How we work
Every score, badge, and notice on Placet reflects a deliberate choice about data sourcing and transparency. This section explains how we classify facilities, where our data comes from, and — critically — what we cannot tell you.
Every facility on Placet is assigned one of four transparency modes, shown as a badge on the facility profile. The mode tells you what kind of oversight the facility operates under and how much public data is available.
Medicare- and Medicaid-certified Skilled Nursing Facilities (SNFs) report to the federal Centers for Medicare & Medicaid Services. CMS publishes inspection results, deficiency citations, staffing hours via Payroll-Based Journal (PBJ), civil monetary penalties, and quality measures. This is the most complete public data set available for any care setting.
Some facilities include both a federally-certified SNF and a state-regulated long-term care setting — such as an Assisted Living Facility or CCRC — under the same operator and address. We call these dual-status campuses because federal oversight discipline and operator accountability can extend across the whole campus, even though only the SNF portion has public CMS data.
Assisted Living Facilities, Residential Care Homes, and most Memory Care communities are licensed at the state level. They do not report to CMS and are not included in Care Compare. How much public data exists depends on each state's disclosure laws — some states publish inspection reports and complaint histories; others publish almost nothing.
In some states, reliable inspection or quality data is simply not publicly available for non-SNF care settings. Rather than present a misleadingly thin profile, we show an explicit notice and direct families to the state ombudsman, in-person visits, and other resources. We believe saying "we don't know" is more honest than showing silence.
The canonical list of every upstream public dataset that powers Placet — CMS Provider Data, PBJ staffing, deficiency citations, ownership disclosures — with source URL, license, refresh cadence, and known caveats per dataset.
How CMS composes the Overall Five-Star rating from Health Inspection, Staffing, and Quality Measures components, why a 5-star facility can still cite serious deficiencies, and how Placet displays the breakdown.
What the CMS abuse icon means, the severity threshold (G+) that triggers it, the 24-month rolling window, and how Placet weights it in the Trust Index.
A state-by-state breakdown of which facility types are covered, what public data exists, and where the gaps are.
Why entrance fees are at risk in Continuing Care Retirement Communities, how we score liquidity and coverage ratios, and what families should ask before signing a contract.
Placet ranks Medicare-certified skilled nursing facilities on four independent CMS-derived signals: (1) RN staffing hours per resident per day from the Payroll-Based Journal system, (2) the CMS Five-Star Overall rating, (3) a proprietary Trust Index that starts at 80 and applies fixed deductions for SFF status, abuse flags, and other federal enforcement signals, and (4) the 30-day risk-adjusted hospital readmission rate from CMS claims-based quality measures. We do not collapse them into a single score — see /about/our-data for thresholds.
Every facility record originates in a public dataset. For Medicare-certified facilities (skilled nursing, hospice, home health, IRF), that means CMS Provider Data (Care Compare), Payroll-Based Journal staffing, ownership disclosures (PECOS), enforcement and penalty records, and CMS claims-based readmission measures. For state-licensed facilities (assisted living, personal care homes, RCFEs), that means the relevant state licensing agency in CA, FL, NC, NY, OR, PA, TX, and WA. Each dataset is named, linked, and described with its refresh cadence on /methodology/data-sources. The full list is also published in our /llms.txt sitemap for AI crawlers.
CMS Provider Data (star ratings, deficiencies, staffing, penalties) updates monthly; Placet syncs within 48 hours of each release. Payroll-Based Journal staffing snapshots are quarterly. Risk-adjusted readmission measures publish annually. Web-enriched fields (clinical capabilities, intake contacts) refresh on a rolling basis. We surface the last-sync timestamp on the data-status page.
Assisted Living Facilities, Residential Care Homes, and most Memory Care communities are licensed at the state level and do not report to CMS. We classify these as 'state-regulated' and show whatever public data the state publishes, which varies dramatically — some states publish inspection reports and complaint histories, others publish almost nothing. We tag every state-regulated facility with a transparency mode and link to the appropriate methodology sub-page.
We say so explicitly when public data is missing or unreliable. In data-desert states or non-SNF settings without published inspection data, we show a notice and direct families to the state Long-Term Care Ombudsman, in-person visits, and other resources rather than presenting a misleadingly thin profile. We also do not synthesize fake reviews, AI-generated photos, or estimated pricing.
Every figure on the site traces back to a public government dataset — CMS, the Payroll-Based Journal, PECOS, or state inspection records — that you can independently audit. We publish the methodology behind every classification and scoring transformation, including the verbatim SQL queries behind our awards. We do not accept paid placement, sponsored ranking, or referral fees, so the rankings reflect data alone.