Readers Weigh in on Hot Topics in Long-Term Care

The Issue: Changes to Nursing Home Compare Five-Star Quality Rating System

The Centers for Medicare & Medicaid Services (CMS) has implemented three important changes to the Nursing Home Compare Five-Star Rating System. According to CMS statements, the changes are expected to “raise the bar for performance” and make it more difficult to achieve a five-star rating, and as a result, many nursing homes (NHs) will see a lower quality measure rating, even though the underlying quality measure data may not have changed. As the New York Times reported, nearly one-third of NHs dropped in their star ratings as a result of the changes (https://bit.ly/NYTimes_5StarNH), which are reviewed below:

• Add two quality measures for use of antipsychotic medication in short-stay and long-stay NH residents who do not have a diagnosis of schizophrenia, Huntington’s disease, or Tourette syndrome.
• Raise performance thresholds for NHs to achieve a high rating on all publicly reported measures in the Quality Measures category. Because progress has been achieved since the launch of the rating system in 2008, the CMS is “resetting” these quality measure thresholds as a way to encourage further progress that enables consumers to identify “meaningful differences in quality” among facilities, according to the CMS.
• Change the scoring method for NHs to achieve a good staffing star rating. NHs must earn a four-star rating on either the RN or total staffing rating to achieve an overall staffing rating of four stars. To verify staff information, the CMS will implement a quarterly electronic system that is auditable back to payrolls; it is expected to provide accurate, timely data based on staff turnover, retention, staff types, and levels of different staff types.

Readers Weigh In:

These responses were submitted freely by readers of Annals of Long-Term Care: Clinical Care and Aging® to a survey that ran on the journal website for approximately 4 weeks in February and March of 2015. The graphs below represent the responses of 72 individuals. If you have thoughts on this or other hot topics in long-term care, please send your comments to smcguire@hmpcommunications.com.