CMS issues stricter standards for nursing home ratings
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CMS issues stricter standards for nursing home ratings

The Centers for Medicare & Medicaid Services (CMS) recently announced stricter standards for its patient-facing nursing home ratings, particularly in the areas of staffing and quality improvement, beginning in April 2019.

Some of the upcoming changes concern:

  • Staffing: Starting April 24, CMS will issue one-star staffing ratings to facilities that lack a registered nurse on-site for four or more days in a quarter, down from the current seven-day standard. The agency will also use Payroll-Based Journal data to guide state-level inspections of understaffed facilities, rather than self-reported data
  • Health inspections: CMS will end the freeze on health inspections ratings, which began in February 2018 so that all facilities could be assessed using new rules and requirements
  • Quality improvement: Every six months, the agency will increase the star thresholds by 50 percent of the average improvement rate among all skilled nursing facilities (SNFs). Therefore, if the average improvement rate among SNFs is two percent, the quality threshold would increase by one percent
  • Short- and long-stay separation: CMS will also release separate quality ratings for short- and long-stay residents and tweak star thresholds to account for differences between the two types of care. CMS will still, however, publish a general score for each facility

Other changes the agency announced include modifying the inspection process, adding data on long-stay hospitalizations and emergency room transfers, and eliminating certain measures deemed redundant.

For more information on this topic, or to learn how Baker Tilly healthcare specialists can help, contact our team.

CMS may eliminate hospital star-rating model for 2020 quality reporting
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CMS may eliminate hospital star-rating model for 2020 quality reporting