Looking for a Trella Health Alternative?

Fonteum vs Trella Health

Facility identity from the source, not inferred from claims

Ingest → provenance → deliver

Common questions

How does Fonteum's post-acute data differ from Trella Health?

Trella Health is built on Medicare claims data — it derives post-acute market intelligence from billing patterns: referral relationships, utilization rates, and PAC provider performance inferred from claims. Fonteum is built on direct CMS facility records: CMS Care Compare for nursing home, home health, and hospice quality ratings; CMS PBJ Daily Nurse Staffing for facility-level RN/LPN/CNA hours (1.3M+ daily records across 14,537 facilities, CY2025Q2); PECOS SNF All Owners for ACA § 6101 ownership disclosure (280,207 ownership rows across 14,425 facilities); and CMS NH Health Deficiency Citations (418,148 records across 14,635facilities). These are the source-of-truth facility identity, ownership, staffing, and quality records — not inferences from billing. The practical difference: a claims model can estimate a facility's referral volume, but only the federal payroll record shows its actual reported nurse hours, only the PECOS disclosure shows its ownership chain, and only the survey record shows its inspection findings. Returned fields expose CMS dataset and snapshot-date metadata where populated; fields may be null.

Does Fonteum have nursing home deficiency and penalty data?

Yes, sourced directly from CMS records rather than derived from claims. Fonteum ingests CMS NH Health Deficiency Citations (Provider Data Catalog) as a per-citation record: scope/severity code on the B–L scale, F-tag taxonomy, survey event ID, and survey date. The dataset spans 418,148 citation records across 14,635 facilities on a three-year rolling basis, and 5.59% of those citations sit at scope/severity G or above — the threshold for actual harm to a resident. The aggregate surface is at /deficiencies, and the analysis at /research/nursing-home-deficiency-correction-time documents a 14.7× disparity in harm-rate citations between Illinois (4.57 G+ per facility) and New Hampshire (0.31) — a state-survey-intensity finding that does not appear in aggregate star ratings. The separate Civil Money Penalties table spans 16,832 records across 6,919 facilities and $467,344,898 in fines. It includes 2,553 payment-denial records covering 1,950 distinct facilities. The median individual fine record is $14,113. Median cumulative fines per fined facility are $34,272. The study is at /research/nursing-home-penalties-enforcement. Available citation metadata identifies the CMS source and methodology version; fields may be null.

Does Fonteum have SNF ownership and chain data?

Yes. Fonteum ingests the PECOS-derived CMS SNF All Owners dataset (ACA Section 6101; 42 CFR § 424.516) — 280,207 ownership rows across 14,425 facilities. Each row carries the owner name and PAC ID, the percentage ownership where disclosed (25.0 = 25%), entity-type flags (for-profit/non-profit, holding company, investment firm, medical staffing company), and the affiliation entity ID used for chain analysis. The ownership and chain-analysis surface is at /ownership. Crucially, Fonteum surfaces a known gap rather than hiding it: 82.4% of the top-10 nursing home chains have missing ownership_percentage values in the source file — a finding first documented in a Health Affairs 2024 analysis and reproducible from the public CMS file. Rather than impute a percentage, Fonteum flags the field with an explicit data-availability state, because ownership percentage is the primary signal for controlling-interest determination under OIG affiliate-exclusion doctrine, and a fabricated value would be worse than a marked silence.

Can I access Fonteum's post-acute data without an enterprise contract?

Yes. All post-acute research snapshots and datasets are free to access and cite at /research, /deficiencies, /staffing, and /ownership — no account and no API key for the static CSV and JSON files. This is possible because the underlying CMS records are federal public works under 17 U.S.C. § 105, so Fonteum redistributes the structured, provenance-tagged versions openly. That is a structurally different model from PAC market-intelligence platforms, which typically gate the same federally derived data behind five- or six-figure annual enterprise contracts. For production use cases — bulk exports scoped to specific facility types, geographies, or ownership chains, or a joined export linking PBJ staffing to SNF ownership and Care Compare quality for a target portfolio — the pilot tier starts at $2,500/mo and adds FHIR R4 API access, methodology-versioning commitments, and a 30-day no-penalty exit. No enterprise contract is required for public data access.

Why does the federal payroll staffing record matter more after the staffing-minimum repeal?

CMS Payroll-Based Journal (PBJ) data captures actual daily staffing hours from facility payroll systems — RN, LPN, CNA, and contract staff — not self-reported estimates. Fonteum ingests it directly: 1.3M+ daily records across 14,537 Medicare-certified facilities for CY2025Q2, one row per facility per day with employee-versus-contractor breakout. This record became more important, not less, after the federal minimum staffing rule (3.48 total nurse hours per resident day) was rescinded on December 3, 2025, effective February 2, 2026. With no federal floor enforceable, per-facility staffing transparency is the remaining accountability mechanism for residents, families, researchers, and acquirers. A facility trending toward contract-heavy staffing or below-threshold RN hours is a quality and regulatory signal that appears in the federal payroll record before it shows up in a Five-Star rating change. A claims-derived model does not see payroll hours at all; the PBJ record is the only source that does, and Fonteum publishes it with full provenance.

Can I join Fonteum's post-acute datasets together for diligence?

Yes — joining ownership, staffing, and quality is the core post-acute diligence workflow, and Fonteum's datasets share the federal facility identifier (the CMS Certification Number, or CCN) that makes the join clean. The CMS Provider of Services (POS) file serves as the CCN identity backbone, so a SNF's PECOS ownership record (280,207 rows), its PBJ staffing history (1.3M+ daily records), its Care Compare star ratings, and its deficiency citations (418,148records) can be assembled into one facility-keyed view. The free surfaces at /ownership, /staffing, /deficiencies, and /care-compare/nursing-homes let you explore each layer; for a target portfolio, the pilot tier delivers a single scoped export joining all of them. Exported fields expose available source, date, and limitation metadata; fields may be null. Because the join keys on the federal CCN rather than a proprietary entity ID, the result is reproducible against the public CMS files rather than locked to a vendor's data model.

Explore the post-acute data layer.

Browse free datasets at /staffing, /deficiencies, and /ownership, or request access to scope a custom PAC export.

• /staffing → PBJ Daily Nurse Staffing — facility-level RN/LPN/CNA hours from the federal payroll record.
• /deficiencies → CMS NH Health Deficiency Citations — per-citation scope/severity, F-tag, and penalties.
• /ownership → PECOS SNF All Owners — ACA § 6101 ownership disclosure and chain analysis.
• /care-compare/nursing-homes → CMS Care Compare NH module — star ratings, staffing, health inspection history.
• /sources → Full source library — the documented federal-source catalog with tier, refresh cadence, and limitations.