CMS Certification Number (CCN) & Care Compare Explained
The CCN is the identifier that proves a nursing home is certified to participate in Medicare and Medicaid, and Care Compare is where the public looks that certification — and everything else about a facility's performance — up. Here's how both actually work.
Quick answer
A CMS Certification Number (CCN) is the identifier CMS assigns once a nursing home is certified to participate in Medicare and/or Medicaid. Getting one requires passing an initial certification survey conducted by the state survey agency against the federal Requirements of Participation, then enrolling with Medicare through Form CMS-855A. Once assigned, the facility's certification status, star rating, and survey history are publicly viewable by anyone at medicare.gov/care-compare.
What Is a CMS Certification Number?
A CMS Certification Number (CCN) — sometimes still called the Medicare provider number or "legacy" number — is the identifier CMS assigns to a healthcare facility once it is certified to participate in Medicare and/or Medicaid. Skilled nursing facilities are assigned CCNs within a specific numeric range reserved for that provider type, distinct from the ranges used for hospitals, home health agencies, or other provider categories.
It's worth being precise here because the terms get mixed up constantly: the CCN is not the same as the National Provider Identifier (NPI). The NPI is a broader identifier used across healthcare billing generally, assigned once to an organization regardless of how many payer programs it participates in. The CCN is specific to Medicare/Medicaid certification and to the physical location it was issued for.
How a Facility Actually Gets One
The CCN isn't something a facility applies for directly the way it might apply for a business license — it's issued as the output of a combined certification-and-enrollment process that runs through both the state survey agency and CMS.
What "Getting CMS Certified" Actually Involves
Build and license the facility
Before federal certification is even on the table, the building itself has to meet state licensure requirements and life-safety code, and the facility has to hold a valid state operating license.
Request an initial certification survey
The facility asks its state survey agency to conduct an initial Medicare/Medicaid certification survey — a full on-site review against the Requirements of Participation (42 CFR Part 483), the same regulation used for ongoing recertification surveys.
Pass the survey and receive state certification
If the survey finds the facility in substantial compliance (or an acceptable Plan of Correction resolves any findings), the state survey agency certifies the facility as meeting federal requirements and forwards that certification to CMS.
Enroll with Medicare via Form CMS-855A
Separately from the survey and certification, the facility files Form CMS-855A — the Medicare Enrollment Application for Institutional Providers — through PECOS (the online system) or on paper, to establish and maintain its Medicare billing enrollment.
CMS assigns the CCN and activates billing
Once certification and enrollment are both in place, CMS assigns the facility its CMS Certification Number and activates Medicare billing privileges; Medicaid participation is handled through the state Medicaid agency, typically using the same underlying certification.
For what that initial certification survey is actually checking the facility against, see our full guide to the CMS Requirements of Participation — the same 42 CFR Part 483 standard used for every recertification survey afterward, not a separate set of rules just for initial certification.
Looking Up a Facility on Care Compare
Care Compare, at medicare.gov/care-compare, is the public CMS tool for looking up any Medicare-certified nursing home in the country. Search by facility name, city, state, or ZIP code, and the listing for each facility shows its Overall Star Rating, its individual Health Inspection, Staffing, and Quality Measure ratings, recent survey and complaint history, and whether it participates in Medicare, Medicaid, or both. Care Compare also supports side-by-side comparison of up to three facilities at once, which is useful for anyone evaluating a placement or benchmarking against nearby competitors.
For how those star ratings are actually calculated once you're looking at them, see our full breakdown of the CMS Five-Star Quality Rating System.
Why the CCN Matters Day to Day
Beyond being a billing prerequisite, the CCN is the key that ties every public record about a facility together — survey history, the Five-Star Rating, Civil Money Penalties, and enforcement actions are all indexed to it on Care Compare and in CMS's underlying datasets. A facility losing its CCN through termination of the provider agreement — the most severe end of the CMS enforcement ladder — loses the ability to bill Medicare and Medicaid entirely, which for most skilled nursing facilities is an existential outcome, not a routine one.
