How the flags work
Every lead comes from published federal records — the Centers for Medicare & Medicaid Services enrollment, ownership and payment files covering home health, hospice, nursing homes and other provider types, pulled from the government's own data feed. Addresses are cleaned up so "123 Main Street, Suite 4" and "123 MAIN ST STE 4" group together. Each rule below is then applied to the full file.
Shared street address
Several enrolled providers list the same street address. Severity increases with the number of providers. Shared medical buildings are common, so check the address before drawing a conclusion.
PO box or private mailbox
The enrollment address matches a post office box, PMB or mailbox-store pattern rather than a place where care is coordinated.
Residential unit
The address includes an apartment, unit, or trailer designation. Small agencies may lawfully operate from homes, so this receives a low severity.
Owner cluster
An owner or manager listed for this provider also appears on other provider enrollments. Provider chains are lawful. The number and timing of the links determine the severity.
New-entity cluster
Two or more providers incorporated in the last four years share one address. This pattern requires comparison with ownership and enrollment records.
Suite stacking
One building hosts providers registered across three or more different suite or unit numbers.
What a flag is not
A flag is a pattern in a public file. It is not an allegation, a finding, or evidence of a crime. Many flags have ordinary explanations. Check documents, records, and direct observations before reporting a provider.
Community notes
Anyone signed in can add a note to a flagged provider saying whether it looks like real fraud, has an innocent explanation, or cannot be judged yet — with their reasoning and links. Others rate those notes helpful or not helpful.
Raters are grouped by their voting history. A note rises to the top only when people who usually reach different conclusions both rate it helpful. Until enough people from both sides have rated, notes show newest first, marked "Needs more ratings". Notes most readers rate unhelpful collapse behind a click, and anyone can report a note for an administrator to review.
How claiming works
- Signed-in investigators who accept the Investigator Agreement can hold up to 3 leads at once.
- Each claim runs for 10 days, extendable once by 7 days.
- When the clock runs out the lead returns to the board — and your notes stay published as public research history so the next person starts where you stopped.