Key points with the new CMS Five-Star ratings this week!
The updated July 2020 Five-Star Ratings were posted on CASPER this week. These will be posted for public viewing on Nursing Home Compare (NHC) on or around July 29, 2020. On June 25th, CMS released memorandum QSO 20-34-NH describing the updates to the staffing and quality measures.
We have been fielding a multitude of questions regarding the inconsistency from past rating reports and wanted to point out a few areas:
1. Staffing Measures and Ratings Domain
- On July 29, 2020, staffing measures and star ratings will be held constant, and based on data submitted for Calendar Quarter 4, 2019. Also, CMS is ending the waiver of the requirement for nursing homes to submit staffing data through the Payroll-Based Journal (PJ) system. SNF must submit data for Quarter 2 by August 14, 2020.
- Because of the waiver, many facilities did not submit staffing data for Quarter 1 2020 since it was optional. This will prevent CMS from updating the staffing star rating next month. Therefore, the July 2020 staffing measures and ratings will be held constant utilizing the data submitted for Quarter 4 2019.
2. Quality Measures
- CMS has concerns with the MDS data submitted after Jan. 1, 2020 based on the waiver that provided leniency for timely submission of MDS data due to the pandemic. Therefore, beginning July 29, 2020, quality measures will be held constant based on the data collection period ending December 31, 2019 (January 1 – December 31, 2019).
- Quality measures that were based on a data collection period prior to December 31, 2019 (e.g., ED Visits & Rehospitalizations, Rate of Successful Return to Home and Community), will continue to be updated until the underlying data reaches December 31, 2019. Note that CMS is NOT freezing the star rating for Quality measures and they will continue to update your star rating based on these measures.
- CMS will continue to freeze this domain based on data from surveys that occurred on or before March 3, 2020 until further notice.
We understand many of these changes may be confusing. Please feel free to contact us if you have any questions. We would be happy to review your report and give you further guidance.
Amy Lee, RN, MSN, CRRN, QCP