“Our updates to Nursing Home Compare reflect more transparent and meaningful information about the quality of care that each nursing home is giving its residents,” CMS administrator Seema Verma said in a statement. The April 2019 changes will also include adjustments to the inspection process, the addition of data on long-stay hospitalizations and transfers to emergency rooms, and the removal of “duplicative and less meaningful measures.” “Medicare is now relying on the new data to evaluate staffing, but the revamped star ratings still mask the erratic levels of people working from day to day,” the publication reported. Part of the issue was the transition period from the self-reported data to the beefier PBJ statistics, a shift that the Times acknowledged in its article. The federal agency also announced in November that it would begin using Payroll-Based Journal data - which replaced nursing homes’ previously self-reported staffing information - to direct state-level inspections of properties deemed to have insufficient staffing. In response, CMS slapped nearly 1,400 nursing homes with a one-star rating in the staffing category because they had seven or more days per quarter with no RN hours. Staffing issues took center stage in the public discourse around Nursing Home Compare last summer, when the New York Times and Kaiser Health News published an expose on the widespread inflation of nursing home staffing coverage in CMS’s data. Additionally, it will reduce the need to have larger adjustments to the thresholds in the future.” Stressing staffingĪ building’s five-star rating on Nursing Home Compare, CMS’s website for nursing home residents and their families, can be vital in securing referrals from hospital partners and attracting potential patients organically preferred provider networks, accountable care organizations (ACOs), and other new payment models also frequently enforce certain star-rating thresholds when looking for new designated skilled nursing partners. “Similar to setting new thresholds, this action also aims to incentivize continuous quality improvement. “For example, if there is an average rate of improvement of 2%, the QM threshold would be raised 1%,” CMS wrote. The exact gain will be set at 50% of the average improvement rate across all SNFs. For the quality measure metric, CMS will increase the star thresholds to better reflect each SNF’s position relative to the crowd every six months. The changes will come with a new overall formula designed to constantly push skilled nursing facilities to improve. A November 2018 study from the University of Chicago found very few safety differences among facilities in the middle of the star-rating pack, while other researchers determined that more stars didn’t necessarily lead to fewer re-hospitalizations. Multiple academic inquiries have also taken aim at the correlation between a facility’s star ratings and overall consumer satisfaction. “They’re just looking to produce a single summary of each nursing home’s care, whereas our long-term vision might be closer to: If you have a stroke, and you’ve just been discharged from a hospital, which skilled nursing facility might be right for you?” Ben Harder, the publication’s chief of health analysis, told Skilled Nursing News at the time. News & World Report, which has compiled its own separate list of top American nursing homes since 2009, introduced individual short- and long-term ratings in its 2018 edition, released last fall - specifically questioning the utility of CMS’s one-size-fits-all quality metric. “Conversely, the main goal of long-stay residents is typically aimed at maintaining or attaining their highest practicable well-being while residing long term in the facility.”ĬMS will still provide an overall score for each facility, with short- and long-term performance ranked equally in the ultimate calculation. “While every nursing home resident has their own individual needs and goals, the overarching goal of the short-stay residents is typically aimed at improving their health status so they can return to their previous setting,” CMS wrote in its extended guidance on the new rules. With the move, CMS acknowledged what many industry-watchers have long insisted: Caring for short-stay, post-acute residents is a fundamentally different service than housing long-term, custodial patients.
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