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.

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