About For The Patient
An independent nonprofit initiative building the most transparent healthcare quality rating system in the United States.
The Story That Started Everything
In December 2023, the North Carolina Division of Health Service Regulation declared immediate jeopardy at Mission Hospital in Asheville — a finding that means patients face an imminent threat of serious harm or death.
One month later, in January 2024, Healthgrades named Mission Hospital one of America's 50 Best Hospitals.
In the fall of 2023, the Leapfrog Group had given Mission Hospital an "A" safety grade — their highest rating — without possessing the underlying data to evaluate it.
Three different signals. One hospital. Two said "outstanding." One said "patients are in danger." Only one was based on what was actually happening inside the building.
A 27-year-old expecting mother choosing a maternity hospital. A 64-year-old facing cardiac surgery. A dialysis patient comparing every option within 30 miles. These people deserve quality information that reflects current conditions — not legacy reputations, not self-reported questionnaires, not pay-to-play endorsements.
ForThePatient.org exists because the Mission Hospital story is not unique. It is the norm. The dominant healthcare rating systems in the United States are structurally incapable of catching quality failures in real time — and some are financially entangled with the very facilities they claim to evaluate.
We set out to build something different.
The problem is now a matter of public record. In March 2026, a federal court reviewing the Leapfrog Group's hospital grades held that its methodology was "deceptive and unfair" — in part because hospitals that declined Leapfrog's voluntary survey were automatically penalized (Palm Beach Health Network v. Leapfrog Group, S.D. Fla., March 2026). Ratings built on voluntary self-reporting and commercial entanglement are not just unhelpful to patients. A federal court has now said so.
What We Do
ForThePatient.org covers more than 48,000 Medicare-certified healthcare facilities across seven facility types — every facility that participates in Medicare. Each facility with sufficient public data (about nine in ten) receives an independent composite quality score on a 1.0–10.0 scale, built from weighted components specific to its facility type and derived entirely from compulsory, government-mandated reporting. Facilities without enough data appear as Unrated — clearly marked, never hidden, and never ranked as "worst" simply for lacking data.
On the map, every scored facility carries a color-coded score and a plain-English label. Facilities under active, genuine survey enforcement are visibly flagged, with each finding translated into language a patient can act on. Medicare payment penalties are shown too — clearly, and separately from the warning flag. No facility can pay to be featured, removed, or reclassified, and no facility can pay to make a finding disappear.
Core Principles
Zero Industry Funding
No facility revenue. No pharmaceutical money. No advertising from the healthcare industry. Ever. This is a founding constraint, not a marketing policy — and it will be written into our articles of incorporation and bylaws as our 501(c)(3) formation completes.
Compulsory Data Only
We use government-mandated reporting from the Centers for Medicare & Medicaid Services (CMS). Facilities cannot choose what to report, when to report it, or how to frame it. Self-reported quality claims are excluded entirely.
Complete Methodological Transparency
Every weight, formula, and data source is published on our methodology page, and when the engine changes, the documentation follows. If you disagree with a scoring decision, you can see exactly how it was made and submit a dispute.
Exponential Recency Decay
Our scoring model weights recent data exponentially more than older data. A facility that was excellent five years ago but deteriorated last quarter will see its score reflect the decline — not the legacy.
A Warning Flag That Means Something
Our enforcement flag fires only on genuine, active findings from government surveys — never on boilerplate paperwork, expired citations, or routine payment penalties. We audited our own flag and cut its firing rate from 45.5% of hospitals to 7.4%, because a warning that fires half the time warns no one.
Plain Language
Every enforcement finding we surface is translated into plain English a patient can understand and act on — what was found, how serious it is, and whether it is still active. No citation codes without explanation.
Zero Industry Funding
Most healthcare rating systems in the United States accept money from the facilities they evaluate. Some sell consulting services to help hospitals improve their ratings. Others accept advertising from hospital systems. A few charge facilities for access to their own quality data.
These financial relationships create structural conflicts of interest that are impossible to fully mitigate. A rating system that depends on hospital revenue cannot credibly threaten to downgrade those same hospitals.
