CMS Announces Changes to 5-Star Rating System; End of Staffing Submission Waiver

In a policy memo on June 25, CMS announced temporary changes to the 5-star rating system on Nursing Home Compare. These changes include freezing pieces of the staffing and quality measures domains, as well as the immediate end to the PBJ staffing submission waiver. These changes are discussed in greater detail below.

In March 2020, CMS waived requirements at 42 CFR 483.70(q) related to submissions of staffing data through the payroll-based journal system. This data is used to calculate the staffing domain rating on Nursing Home Compare and updates on a quarterly basis. The staffing ratings currently reflected on Nursing Home Compare are based on data from calendar quarter 4 2019 (October – December). The next scheduled update for this domain, July 2020, would rely on data collected for calendar quarter 1 2020 (January – March), the submission of which was waived. As a result, the staffing domain measures and ratings for the July update will be held constant.

CMS notes that holding this domain constant denies providers the resolution of penalties, such as the automatic downgrade to a one-star rating that a provider receives when they fail to submit data or when they report more than 4 days in a quarter with no RN on site. For providers in this circumstance, the measures and ratings for the staffing domain will be suppressed with the July update.