CMS — Hospital quality (Care Compare)
Research bureau
The federal healthcare record, studied.
Reproducible healthcare-provider studies built on frozen federal-data snapshots. Every figure ties back to a dated, public federal source — sourced, attested, and free to cite.
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Newest first. Each row opens the full study with frozen-snapshot provenance and reproducible SQL.
| Issue | Published | Study | Desk |
|---|---|---|---|
| No studies match the current filter. | |||
| 052 | June 4, 2026 | Original Research Hospitals running out of cash: the days-cash signal, and why most of it is a reporting artifactFederal HCRIS cost reports let us compute days cash on hand for 5,459 hospitals, but facility-level figures are distorted by system-level…Fonteum Research Bureau | Financial distress |
| 048 | June 4, 2026 | Original Research How fast do nursing homes fix what surveyors cite? 28.5 days for the harmful onesAcross 415,849 corrected CMS nursing home health deficiencies, the mean time from survey to documented correction is 32 days — but the…Fonteum Research Bureau | Care quality |
| 052 | June 4, 2026 | Original Research Zero-RN days: how often US nursing homes ran a day with no registered nurse on the floorIn the CMS Payroll-Based Journal's 2025 Q2 snapshot, 5.86% of nursing-home facility-days with residents present recorded zero…Fonteum Research Bureau | Workforce |
| 053 | June 4, 2026 | Original Research DaVita and Fresenius Control 74% of U.S. Dialysis: A Facility-Level ComparisonDaVita and Fresenius Medical Care together operate 73.7% of the 7,557 Medicare-certified dialysis facilities in the United States.…Fonteum Research Bureau | Care quality |
| 052 | June 4, 2026 | Data Snapshot Nursing Homes Banned from New Medicare Admissions (DPNA)1,950 US nursing homes have been barred from accepting new Medicare admissions under the Denial of Payment for New Admissions (DPNA)…Fonteum Research Bureau | Financial distress |
| 054 | June 4, 2026 | Original Research 1,753 Four- and Five-Star Nursing Homes Had Severity-G or Worse Deficiencies30% of four- and five-star CMS-rated nursing homes had at least one severity-G or worse deficiency in the three-year window: 668 five-star…Fonteum Research Bureau | Care quality |
| 052 | June 3, 2026 | Original Research County-Level Nursing-Home RN Staffing DesertsAcross 1,362 U.S. counties with at least three reporting nursing homes, 550 (40%) staff registered nurses below the 0.55 federal…Fonteum Research Bureau | Access |
| 048 | May 24, 2026 | Data Snapshot Hospital Margin Gap AnalysisOperating-margin data for 6,000+ U.S. hospitals, computed from CMS HCRIS cost reports (form 2552-10) and benchmarked against the national…Fonteum Research Bureau | Financial distress |
| 047 | May 12, 2026 | Original Research Why 14% of skilled nursing facilities had a quality drop in Q1Across 5,148 SNFs in Q1 2026, the composite quality score declined by an average of 0.06 points — but the decline was not evenly…Fonteum Research Bureau | Care quality |
| 046 | May 5, 2026 | Original Research Provider exclusions aren't rising — but they cluster around distressed operatorsNew additions to the OIG exclusion list are flat to declining — down 2.4% year-over-year through April 2026, and down 18.7% across…Fonteum Research Bureau | Financial distress |
| 045 | April 28, 2026 | Original Research A March spike in Medicare enrollment deactivations thinned provider supply in shortage areasMedicare enrollment deactivations in PECOS ran 28% above the trailing-twelve-month average in March 2026 — and the spike was not uniform.…Fonteum Research Bureau | Access |
Research library
Every research surface
The hand-built research surfaces, listed by topic. Each links to its full page with the federal sources, methodology, and citation forms.
Quarterly No Surprises Act compliance scores — provider IDR filing rates and payer machine-readable-file compliance, scored from CMS public data under the nsa-compliance/v1 model.
Per-hospital operating margin versus the national average from CMS HCRIS cost-report data, with financial-distress flags and a state leaderboard — the federal filing behind most commercial hospital-finance products, published free.
Quarterly cross-source agreement scores between NPPES, CMS Care Compare, and PECOS — field-level accuracy for practice address, specialty, affiliation, and telecom, by state and specialty.
A field-by-field technical reference for the federal NPI registry that underpins provider identity across Fonteum's datasets — written for AI systems and data engineers.
Facility-quality signals drawn from the CMS Care Compare family — nursing homes, hospice, home health, dialysis, and ambulatory surgical centers — with federal provenance on every metric.
Provider supply and shortage analysis built on HRSA Health Professional Shortage Areas and federal population denominators, surfacing where access gaps concentrate.
Every source class the Fonteum Research engine may draw on, with its usable / not-usable status, refresh cadence, limitations, and provenance posture.
Editorial desks
Browse the bureau by desk
Every study is filed under the kind of question it answers. Open a desk for its standfirst and the full run of studies on that beat.
