Effective in April 2019, the federal government has revised its ratings system for all nursing homes. The changes include revisions to the nursing home inspection process, adding new quality measures to its ratings system, and further enhancing details about facilities’ staffing numbers. On the latter, officials say they are dropping the number of days SNFs can go without an RN before they’re bumped down to a one-star rating.
The Centers for Medicare & Medicaid Services (CMS) first announced the slew of modifications that it’s making to both Nursing Home Compare and the field’s Five-Star Quality Rating System in March 2019. Agency officials said their primary aim is to promote quality improvement among SNFs and improve outcomes for residents, according to an announcement.
Additionally, the revisions include a lift on the current freeze of health inspection ratings, instituted in February 2018. CMS had done so previously in this category after it implemented a new survey process for long-term care providers. The concern was that some nursing homes would have been surveyed under the old process while others would be assessed using the new process.
Further, CMS said it is setting higher thresholds and evidence-based standards for nursing home staffing levels. The agency notes that staffing has the highest impact on quality of care. Currently, those that report seven or more days in a quarter with no registered nurse onsite are automatically dropped to one star, but that threshold for an automatic downgrade will fall to four days.
Officials said they also are changing the quality component of Nursing Home Compare to better identify differences in care among various nursing homes, and incentivize providers to up their game.
Finally, the changes will also mean the addition of new measures tied to long-stay hospitalizations and emergency room transfers, along with removing some “duplicative and less meaningful” metrics. The agency said it will establish separate quality ratings for short-stay and long-stay residents, and revise rating thresholds to better pinpoint quality variations among SNFs.
How does the newly revised CMS nursing home rating system impact New Jersey and Pennsylvania nursing homes? Below is a Philadelphia Inquirer article that discusses the impact on area nursing homes.