Latest Insights and Updates

The article discusses the changes to the Nursing Home Compare website and the Five-Star Quality Rating System used by the Centers for Medicare and Medicaid Services (CMS). The updates aim to provide a more accurate reflection of nursing home quality and resident care.

Key Changes:

1. Weighting of measures: The scoring rules for quality measures have been changed to give more weight to those with greater opportunity for improvement.

2. New point thresholds: New point thresholds have been established for the overall quality measure rating, as well as short-stay and long-stay ratings.

3. Additional measures: Measures of long-stay hospitalizations and long-stay emergency department visits have been added to the quality measure rating.

4. Removal of physical restraints measure: The long-stay physical restraints measure has been dropped from the quality measure rating.

Impact on Star Ratings:

Facilities may see a change in their overall star rating due to various reasons, including:

1. Changes in health inspection data
2. Updates to staffing measures and ratings
3. Changes in quality measures

Health Inspection Rating Changes:

Events that could change the health inspection score include:

1. New health inspections
2. New complaint deficiencies
3. Revisits (second, third, or fourth)
4. Resolution of Informal Dispute Resolutions (IDR) or Independent Informal Dispute Resolutions (IIDR)
5. Aging of complaint deficiencies

Staffing Rating Changes:

Changes in staffing measures and ratings may be due to:

1. Differences in the number of hours submitted for staff
2. Changes in daily census
3. Changes in resident case-mix from the previous quarter

Quality Measure (QM) Rating Changes:

A set of quality measures has been developed to describe the quality of care provided in nursing homes. These measures address a broad range of function and health status indicators. Changes in the quality measures may change the star rating.

The updates typically occur quarterly, and technical specifications for all measures are available on the CMS website.

The article discusses the importance of the Centers for Medicare & Medicaid Services (CMS) Five-Star Rating system for skilled nursing facilities (SNFs). The rating system has been updated to include a new staffing domain, which may lead to changes in a facility's overall star rating. A lower star rating can have significant consequences, including reduced occupancy and Medicare volumes, as well as limited participation in value-based models.

The article cites an analysis by CLA, a professional services firm, which found strong correlations between CMS Five-Star Ratings and key performance indicators such as occupancy and Medicare volumes. The analysis also suggests that facilities with lower star ratings may be bypassed by consumers or referral sources in favor of those with higher star ratings.

Rob Schile, Principal at CLA, notes that the time is now for nursing homes to understand the changes occurring in the market and in Medicare, including the new star ratings methodology and the forthcoming transition to the Patient-Driven Payment Model. Cory Rutledge, senior living leader with CLA, emphasizes the importance of understanding these changes and their potential impact on a facility's financial performance.

CLA offers assistance to nursing homes through its senior living professionals, who can help model the financial impacts of changing star ratings and provide guidance on navigating the updated rating system.

Key points from the article:

• The CMS Five-Star Rating system has been updated to include a new staffing domain.
• A lower star rating can have significant consequences, including reduced occupancy and Medicare volumes.
• Facilities with lower star ratings may be bypassed by consumers or referral sources in favor of those with higher star ratings.
• CLA's analysis found strong correlations between CMS Five-Star Ratings and key performance indicators such as occupancy and Medicare volumes.
• The time is now for nursing homes to understand the changes occurring in the market and in Medicare, including the new star ratings methodology and the forthcoming transition to the Patient-Driven Payment Model.

Overall, the article highlights the importance of understanding the updated CMS Five-Star Rating system and its potential impact on skilled nursing facilities.

The Centers for Medicare and Medicaid Services (CMS) has made significant changes to the Minimum Data Set (MDS) 3.0 assessment, effective October 1, 2023. These changes will impact Five-Star reporting for both Quality Measure (QM) ratings and Staffing ratings. The changes include the removal of section G used to calculate activities of daily living (ADL) scores, which will affect the QM rating and Staffing rating reported on the Care Compare website.

The changes will also impact the Five-Star Staffing Rating. Providers use the Payroll-Based Journal (PBJ) system to report actual staffing levels to CMS, which are then case-mix adjusted for acuity prior to calculating staffing rating points. The case-mix adjustment methodology has been updated to use a similar approach based on the Patient-Driven Payment Model (PDPM) Nursing Case-Mix Group (CMG). Additionally, revisions to the staffing rating thresholds have been made to ensure that the distribution of points remains unchanged.

The changes will also impact several Quality Measures (QMs), including short-stay and long-stay measures. The Residents Who Made Improvements in Functions short-stay measure will be replaced with the Discharge Function Score measure, while three long-stay QMs will be reformatted to replace section G data with equivalent section GG data. Reporting on these new measures will begin in January 2025. CMS has provided additional guidance and resources on these changes, including updated technical user guides and measure calculation manuals.

The article also notes that CMS-672 forms completed for survey purposes will no longer require the completion of fields using section G data as of September 29, 2023. The remainder of the form will still be completed until October 22, 2023, when these fields will be moved to CMS-671 and CMS-672 will be discontinued.

Overall, these changes aim to improve the accuracy and reliability of Five-Star reporting for nursing homes. However, they may require significant updates and adjustments from providers to ensure compliance with the new requirements.

This text appears to be a Centers for Disease Control and Prevention (CDC) report on the early COVID-19 vaccination coverage among residents and staff members of skilled nursing facilities participating in the Pharmacy Partnership for Long-Term Care Program. Here is a summary of the report:

Background: The CDC, in collaboration with other organizations, launched the Pharmacy Partnership for Long-Term Care Program to provide COVID-19 vaccines to residents and staff members of skilled nursing facilities.

Methodology: The report analyzed data from December 18, 2020, to January 17, 2021, on vaccination coverage among residents and staff members of skilled nursing facilities participating in the program. The analysis included 11,376 facilities with a unique CMS Certification Number and at least one on-site clinic conducted through the program.

Findings: The report found that:

• As of January 17, 2021, approximately 77% of residents and 37% of staff members had received at least one dose of COVID-19 vaccine.
• Vaccination coverage varied by jurisdiction, with median percentages ranging from 51.4% to 95.5% among residents and 21.1% to 64.3% among staff members.

Conclusion: The report highlights the progress made in vaccinating residents and staff members of skilled nursing facilities through the Pharmacy Partnership for Long-Term Care Program. However, it also notes that there is still a need to increase vaccination coverage among both groups, particularly among staff members.

The text also includes tables, figures, and footnotes providing additional information on the methodology, data sources, and limitations of the analysis.