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Five Star and Nursing Home Compare Changes Clarified

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

Important 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 will now 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 comparable 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.
  • The star ratings for Special Focus Facilities (SFFs) will be identified by an icon and text indicating their status as an SFF, however, their star ratings will not be displayed.

April 2019 will reflect the most current status of quality on Nursing Home Compare.

We can assist in your organization’s compliance with clinical and financial systems review, MDS reviews, MDS education, survey readiness, QAPI or requirements of participation, and cost report preparation. If you have questions or would like to learn more, please contact us:

Nancy Hublar, RAC-CT (nhublar@blueandco.com or 502-992-3528)
Nicole Cameron, RHIA, CDIP, CCS (ncameron@blueandco.com or 317-713-7915)
Landon Hackett, CPA, MSA (lhackett@blueandco.com or 317-713-7929)
Jennifer Scott, RN, BSN, PLNC, CDP (jscott@blueandco.com or 502-992-2567)

If you’d like to learn more about our post-acute care services, click here.

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