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CMS Makes Improvements to Nursing Home Rating System

Earlier this year, the Centers for Medicare & Medicaid Services, also known as CMS, made improvements to the Nursing Home Compare and the Five-Star Quality Rating System. These changes make it easier to compare quality between nursing homes.

The Nursing Home Compare website and Five-Star Quality Rating System were created to help consumers, their families, and caregivers compare nursing homes and identify areas they may want to ask about when looking at nursing home care.

Nursing Home Compare has a quality rating system that gives each nursing home a rating between 1 and 5 stars. Nursing homes with 5 stars are considered to have above average quality and nursing homes with 1 star are considered to have quality below average. There is one Overall 5-star rating for each nursing home, and a separate rating for health inspections, staffing levels, and quality measures.

The changes include revisions to the inspection process, enhancement of new staffing information, and implementation of new quality measures.

One of the most important changes involves setting higher thresholds and evidence-based standards for nursing homes’ staffing levels. CMS found that as staffing levels increase, quality increases and is therefore assigning an automatic one-star rating when a Nursing Home facility reports “no registered nurse is onsite.” Currently, facilities that report seven or more days in a quarter with no registered nurse onsite are automatically assigned a one-star staffing rating. Under the new system, the threshold for the number of days without an RN onsite in a quarter that triggers an automatic downgrade to one-star will be reduced from seven days to four days. CMS is also making changes to the quality component on Nursing Home Compare that would improve identifying differences in quality among nursing homes, raise expectations for quality, and incentivize continuous quality improvement.

To provide further value, the Nursing Home Compare Update includes adding measures of long-stay hospitalizations and emergency room transfers, and removing duplicative and less meaningful measures. CMS is also establishing separate quality ratings for short-stay and long-stay residents. Revising the rating thresholds to better identify the differences in quality among nursing homes makes it easier for consumers to find the right information needed to make decisions.

If you would like help choosing a nursing home, Kimbrough Law may be able to assist. Just give our office a call.

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