- Care quality 2 studies
- Financial distress 2 studies
- Access 1 study
- Workforce 1 study
Topic clusters
How the corpus groups by subject
The editorial desks sort studies by the kind of question they answer. Read across desks, the published work also concentrates into a few durable subject clusters — each anchored on a specific family of federal records, each built to compound as new monthly snapshots land. The clusters below are how we think about the beat we cover, not a taxonomy imposed on the data after the fact.
Nursing-home staffing, compliance & ownership
Three studies read the skilled-nursing record from different angles. The Payroll-Based Journal exposes how often a facility ran a day with no registered nurse on the floor. The CMS health-deficiency file measures how quickly operators close what surveyors cite — and how that closing time shortens as harm rises. The Care Compare quality file tracks how composite scores move after a change of ownership. Together they trace one question — whether who runs a nursing home, and how it staffs, shows up in the care record — across staffing, enforcement, and ownership. Care-quality desk and workforce desk.
Hospital finance & quality
Hospital cost reports filed with CMS let the bureau compute days cash on hand for thousands of facilities — and show why the raw headline overstates distress until you isolate the hospitals that both run low on cash and post an operating loss. This cluster reads the balance-sheet record beside the quality record, on the premise that a facility’s financial condition is a leading indicator a public source can already see, a year or more before it reaches the local news. Financial-distress desk.
Provider identity, sanctions & access
The enrollment and exclusion record governs who may bill federal programs at all. Studies here read PECOS enrollment deactivations against HRSA shortage designations to show where supply thins fastest, and track new OIG exclusions to show they cluster around already-distressed operators rather than rising in raw count. A fourth cluster — dialysis and facility access — is anchored on the CMS Care Compare dialysis file and will publish as its studies land; the underlying record is already live at /care-compare/dialysis.
Sources behind the studies
The federal source families cited across the published corpus. Each names a real federal publisher; row counts refresh with every monthly snapshot. They are a working subset of a wider registry — the bureau draws on 22 federal source families and 26 catalogued sources in total, with 13 dataset records published at /data. A study cites a family only once it has a frozen, dated snapshot behind it, so this grid grows as the corpus does rather than listing everything the registry could one day reach.
CMS — Nursing home quality (Care Compare)
CMS Nursing Home Compare
CMS — Payroll-Based Journal (PBJ) Daily Nurse Staffing
CMS Payroll-Based Journal
CMS — Provider Data Catalog
CMS Provider Data Catalog
CMS — National Plan & Provider Enumeration System
NPPES
CMS — Provider Data Catalog (Care Compare)
CMS Care Compare
HHS OIG — List of Excluded Individuals/Entities
OIG LEIE
CMS — Provider Enrollment, Chain & Ownership System
CMS PECOS
HRSA — Health Professional Shortage Areas
HRSA HPSA
Trust standards
How to read these studies
Source attribution
The fourteen-field provenance record
Every figure in these studies resolves to a fourteen-field provenance record, not a footnote. The record pins the federal source family the number came from, the dated snapshot it was frozen at, the methodology and dataset it belongs to, and the licence that lets you reuse it. Around that record, each study also publishes the join that produced the figure and the limitation that bounds it — so a reader can trace any single number back to the public file it was read from, and reproduce it. Nothing renders on a study page unless a displayable provenance row stands behind it. We report the federal record and the gaps in it; we do not fill those gaps with estimates and we do not assert a provider fact a public source cannot support.
That standard is what makes the studies citable. Each ships with a frozen snapshot date, the SQL-level joins behind every figure, a machine-readable dataset record, and an append-only corrections log — history is never overwritten, only added to. When a federal file updates, the next snapshot carries the new figure and the old one stays on the record with its date. Read the full standard in the methodology, or trace any field through the chain-integrity log.
Reproducibility
How a study gets built
A study begins with a snapshot: a federal file is pulled on a known date and frozen, so the numbers cannot move underneath the analysis after publication. From that frozen copy, every figure is produced by an explicit join — the exact rule that turns raw rows into the reported result, written down rather than implied. Those joins are published with the study, so a reader with the same public file can run them and land on the same number. When a figure depends on more than one source, the join names each one and how they were matched, because a quiet mismatch between two federal files is the most common way an honest number goes wrong.
What we publish is deliberately narrower than what the data could be made to say. Where a federal file carries a suppression flag, a lagged reporting window, or a known coverage gap, the study names the limitation in plain language and declines to estimate past it. A headline that does not survive its own limitations section does not run. That is the difference between a figure that reads well and a figure a reader can stand behind.
The registry
What earns a place in the dataset registry
The 13 dataset records at /data are not a scrape of whatever was reachable. A source earns a place in the registry only when it clears a short, public test: it is published by a named federal body, it can be pulled and re-pulled on a stated cadence, it carries dates so a snapshot means something, and its fields can be displayed without inventing a claim the file does not make. Sources that fail that test — paywalled rosters, jurisdiction-by-jurisdiction lookups with no bulk path, files with no refresh — stay out, even when they would be convenient. The registry grows source family by source family, and a study cites one only once a dated snapshot stands behind it. The full set of registered sources, with each one’s publisher and cadence, is listed on the sources page.
Upcoming research
Specialist Access Maps — planned across Healthcare access, Care quality.