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Federal Government Announces Changes to Nursing Home Rating System

February 20, 2015

On February 12th, the Centers for Medicare and Medicaid Services (CMS) announced it was making changes to its Nursing Home Compare 5-Star Quality Rating System, which allows consumers to learn about and compare nursing homes in terms of their performance on surveys (inspections), staffing levels and quality measures. The following changes were made to the ratings, which are now updated on the Nursing Home website: 

  1. The addition of 2 new antipsychotic quality measures - one for long stay residents, the other for short stay residents - to the 5-star calculations.  Antipsychotic medication use had previously not been calculated into the rating;

  2. Raising the bar for performance on quality measures through the increase of the number of total quality measure points needed to achieve each star rating;

  3. The conduction of specialized onsite surveys of a sample of facilities nationwide to assess accuracy of the resident assessment information used to calculate quality measures; and

  4. The adjustment how the number of stars awarded for staffing is determined. Up to this time, a facility could have 3 stars for RN staffing and 3 stars for total nursing staff hours and receive four stars for overall staffing.  Under the new system, a facility must have at least 4 stars in either RN staffing or total nursing staff hours to be awarded 4 stars.

CMS has noted that it expects the changes, which went live on Friday, February 20th, to result in a number of facilities dropping stars in the quality measure and /or staffing domains with a resulting drop in overall stars in a number of cases.  To read CMS’s fact sheet, click here. Consumer Voice's press release on these revisions can be read here.

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