Five Star Changes: What’s coming next month?

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Prepare yourselves! The stars will be realigning next month based on the announcement from CMS this week. Not only will survey results be reinstated (they have been on hold since last November) but there is sure to be more shifting based on changes made to the quality measures and staffing methodologies.

The revised Five-Star Technical Users’ Guide outlines all of the changes taking effect April 1st including the survey domain returning to what it was prior to February 2018, adjustments to the staffing thresholds and requirements for having an RN onsite, and the most significant change involving the inclusion of 2 new long term care measures and the overall scoring changes for the 17 of the quality measures. Here’s an easy view of what’s coming:

Click here to view the state averages table.

Threshold Prior to April 2019

Threshold Effective April 2019

These 3 domains do not work in silos and each needs their own special focus. Keep in mind that the survey domain forms the basis for the “overall” rating making this area an easy target for improving your rating. Survey preparation and functioning in a continuous survey readiness mode is key.

Getting your arms around the staffing domain begins with establishing a process for submitting PBJ data. Waiting until the end of the quarter will not help you in this domain. It is an open book test, as I often say. This warrants some studying and review prior to the quarterly deadline.

If the quality measure domain achieves a 5 Star, it can add a star to the overall rating. On the other hand, it can cause a star to be taken away from the overall if it is a 1 Star. Monitoring points for each of the 17 quality outcomes can help prioritize improvement opportunities. A job well placed in front of the Quality Assessment & Assurance Committee (QA&A).

In a nutshell, hold onto your seats when these changes take effect next month.

Reach out to us if you’d like assistance focusing your 5 Star improvement opportunities. We recognize these challenging times and are here to help you and your team facilitate positive change to produce superior outcomes.

Amy Lee, RN, MSN, CRRN, QCP
President/CEO

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