Addition of two quality measures to the Quality Measure score.CMS has not recalibrated the scales to the distributions originally calculated in 2009, when 20.0% of facilities received one star in QMs, 22.8% received two stars, 23.2% received three stars, 24.0% received four stars, and 10.1% received five stars. After the recalibration, about 49% will receive four or five stars. CMS describes the change as both raising the standard for nursing facilities and providing meaningful differences among facilities (that is, preserving sensitivity of the scale) to benefit the consumers who use the Star Rating System.ĬMS’s Press Release reports, “About two thirds of nursing homes will see a decline in their quality measures rating and about one third of nursing homes will experience a decline in their Overall Five Star Rating.” Before the recalibration, about 80% of all nursing facilities received four or five stars on their QM rating. For the first time since the Five Star Quality Rating System was introduced six years ago, CMS has reset the scale to identify the number of points that are needed to achieve different star ratings on the five-star scale (with one star being the lowest and five stars the highest). Recalibration of the Quality Measures.Here are the specific changes to Nursing Home Compare: The New York Times reported in August 2014 that there is considerable gaming on the rating system. Although the overall rating begins with the health survey, high scores on the self-reported staffing measure and QMs will increase a facility’s overall rating.Īn evaluation of the Five Star Rating System in 2014 by Abt Associates found “dramatic” changes in the QM scores between 20, with the percentage of facilities receiving five stars in QMs more than tripling, from 10.1% to 34.8%, and the percentage of facilities receiving one star in QMs declining, from 20.0% to 3.2%. An overall rating combines the three individual scores. At present, approximately 80% of facilities receive either four or five stars on their QMs. The QMs use different scoring systems for different measures and generally national data, but, significantly for this discussion, they use fixed numeric thresholds for each star level. The survey measure uses fixed percentages of facilities at each star rating level, with facilities compared to other facilities in their state. The Rating System provides individual ratings on three separate measures: (1) the health survey measure, which is based on unannounced annual surveys and complaint surveys conducted by state survey agencies (2) the staffing measure, which is based on self-reported information of nurse staffing in the two weeks before the annual survey and (3) the QMs, which are based on risk-adjusted resident assessment information. In December 2008, CMS introduced the Five Star Quality Rating System to the website “to assist the public in identifying meaningful distinctions among providers.” Revisions over the years have expanded the categories of information included on the site. Nursing Home Compare is the federal website where, since 1998, CMS has published information about nursing homes. These changes were announced February 12 at the Skilled Nursing Facility (SNF) Open Door Call and in a CMS Fact Sheet, and were further described February 20 in a Survey and Certification Letter and CMS Press Release. In addition, CMS is expanding the focused surveys that are designed to improve the accuracy of resident assessment information. The changes recalibrate the Quality Measures (QMs), add antipsychotic drug use to the QM star rating, and adjust the criteria for the staffing measure. One-Third of Facilities Will See Decline in Their Overall ScoreĪs promised in October 2014, the Centers for Medicare & Medicaid Services (CMS) has made significant changes to Nursing Home Compare, effective February 20, 2015. Two-Thirds of Nursing Facilities Nationwide Will See Decline In their Quality Measures Listen to Medicare & Health Care Stories.Join the Center for Medicare Advocacy Founder’s Circle.Career, Fellowship & Internship Opportunities.Ossen Medicare Outreach, Education and Advocacy Project.Connecticut Dually Eligible Appeals Project.The Center for Medicare Advocacy Founder’s Circle.CMA Annual Report | Fiscal Year July 2021 – June 2022.Nursing Home / Skilled Nursing Facility Care.
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