How Much Revenue Is Your CMS Star Rating Costing You?
Every star level change affects both your per-diem rate and occupancy. See the exact dollar impact for your facility — by state, bed count, and current rating.
Facility Inputs
Enter your facility details to see current revenue and the potential uplift from improving your CMS star rating.
Typical for this rating: 65–78%
Full Revenue Breakdown
100 beds · New York| Metric | Current | With Circle Care | Change |
|---|---|---|---|
| Star Rating | 2 Stars | 4 Stars | — |
| Base Per Diem | $380 | $380 | — |
| Quality Multiplier | 0.90× | 1.10× | +0.20× |
| Effective Per Diem | $342 | $418 | +$76 |
| Occupancy Rate | 75% | 82% | +7% |
| Occupied Beds | 75 | 82 | +7 |
| Monthly Revenue | $769,500 | $1,028,280 | +$258,780 |
| Annual Revenue | $9,234,000 | $12,339,360 | +$3,105,360 |
Formula: Beds × Occupancy % × Base Rate × Quality Multiplier × 30 days
CMS Star Rating — Occupancy & Quality Multiplier Reference
CMS publishes a Five-Star Quality Rating for every Medicare- and Medicaid-certified skilled nursing facility. Each rating level correlates with observable differences in occupancy rate and reimbursement positioning. Both factors are applied in this calculator.
| Rating | Quality Multiplier | Occupancy Range | Default Used | Market Context |
|---|---|---|---|---|
| 1 Star | 0.80× | 55–70% | 63% | Lowest reimbursement tier. Significant revenue and occupancy gap. |
| 2 Stars | 0.90× | 65–78% | 75% | Below average. Occupancy improvements drive meaningful uplift. |
| 3 Stars | 1.00× | 75–85% | 80% | Baseline rate. Solid occupancy, competitive in most markets. |
| 4 Stars | 1.10× | 82–90% | 82% | Above average. Higher referrals and preferred-provider status. |
| 5 Stars | 1.20× | 88–95% | 92% | Maximum multiplier. Premium occupancy and market positioning. |
Why Per-Diem Rates Vary by State
Skilled nursing facility reimbursement reflects local labour costs, cost-of-living indices, and state Medicaid supplementation policies. The calculator groups all 50 states into five tiers — from $180/day in value markets to $380/day in high-cost states — and applies the correct base rate automatically when you select your state.
These are blended Medicare/Medicaid averages. Facilities with a higher Medicare-to-Medicaid ratio typically receive above-tier rates; those with heavy Medicaid census may see below-tier effective rates.
State Base Rate Tiers
| Tier | Base Rate | States |
|---|---|---|
| Tier 1 | $380/day | NY, CA, MA, CT, MD, NJ, OR, HI, AK, WA |
| Tier 2 | $320/day | CO, DE, ME, MN, NH, RI, VT, VA |
| Tier 3 | $240/day | FL, ID, IL, IN, IA, KS, MI, MO, MT, NE, NV, NM, ND, OH, PA, SD, TX, UT, WI, WY |
| Tier 4 | $210/day | AZ, GA, KY, LA, NC, SC, TN |
| Tier 5 | $180/day | AL, AR, MS, OK, WV |
Size Your Opportunity in Three Steps
Enter your facility details
Select your state, enter the total number of licensed beds, and set your current CMS star rating. The calculator instantly applies the correct base per-diem rate and quality multiplier.
Set your target star rating
Choose the CMS star rating you expect to achieve with Circle Care's care coordination programs. The projected occupancy rate and quality multiplier update automatically.
See your revenue uplift
The calculator shows current monthly and annual revenue side-by-side with your projected revenue — with the full dollar difference highlighted so you can size the opportunity instantly.
About the SNF Revenue Calculator
How is the revenue estimate calculated?
Where do the state base rates come from?
How does CMS star rating affect revenue?
Can Circle Care actually improve our CMS star rating?
Are these figures guaranteed?
How long does it take to improve a CMS star rating?
Ready to Improve Your CMS Star Rating with Circle Care?
Our team will design a care coordination program that improves your quality measure scores, reduces avoidable hospitalisations, and builds the documentation trail to support a higher star rating — at zero upfront cost.