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.

There are fewer 5-star rated Philadelphia-area nursing homes under new federal system

About Jerry

Jerold E. Rothkoff, a practicing New Jersey and Pennsylvania attorney, is the Principal of the Rothkoff Law Group, an elder care law firm. Jerry dedicates his practice to serving clients in the areas of life care planning, long-term care planning, Medicaid & VA benefits, and advocacy for the elderly and disabled. He is past President of the NJ Chapter of the National Academy of Elder Law Attorneys, former chair of the elder law section of the NJ State Bar Association, and past President of the Life Care Planning Law Firm Association. Jerry continues to be an outspoken advocate for the rights of the elderly and disabled. He writes for and gives presentations regularly to attorneys and other professionals about legal issues related to seniors and those with disabilities. Jerry’s community activities include the Twilight Wish Foundation, the Delaware Valley Stroke Council, the Alzheimer’s Association, as well as numerous other advocacy groups. When not in the office, Jerry spends time with his wife, Erica, and their five children, eighteen-year old identical twin girls, Liza and Julia, fifteen-year old fraternal twin boys, Evan and Gregory, and six-year old Aitan.

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