How we test

Who does the testing

The criteria: the DON Fit Score

Every ranked provider, in every category, is scored on the same seven weighted criteria. Weights add up to 100. The full calculation is on the scoring methodology page.

1. 1

   Post-acute and long-term care focus 25%

   How much of the provider's work is DON, ADON and nurse-leader placement in skilled nursing and assisted living, rather than hospital or general healthcare hiring.

2. 2

   Fee model and price transparency 20%

   Whether fees, retainers, interim day rates or subscription costs are stated in writing before an engagement, and what an independent operator should expect to pay.

3. 3

   Guarantee and contract terms 15%

   Replacement guarantees, cancellation terms, conversion fees and exclusivity clauses - read from the contract language, not the sales page.

4. 4

   Search process and candidate vetting 15%

   How candidates are sourced and screened: license verification, survey-history questions, reference checks and fit to the facility's environment.

5. 5

   Fit for independent operators 10%

   Whether a single-building or small multi-site operator is served as well as a large chain - minimums, responsiveness and who actually runs the search.

6. 6

   Speed and geographic coverage 10%

   Stated time-to-slate and time-to-fill, and whether the provider works in the operator's state and market type (rural, suburban, urban).

7. 7

   Evidence and disclosure 5%

   Whether claims about placements, retention or outcomes are documented and verifiable, and whether commercial relationships are disclosed.

The process

1. Define the decision

   Each category starts from the decision an administrator actually faces - cover the seat, run a search, use a recruiter - and the criteria are fixed before any provider is looked at.

2. Collect the documents

   Pricing pages, sample contracts, guarantee terms, service descriptions and licensing information are gathered from each provider and from public records.

3. Ask as an operator would

   Where a provider offers an inquiry or quote process, the reviewer asks the questions an independent SNF or assisted living operator would ask, and records the answers in writing.

4. Check claims against data

   Pay, staffing and survey claims are checked against BLS wage data and CMS Care Compare / Payroll-Based Journal data, and cited where they appear.

5. Score and rank

   Each provider is scored on the same weighted criteria to produce its DON Fit Score. The ranking order follows the score.

6. Re-review

   Rankings are revisited on a set schedule and whenever a provider materially changes its terms, with the review date shown on the page.

Questions about our testing

Answers to common questions about the methodology will be published here.