Five-Star and Nursing Home Compare Change

The Centers for Medicare & Medicaid Services (CMS) recently issued a memorandum, "April 2019 Improvements to Nursing Home Compare and the Five Star Rating System," about changes to the Five-Star Rating system on Nursing Home Compare that will go into effect in April 2019. CMS has also posted a revised Technical Users' Guide reflecting these changes.

Highlights of the changes are:

• CMS will end the survey freeze on the health inspection domain of Five Star and will resume the traditional method of calculating the health inspection scores by using three cycles of inspections.
• Nursing Home Compare will begin to report separate ratings for short-stay quality measures and long-stay quality measures. With the introduction of these separate ratings, the thresholds for quality measures will increase every six months.
• Additionally, two measures are being added to the quality measure domain, which include long-stay hospitalization and long-stay Emergency Department (ED) visits. The long-stay physical restraints measure will be removed from the quality measure rating. The short-stay pressure ulcer and short-stay discharge community measures currently used will be replaced with their analogous Quality Reporting Program (QRP) measures.
• CMS will be adjusting the thresholds for overall staffing ratings, which will provide a greater emphasis on RN staffing.
• CMS will give a one-star staffing rating to those facilities that report four or more days without an RN in a quarter.

Click here for a more detailed summary.

AHCA will continue to provide updates on these changes. If you have any questions, please contact research@ahca.org.