECOS Public Provider Enrollment File — Centers for Medicare & Medicaid Services (CMS), Monthly. Primary source ↗ · Archive ↗
Used for: Enrollment backbone the ownership records attach to (enrollment_id key). - Nursing Home — Provider Information (4pq5-n9py) — Centers for Medicare & Medicaid Services (CMS), Monthly. Primary source ↗ · Archive ↗
Used for: Facility identity, star ratings, and Special Focus status joined on the CCN. - Ownership transparency policy basis — U.S. Department of Health & Human Services / CMS (Federal Register), As issued. Primary source ↗ · Archive ↗
Used for: The disclosure rule that requires SNFs to report owners and additional disclosable parties.
Data last updated: 2026-05-25 · Reviewed by Jennifer Montecillo, MD · June 2026. Non-practicing medical reviewer.