Common Mistakes
- Confusing the CCN with the National Provider Identifier (NPI) — they are different identifiers serving different purposes, and a facility has both
- Assuming Form CMS-855A enrollment happens before or instead of the certification survey, when survey certification by the state agency generally precedes and feeds into Medicare enrollment
- Treating Care Compare's public star rating as the same thing as certification status — a facility can be certified and still carry a 1-star rating; certification and rating quality are separate questions
- Assuming a facility keeps its CCN permanently regardless of ownership change — a change of ownership can trigger new enrollment paperwork and, in some circumstances, a new survey
- Not checking Care Compare's individual domain breakdown (Health Inspections, Staffing, Quality Measures) and only looking at the single Overall Rating number
Protect what your CCN represents
Certification is the floor, not the finish line — staying in substantial compliance is a continuous job. PoC360's daily compliance tasks, AI-drafted Plans of Correction, and Five-Star tracking help keep the facility your CCN represents ahead of the next survey, not scrambling to catch up before one.
Start Free Trial →Frequently Asked Questions
What is a CMS Certification Number (CCN)?+
A CMS Certification Number (CCN), sometimes called the Medicare provider number or "legacy" number, is the identifier CMS assigns to a healthcare facility once it's certified to participate in Medicare and/or Medicaid. Skilled nursing facilities are assigned CCNs within a specific numeric range reserved for that provider type. It's distinct from the National Provider Identifier (NPI), which is a separate, broader identifier used across healthcare billing generally.
How does a nursing home get a CCN?+
A facility first has to pass an initial Medicare/Medicaid certification survey conducted by its state survey agency against the federal Requirements of Participation. Once certified, it enrolls with Medicare using Form CMS-855A (filed through PECOS or on paper). CMS assigns the CCN once certification and enrollment are both complete — the CCN isn't something a facility applies for directly; it's issued as the output of that combined process.
What is Form CMS-855A?+
Form CMS-855A is the Medicare Enrollment Application for Institutional Providers — the form skilled nursing facilities and other facility-based providers use to establish and update their Medicare enrollment information. It was revised effective October 1, 2024, and facilities must use the current version for all enrollment submissions and changes.
What is Care Compare?+
Care Compare, at medicare.gov/care-compare, is the CMS public tool for looking up and comparing Medicare-certified providers, including nursing homes. For nursing homes specifically, it displays the CMS Five-Star Quality Rating, individual domain scores (Health Inspections, Staffing, Quality Measures), survey history, and whether the facility participates in Medicare, Medicaid, or both.
How do I look up a specific nursing home's certification and rating?+
Go to medicare.gov/care-compare, search by facility name, city, state, or ZIP code, and select the facility from the results. The listing shows the Overall Star Rating along with the individual Health Inspection, Staffing, and Quality Measure ratings, recent survey history, and Medicare/Medicaid participation status. See our full guide to the CMS Five-Star Quality Rating System for how each of those numbers is actually calculated.
Is getting a CCN the same as passing a CMS survey?+
They're connected but not identical. Passing the initial certification survey is a required step toward getting certified, but the CCN itself is assigned once CMS completes the combined certification-and-enrollment process, including the Form CMS-855A filing. A facility could, in principle, pass survey and still not yet have an active CCN if enrollment paperwork isn't finalized.
What is the relationship between a CCN and the Requirements of Participation?+
The CCN is the identifier; the Requirements of Participation (42 CFR Part 483) are the substantive standard a facility has to keep meeting to retain it. Certification isn't a one-time event — the facility must remain in substantial compliance with the RoP on an ongoing basis, verified through recertification surveys roughly every 9 to 15 months (and sooner in response to complaints), or risk enforcement action up to termination of the CCN and provider agreement. See our full guide to the CMS Requirements of Participation for what that standard actually covers.
Does every nursing home have a CCN?+
Only facilities certified to participate in Medicare and/or Medicaid have one. A facility that operates purely as a private-pay assisted living or personal care setting, outside Medicare/Medicaid certification entirely, would not have a CCN — but any skilled nursing facility billing Medicare or Medicaid for resident care must hold one.
Sources: CMS.gov Medicare Provider Enrollment and Certification, Form CMS-855A (revised September 2024, effective October 1, 2024), medicare.gov/care-compare. Last reviewed 2026-09-30. We review this article as CMS enrollment and certification guidance changes.