Methodology
How we score facilities
No single number captures quality. We show four independent signals so you can weigh what matters most for your patient — without one composite hiding problems.
Why four pillars
Composite scores are convenient but dangerous. A facility can have stellar CMS stars while its RN hours are dangerously low. Another might have a high bounce-back rate because it takes complex post-surgical patients — not because it's poorly run.
We surface four signals independently so case managers can see the full picture. Each pillar has its own color: green (good), yellow (watch), and red (concern). Gray means not yet reported.
Pillar 1: RN Hours
What it is: Registered nurse hours per resident per day, from CMS Payroll-Based Journal (PBJ) data — actual clock-in/clock-out records, not self-reported estimates.
Why it matters: RNs are the clinical backbone of SNF care. They catch early signs of deterioration — a rising heart rate, a subtle change in breathing — that CNAs and LPNs may not have the training to identify. Research consistently links RN hours to lower readmission rates, fewer pressure ulcers, and better discharge outcomes.
Source: CMS staffing data (PBJ). Updated quarterly.
Pillar 2: CMS Stars
What it is: CMS Five-Star Quality Rating — a 1–5 composite of health inspections, staffing levels, and quality measures. Updated quarterly by the Centers for Medicare & Medicaid Services.
Useful, but limited: Star ratings are the most widely recognized signal in post-acute care. However, health inspection ratings depend on when CMS last surveyed the facility (surveys are supposed to be annual; in practice they can slip). Staffing scores in the star system use self-reported data — less reliable than the PBJ clock-in records we use for RN Hours. We show stars as one input, not the whole picture.
Source: CMS Five-Star Quality Rating System. Updated quarterly.
Pillar 3: Trust Index
What it is: Placet's proprietary risk-flag score. Starts at 80, then applies adjustments based on federal enforcement actions and structural risk factors. Clamped to a 10–100 range, then mapped to a 1.0–5.0 star display.
Explicitly independent of RN hours and CMS stars — those are their own pillars. The Trust Index captures things CMS stars don't fully surface: persistent federal oversight, abuse and neglect citations, and ownership structure signals. Learn more about how the Trust Index is calculated →
Scoring factors (base score: 80)
Source: CMS Provider Information, updated quarterly. For-profit flag from CMS enrollment data.
Pillar 4: Bounce-back Rate
What it is: 30-day all-cause hospital readmission rate for short-stay residents — the percentage who end up back in a hospital within 30 days of admission to the SNF.
Why it's our highest-value signal: Readmissions are expensive, medically disruptive, and often preventable. A high bounce-back rate is the clearest downstream signal of poor care coordination, inadequate monitoring, and premature discharge. It's the primary concern of referring case managers.
Risk adjustment: CMS adjusts for patient diagnosis mix using HCC (Hierarchical Condition Category) risk scores derived from Medicare claims. This means a SNF that takes complex, high-acuity patients isn't unfairly penalized for a naturally higher raw readmission rate. We show the risk-adjusted figure.
Source: CMS Medicare Claims Quality Measures (dataset ijh5-nb2v), measure 521. Updated annually.
Data sources
| Source | What we use | Update frequency |
|---|---|---|
| CMS Provider Information | Facility name, address, ownership, beds, SFF status, abuse flag | Quarterly |
| CMS Five-Star Quality Rating | Overall rating, health inspection, staffing, QM ratings | Quarterly |
| CMS Payroll-Based Journal | RN, LPN, CNA hours per resident day (actual clock-in records) | Quarterly |
| CMS Medicare Claims QM | 30-day readmission rate (risk-adjusted, short-stay) | Annual |
| CMS SNF Enrollments | NPI → CCN crosswalk for payer network matching | Monthly |
| State DOH (NY, CA, PA, IL, FL, MA, NJ) | Supplemental inspection data, complaint records | Varies |
What we don't do
- 🚫No pay-for-placement — facilities cannot pay to appear higher in search results or improve their displayed score.
- 🚫No hidden removals — we do not remove ratings or citations at a facility's request.
- 🚫No lead selling — we do not sell contact information or referral data to facilities or third parties.
- 🚫No synthetic scores — every data point shown on Placet traces back to a specific federal or state dataset. We do not generate AI-fabricated quality estimates.