Guide

Nursing Home Ownership Data: What PECOS Shows

PECOS is the Medicare enrollment system, and its published files are the public route from a nursing home to the companies and people behind it. They list direct and indirect owners, officers and managing entities for each enrollment, and they link to a facility by CCN. They are free, and the roles are what matter: not every row is an ownership stake.

The three files

FileWhat it answersNotes
All Owners
Every organization and individual tied to an enrollment, with role and ownership percentage
Who is associated with this facility?The main file
Change of Ownership
CHOW filings: buyer, seller, effective date, transaction type
Has it been sold?2016 onward
Enrollment
The enrollment record itself, linking a CCN and NPI to its enrolled entity
Which entity holds the licence?The join point

All three are published on data.cms.gov and refreshed roughly quarterly.

What the role codes mean

Every row carries a role, and only some of them are ownership. These are the ones you will see most.

5% or greater direct ownership interest
A real owner of the enrolled entity. This is what most people mean by “owner”.
5% or greater indirect ownership interest
Owns a share of something that owns the entity. The chain can run several layers deep.
Operational or managerial control
Runs the facility without necessarily owning it. Often the operating company.
Corporate officer / director
A named person on the governing body. A role, not a stake.
ADP of the SNF
Authorized or delegated official — an administrative contact. Not an ownership role at all.

What you can find out

Who owns a facility
The files list direct owners, indirect owners, and the entities holding operational control for each enrollment.
Whether it has changed hands
Change-of-ownership filings give the buyer, the seller and the effective date. Our copy holds 5,227 SNF filings from 2016 to 2024.
Whether it belongs to a larger group
The same owner appears against every enrollment it holds, which is how one facility connects to the rest of a group.
Whether an outside investor is involved
Enrollment forms carry private-equity and REIT flags. They are self-reported, so read them as a floor rather than a count.

Going deeper

Ownership, already resolved

SNF Insights reads these files down to the operating entity behind each facility and keeps it alongside quality, staffing, financials and payer rates.

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Figures reflect our copy of the CMS SNF ownership files as of August 2026 and change with each CMS release. Ownership is self-reported on enrollment forms. SNF Insights is independent and is not affiliated with or endorsed by CMS.