Methodology · 2026

How we choose winners for Clean Survey Record

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 Clean Survey Record award honors nursing facilities that have completed five consecutive CMS inspection cycles with zero deficiencies at scope and severity G or higher. Severity G is the CMS threshold for "actual harm" — anything below G is procedural; G and above means a resident was hurt or could have been.

Why this matters

Most CMS deficiencies are below severity G. Facilities chasing five-star ratings can absorb a steady drip of D/E/F citations. What separates a safe facility from a paperwork-shuffler is the absence of harm-level findings. Five clean cycles in a row is hard to fake.

Cohort

All Medicare/Medicaid certified nursing facilities with at least five recorded inspection cycles in the CMS deficiencies dataset.

Threshold

Zero deficiencies at scope_severity in (G, H, I, J, K, L) across the five most recent inspection survey dates for each facility.

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 cycles AS (
    SELECT d.ccn, d.survey_date,
           DENSE_RANK() OVER (PARTITION BY d.ccn ORDER BY d.survey_date DESC) AS cycle_rank,
           BOOL_OR(d.scope_severity IN ('G','H','I','J','K','L')) AS has_harm
    FROM public.deficiencies d
    WHERE d.survey_date IS NOT NULL
    GROUP BY d.ccn, d.survey_date
), recent_five AS (
    SELECT ccn, COUNT(*) AS cycles_seen, BOOL_OR(has_harm) AS any_harm
    FROM cycles
    WHERE cycle_rank <= 5
    GROUP BY ccn
    HAVING COUNT(*) >= 5
)
SELECT f.ccn, f.facility_name, f.state, r.cycles_seen
FROM recent_five r
JOIN public.facilities f ON f.ccn = r.ccn
WHERE r.any_harm = FALSE
  AND NOT public.is_facility_excluded_from_awards(f.ccn);

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).

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