New Five-Star Ratings for Individual Facilities

The American Health Care Association (AHCA) has notified us that as of last week nursing facilities were able to access their new Five-Star rating and quality measure information via the CASPER on-line reporting system.  The Centers for Medicare & Medicaid Services (CMS) announced that they anticipate releasing this information publicly via Nursing Home Compare  on July 19th.  Changes to the Nursing Home Compare website that facilities and consumers will see as of that date include updates to the look, feel and some functionalities as well as new information, including:

  •  Survey deficiency reports (2567 forms), beginning for surveys conducted in calendar year 2011.
  •  New MDS 3.0-based quality measures, including two new measures of off-label use of antipsychotic drugs (long-stay prevalence and short-stay incidence).
  •  Ownership information.
  •  Physical therapist staffing levels.

The Five-Star rating system has been modified to incorporate the new quality measures and adjust expected staffing calculations based on MDS 3.0 data.  The approach to revising these measures and calculations has been designed to transition with minimal change to the overall distribution of ratings. CMS has also reported that overall trends in Five-Star ratings since the debut of the system in 2008 have shown improvement, with an increasing proportion of facilities receiving four- and five-star ratings and fewer receiving one-star ratings.

The following new quality measures will be posted, with a subset (indicated in bold) used in calculating the Five-Star rating:

Long Stay Quality Measures

  •   % of residents given influenza vaccination during the flu season
  •   % of residents who were assessed and given pneumococcal vaccination
  •   % of residents experiencing one or more falls with major injury
  •   % of residents who have moderate to severe pain
  •   % of high-risk residents who have pressure sores
  •   % of residents who had a urinary tract infection
  •   % of low-risk residents who lose control of their bowels or bladder
  •   % of residents who have/had a catheter inserted and left in their bladder
  •   % of residents who were physically restrained
  •   % of residents whose need for help with daily activities has increased
  •   % of residents who lose too much weight
  •   % of residents who are more depressed or anxious
  •   % of residents who received an antipsychotic medication

Short-Stay Quality Measures

  •    % of residents given influenza vaccination during the flu season
  •    % of residents who were assessed and given pneumococcal vaccination
  •    % of residents who had moderate to severe pain
  •    % of residents with pressure ulcers that are new or worsened
  •    % of residents who newly received an antipsychotic medication

Each of the measures used in the Five-Star rating is weighted equally in the calculations, which are based on percentile rankings.  

AHCA will continue to provide updates as CMS shares any additional information.  AHCA will be holding a webinar detailing the new measures and other changes to Nursing Home Compare on July 11th at 2:00 pm EDT.  You can register here. The provider Five-Star Help line at 800-839-9290 will be open for an extended period from June 18 through August 3. Provider questions may also be addressed to bettercare@cms.hhs.gov.