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CMS Announces Temporary Freeze to Five-Star Quality Rating Domain

In a new QSO Memo dated April 24, 2020, the Centers for Medicare & Medicaid Services (CMS) announced a temporary freeze to the Five-Star Quality Rating Health Inspection Domain. The decision to hold the survey data constant was based on the Agency’s earlier guidance regarding the suspension of certain survey activities (3/4/2020 Ref: QSO-20-12-ALL) and the subsequent March 20, 2020 QSO Memo regarding prioritization of other surveys (3/20/2020 Ref: QSO-20-20-ALL – revised)  due to the COVID-19 pandemic. The Five-Star Quality Rating System State-Level Cut Point Tables have been revised as a result.

What to Know About Surveys

CMS has been conducting COVID-19 Focused Surveys as one of its priorities and from what our team is hearing, many of these inspections are resulting in Immediate Jeopardy-level citations. The new QSO Memo states that given the shift in focus to the number of nursing homes being inspected and the types of inspections being conducted by surveyors, that the Inspection domain of the Five-Star Quality Rating data would not be properly weighted and thus will remain constant for the foreseeable future. However, the results of all health inspections conducted on or after March 4, 2020 will be posted publicly on April 29. 2020 via a link on the Nursing Home Compare website. So, while these inspections are not going to be considered in the Five-Star Quality Rating changes for the time being, consumers, the media and others will have access to inspection results. This means that providers should review and use the Focused COVID-19 survey tools, guidance from their state/local health departments, and the Centers for Disease Control (CDC) to ensure they are utilizing current guidance for infection prevention and control. CMS announced last week that it will be updating its requirements for nursing home infection surveillance and reporting to residents/representatives based on what is occurring during this pandemic, so facilities should be making a concerted effort to ensure they are aware of these types of updates that are frequently being revised or added.

This QSO Memo, “Nursing Home Five Star Quality Rating System Updates, Nursing Home Staff Counts and Frequently Asked Questions” includes a significant amount of information, including information on how PBJ data will be used and answers to many questions providers may have. We will be covering these in other CMSCG Blog posts shortly. View the April 24, 2020 QSO Memo (Ref: QSO-20-29-NH) here.

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