ForThePatient.org accepts zero revenue from the healthcare industry. To date, the project has been built and funded entirely independently — no industry money of any kind has ever touched it. As our nonprofit formation completes, funding will come from individual donors, foundations, and grants that share our commitment to independent patient information — never from the facilities we rate, their trade associations, or the vendors that sell to them. We are not yet accepting donations; when we are, it will be announced here first.
We believe the question "Who pays for this?" is the single most important question you can ask about any quality rating system.
How Scoring Works
Each scored facility receives a composite quality score from 1.0 to 10.0, classified as Exceptional, Above Average, Average, Below Average, or Poor. Labels are assigned per facility type using fixed, published thresholds — an Above Average nursing home is judged against nursing-home standards, not hospital ones — and those thresholds stay frozen between methodology versions, so a label means the same thing at every data refresh. Facilities with insufficient data are classified as Unrated and still appear on the map.
Composite scores are built from 4–5 weighted components tailored to each facility type. Hospital scores, for example, incorporate mortality, safety & infections, readmissions, patient experience, and timely & effective care — each weighted according to its demonstrated impact on patient outcomes.
What makes our scoring different
- Percentile ranking against national distributions — a facility's performance is measured against all facilities of the same type, using per-measure national distributions rather than arbitrary thresholds.
- Exponential recency decay — recent data carries exponentially more weight, so scores reflect current quality rather than historical averages.
- Two-tier enforcement — active, genuine survey findings can flag a facility and cap its score; routine Medicare payment penalties (readmission and hospital-acquired-condition programs) are a separate, clearly labeled signal at half weight — visible, but never the reason a red flag appears.
- Frozen, criterion-referenced labels — score labels come from fixed per-type thresholds, calibrated once against real national distributions and then frozen. Labels are never re-normalized run to run, so a facility's trend over time is real, not a grading-curve artifact.
- No CMS star deference — where CMS publishes star ratings, we incorporate them as a minor component (10–30%) rather than deferring to them. For most facility types, our scoring is entirely independent of CMS stars.
Full details are available on our methodology page, including component weights, data transformations, and scoring formulas for all seven facility types. (Our scoring engine had a major upgrade in June 2026; that page carries a dated notice while its full documentation is rewritten.)
Coverage
ForThePatient.org covers every Medicare-certified facility in the United States across seven types. Exact counts shift slightly with each quarterly CMS refresh; the figures below reflect the June 2026 data release:
- Hospitals — 5,421 acute-care and critical-access hospitals
- Nursing Homes — 14,713 skilled nursing facilities
- Dialysis Centers — 7,557 end-stage renal disease facilities
- Home Health Agencies — 12,251 home-based care providers
- Hospices — 6,970 end-of-life care providers
- Inpatient Rehabilitation Facilities — 1,221 post-acute rehabilitation centers
- Long-Term Care Hospitals — 319 facilities for extended acute care
Data comes from CMS's Provider Data Catalog — 24 core datasets across the seven facility types, updated quarterly — plus CMS survey-enforcement records and Medicare payment-penalty files. All of it is compulsory, and all of it is public. Our scoring engine processes everything through a unified pipeline and refreshes scores when CMS publishes new data.
Nonprofit Status
ForThePatient.org is an independent nonprofit initiative; 501(c)(3) formation is underway. Until incorporation and IRS recognition are complete, we will not describe ourselves as a 501(c)(3) — this page is updated when a milestone is actually finished, never before. That is the same standard we hold facilities to: claims should match the record.
What is already true today: the project takes no industry money, sells nothing to the facilities it rates, and publishes its methodology. What formation adds: a legal entity that holds the project's work, an independent board with zero seats for rated entities, a conflict-of-interest policy that binds the founder personally, and — as we grow — an independent methodology advisory board with real authority over scoring changes.
Nonprofit status means no profits are ever distributed to any private individual; all revenue is reinvested in the mission of making healthcare quality information freely accessible to every patient in the United States. Our long-term vision includes a complementary 501(c)(4) advocacy organization to advance healthcare-quality policy, but the rating system itself will always remain independent, nonpartisan, and free from industry influence.
Contact
ForThePatient.org is an independent, U.S.-based initiative.
For general inquiries, data questions, or partnership discussions, reach us at hello@forthepatient.org.
To dispute a facility score or report a data error, please use our formal dispute process to ensure your request is tracked and answered within 30 days.
Media inquiries: press@forthepatient.org.