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 to 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 and abuse and neglect citations. Learn more about how the Trust Index is calculated →
Scoring factors (base score: 80)
Source: CMS Provider Information, updated quarterly.
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.