🏅 The Trusted Care Index (TCI) Methodology
How We Calculate Your Proprietary Quality Score
The TCI is our independent rating designed to give families a more reliable and holistic measure of facility quality than the standard federal star system alone. It incorporates the most critical data points, penalty history, hospital readmission rates, family and user ratings, CMS ratings, and staffing quality — to uncover risks or strengths overlooked by government ratings.
The TCI is calculated using a formula that weights four key areas, ensuring strong performance in clinical and staffing quality while heavily penalizing poor safety records. The TCI generates an internal score from 0-100, which determines the final star rating.
| Quality Area | Weight Focus | Data Used |
|---|---|---|
| Clinical Outcomes & Patient Health | Highest | Adjusted readmission rates and success rate of discharging patients home (CMS QRP data). |
| Staffing Quality | High | Registered Nurses (RN) and Certified Nursing Assistant (CNA) hours per resident day (HPPD). |
| User-Based Reviews | Medium | Average user star rating left by visitors and residents on The Nursing Home Site. |
| CMS Overall Rating | Baseline | The standard federal rating, used as a starting reference point. |
This is the most crucial part of the TCI. It ensures that good staffing scores aren't masking severe or repeat safety failures.
The TCI algorithm applies a direct, immediate negative point deduction based on the severity of violations and financial penalties received:
- High Severity Penalties: Denial of Payment or Fines greater than $20,000 result in the largest deduction.
- Medium Severity Penalties: Fines between $5,000 and $20,000 result in a substantial deduction.
- Low Severity Penalties: Smaller fines result in a minor deduction.
Long-Term Transparency: The government removes penalty records after 3 years. We uniquely track facility history for over 5 years, applying a time decay factor to ensure the TCI reflects a facility's long-term safety pattern, not just a snapshot.
The final numerical TCI score (0-100) determines the star rating displayed on the profile page.
| TCI Star Rating | TCI Score Range (Internal) |
|---|---|
| ⭐⭐⭐⭐⭐ | 85 or higher |
| ⭐⭐⭐⭐ | 70 – 84 |
| ⭐⭐⭐ | 55 – 69 |
| ⭐⭐ | 40 – 54 |
| ⭐ | 39 or lower |
If your facility has achieved a great TCI star rating, grab one of our official badges to display on your website or blog. This is the best way to showcase your commitment to quality and transparency!
Instructions: Find your facility's profile on The Nursing Home Site, then copy the following code snippet and paste it directly into your website's HTML. The badge links directly back to your profile page.
5 Star Code (Score 85+):
4 Star Code (Score 70+):
3 Star Code (Score 55+):