Volume XXX, Number 3,
March 2015

CMS announces changes to Five-Star Quality Rating System

The Centers for Medicare & Medicaid Services (CMS) recently announced changes that to the Five-Star Quality Rating System, effective February 20, 2015.  According to recent communications from the American Health Care Association (AHCA), the changes impact how CMS assigns stars for both the Staffing and Quality Measure components, which may impact a center’s Overall rating. CMS also added two new measures to the Quality Measure component: the short-stay antipsychotic measure and the long-stay antipsychotic measure that CMS has been using on Nursing Home Compare for the past several years.  AHCA provides the following summary of the changes to the Five-Star components:

• Overall Five-Star rating
  • No changes to methodology but changes to Staffing and Quality Measure (QM) components will impact your overall rating
• Survey component
  • No changes
• Staffing component
  • Changed how 3- and 4-Star ratings are determined on Staffing component.
    • Centers that have a 3-Star rating on both their RN and Direct Care Staffing will no longer receive 4 Stars but will now receive a 3-Star rating.
    • This also may impact a Center’s Overall rating since a 4- or 5-Star rating on the Staffing component added one star to your Overall rating.
• Quality Measure component
  • Added two new Quality Measures to the current nine QMs
    • Short-Stay use of antipsychotics
    • Long-Stay use of antipsychotics
  • Rescaled the cut points for each star level on the Quality Measure component. CMS did not provide the new cut points on the call but will release this information shortly in the new technical user’s manual.
    • This will result in many members losing one or two stars on the Quality Measure component. Since the QM component contributes to the Overall rating, a sizable number of centers may also lose a star on their Overall rating.

Additional information regarding these changes as well as an archived webinar presentation on the subject hosted by AHCA CEO Mark Parkinson can be accessed via the members-only section of AHCA’s website by CLICKING HERE.

President’s Report

• Regulations, Rates and Readiness

Legislative Update

• Three Strikes Bill heard in Senate Committe

• Warren urges budget writers to remember Long Term Care

• THCA members pounding the pavement at the Texas Capitol

State News

• Managed Care resources

• THCA MEMBER ADDED VALUE:  Fact Sheet on STAR+PLUS Managed Medicaid for Physicians / Practitioners

• Nursing facility upper payment limit / Minimum payment amount –  Program update

• Nursing facility administrators can now complete licensing tasks online

• TMHP schedules system maintenance

• Distribution of resident days by RUG level

Federal News

• CMS announces changes to Five-Star Quality Rating System

• Focused dementia care survey pilot in Texas

• Surveyor guideline from CMS on CPR certification

THCA Membership Contribution

• “Maintain a Competitive Edge – Enhance Clinical Capabilities”

Announcements & Recognitions

• Newly appointed / elected THCA Board members!
• THCA welcomes our newest facility members
• THCA facility contact information sheet
• THCA Facebook & Twitter pages

• Call for Presentations for the 2015 THCA 65th Annual Convention & Trade Show

• Activity Professional Award Nominations due March 26th

THCAPAC

• THCAPAC “500 Club” recognition

• How to submit your contribution to THCAPAC

• THCAPAC Spring golf tournament

Region News

• “Step Back, Have a Seat and Take Care of Yourself”

• Region Information / Updates

Education

• THCA Spring Conference and Resource Fair April 20-22, 2015 – Omni Barton Creek Conference Center
  Austin, Texas

• THCA 65th Annual Convention and Trade Show – “65: Commitment & Devotion” – September 21-24, 2015 – The Gaylord Texas – Grapevine, Texas

• Nursing facility webinars to assist with the transition to Managed Care

• DADS and DSHS conference: Infection Control in Long-term Care 2015

If you have suggestions for education sessions or questions about THCA education, please contact Sue Wilson at the THCA office swilson@txhca.org.

Calendar

• March 2015

• April 2015