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← Capability-Verified Top 10%

Methodology · 2026

How we choose winners for Capability-Verified Top 10%

This is the complete methodology. Every CMS field, every threshold, every exclusion, and the exact SQL that produces the winner list. If you can read SQL, you can audit this award.

What this award recognizes

The Placet Capability-Verified Top 10% award identifies, for each U.S. state, the top 10% of skilled nursing facilities by a composite of three CMS Care Compare metrics — overall rating, staffing rating, and health inspection rating — restricted to facilities with at least one verified clinical capability that takes a complex patient.

Why this filter

CMS star ratings alone do not tell you whether a facility can take a tracheostomy, ventilator, IV antibiotic, dialysis, wound vac, or bariatric patient. Many high-rated facilities cherry-pick low-acuity residents. We filter to facilities that say yes to at least one of those capabilities so that the award reflects measurable clinical capacity, not just survey performance with an easy patient mix.

Composite score

composite = overall_rating + staffing_rating + health_inspection_rating (range 3 to 15). Ties broken by overall_rating, then staffing_rating, then alphabetical facility name.

Cohort

All Medicare/Medicaid certified nursing facilities (CCN-bearing) in the United States, grouped by state.

Threshold

Top 10% of the eligible cohort within each state, with a floor of at least 1 winner per state if the eligible pool has more than 10 facilities. Maximum 50 winners per state.

Exclusions

  • Active CMS abuse icon flag
  • Special Focus Facility designation, including candidate status
  • Any complaint-driven deficiency in the past 12 months at scope/severity G or above (actual harm or immediate jeopardy)
  • Facilities with no verified clinical capability

Time window

The award is computed annually. The CMS data snapshot used is the most recent quarterly Provider Info release as of the computation date.

Computation SQL · verbatim

This is the literal query stored in award_categories.computation_sql. Re-running it against the same CMS snapshot produces the same winners.

WITH eligible AS (
    SELECT f.ccn, f.facility_name, f.state,
           qr.overall_rating, qr.staffing_rating, qr.health_inspection_rating,
           (COALESCE(qr.overall_rating,0) + COALESCE(qr.staffing_rating,0) + COALESCE(qr.health_inspection_rating,0)) AS composite,
           (COALESCE(sd.accepts_tracheostomy,FALSE) OR COALESCE(sd.accepts_ventilator,FALSE)
            OR COALESCE(sd.accepts_wound_vac,FALSE) OR COALESCE(sd.accepts_iv_antibiotics,FALSE)
            OR (sd.accepts_dialysis IS NOT NULL AND sd.accepts_dialysis <> 'No')
            OR COALESCE(sd.accepts_bariatric,FALSE)) AS has_verified_capability
    FROM public.facilities f
    JOIN public.quality_ratings qr ON qr.ccn = f.ccn
    LEFT JOIN public.scraped_data sd ON sd.ccn = f.ccn
    WHERE NOT public.is_facility_excluded_from_awards(f.ccn)
      AND qr.overall_rating IS NOT NULL
), ranked AS (
    SELECT ccn, facility_name, state, composite, overall_rating, staffing_rating, health_inspection_rating,
           PERCENT_RANK() OVER (PARTITION BY state ORDER BY composite ASC, overall_rating ASC, staffing_rating ASC) AS pr,
           ROW_NUMBER() OVER (PARTITION BY state ORDER BY composite DESC, overall_rating DESC, staffing_rating DESC, facility_name ASC) AS rk
    FROM eligible
    WHERE has_verified_capability
)
SELECT * FROM ranked WHERE pr >= 0.9 AND rk <= 50;

Universal exclusions

Across every Placet Award, the following facilities are excluded regardless of how well they score:

  • Active CMS abuse icon flag
  • Special Focus Facility designation, including candidate status
  • Any complaint-driven deficiency in the past 12 months at scope/severity G or above (actual harm or immediate jeopardy)

Enforced in the database by is_facility_excluded_from_awards(ccn).