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Nursing Home Compare Five Star Ratings Change July 27, 2016

In March, CMS announced that it would be adding six new Quality Measures to Nursing Home Compare in July. The data from those six QMs is now publicly available, but not yet being considered as part of the Five Star Quality Rating score. That is about to change though, as five of these six new QMs will be phased in to the Five Star system starting next week, on July 27. The new QMs that will be part of a nursing home’s Five Star rating include:

  • Percentage of short-stay residents who were successfully discharged to the community (claims-based and MDS used for risk-adjustment/covariates)
  • Percentage of short-stay residents who have had an outpatient ER visit (claims-based and MDS used for risk-adjustment/covariates)
  • Percentage of short-stay residents who were rehospitalized after a nursing home admission (claims-based and MDS used for risk-adjustment/covariates)
  • Percentage of short-stay residents who made improvements in function (MDS-based)
  • Percentage of long-stay residents whose ability to move independently worsened (MDS-based)

The sixth QM will not be incorporated into the Five Star Quality Rating System yet since more work needs to be done to identify appropriate thresholds for the measure. This QM is the percentage of long-stay residents who received an anti-anxiety or hypnotic medication.

Several things to note:

  • Four quarters of data will be used for determining QM ratings, rather than three.
  • For the ADL QM, national cut points will be assigned rather than using state-specific thresholds.
  • The five new measures added to the Five Star System will be phased in from July 2016 through January 2017. In July, the new QMs have 50% of the weight of the eleven QMs that were part of the ranking prior to July 2016. In January 2017, the new QMs will have the same weight as the others.

For more information, be sure to check the Five Star Quality Rating System Technical Users’ Guide updated July 2016.

Don’t forget that your survey star rating is a huge portion of your overall rating! If your health inspection rating is 1 star, then your overall rating cannot be upgraded by more than 1 star based on the staffing and QM rating. Your facility needs to have strong scores in each area, but the health inspection counts for 60% of your rating! Need help improving your Quality Measure scores to help your Five-Star rating? We can help. 

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