CMS Announces Updates To Five Star Quality Rating System

CMS Announces Updates to Five Star Quality Rating System

Nov 30, 2020 | Five Star Staffing Ratings, CMS' PBJ Policies

News Digest: PBJ Based Staffing Five Star Ratings to Resume after Pandemic Waiver

CMS released a substantial update and upgrade to the Five Star rating system as posted on Nursing Home Compare. Particularly, the changes reflected a post-pandemic restart of normal activities.

CMS will resume calculating nursing homes Health Inspection and Quality Measure ratings on January 27, 2021.

CMS Announces Updates to Five Star Quality Rating System

CMS will resume updating health inspections, quality measures with January 2021 refresh. The Centers for Medicare and Medicaid Services (CMS) announced on December 4 that the Five Star Quality Rating system will resume all updates with the January 2021 refresh. Due to the public health emergency (PHE) first issued in March 2020, the 3 domains of the rating system had previously been held constant at varying times throughout the past 9 months as a result of changes to health inspections and certain temporary regulatory waivers.

During this time, CMS also unveiled the new Care Compare site, which officially replaced all legacy sites, including Nursing Home Compare, on December 1, 2020. Complete updates to the Five Star Quality Rating system will be available at the new Care Compare site on January 27, 2021

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Eyigor, Jodi. “CMS Announces Updates to Five Star Quality Rating System.” LeadingAge, 4 Dec. 2020, leadingage.org/regulation/cms-announces-updates-five-star-quality-rating-system.

Five-Star Ratings Updated and Second Quarter PBJ Staffing Data Released

On Wednesday, October 28 Nursing Home Compare and Five-Star ratings were updated. Survey Ratings did not change as traditional nursing home surveys have not yet resumed equally across the nation and CMS prioritizes focus surveys on infection prevention and control during the COVID-19 pandemic.

Quality Ratings were updated to reflect the replacement of the short-stay pressure ulcer measure with a new Quality Reporting Program (QRP) measure—Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury. All quality measure data still only reflects data up to the fourth quarter (Q4) of 2019 and before the COVID-19 pandemic. There were minimal changes in Quality Ratings.

Staffing Ratings were updated and reflect Payroll Based Journal (PBJ) data for Q2 2020 (April – June 2020). Previously, Staffing Ratings were based on Q4 2019 PBJ data because Q1 2020 data submission was optional due to COVID-19.

READ FULL ARTICLE

Sreenivas, Kiran. “Five-Star Ratings Updated and Second Quarter PBJ Staffing Data Released.” AHCA/NCAL, 12 Nov. 2020, www.ahcancal.org/News-and-Communications/Blog/Pages/Five-Star-Ratings-Updated-and-Second-Quarter-PBJ-Staffing-Data-Released.aspx.

Related CMS and PBJ Resources

To learn more about the details, policies and information in these articles, please review these CMS and PBJ publications.

QSO Memo 21-06-NH

📢 CMS QSO Memos Library

Technical Users' Guide

October 2020

⭐ Five Star Users’ Guides

PBJ News Topics

PBJ News Tools

PBJ Policy Library

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Five Star Staffing Ratings, CMS' PBJ Policies

U.S. Bill Would Require More Staffing And Curtail Arbitration In Nursing Homes

Sep 21, 2021

Nursing homes would face minimum staffing requirements and a prohibition on pre-dispute arbitration agreements, among other significant potential changes included in legislation introduced last week by a group of Democratic senators.

Staffing Rating Under 4 Stars? Review PBJ Data; Set and Monitor Goals

Sep 20, 2021

Staffing is difficult—that was a defining truth for nursing homes before the COVID-19 public health emergency created a full-blown staffing crisis that still is harming providers throughout healthcare. So, it may seem like the wrong time for directors of nursing services (DNSs) to pay much attention to the staffing domain in the Five-Star Quality Rating System.

“However, all of the Five-Star data—the staffing, health inspections, and quality measures domains—funnels into multiple parts of a facility’s life,” says Shelly Maffia, RN, MSN, MBA, NHA, QCP, CHC, director of regulatory services for Proactive Medical Review and Consulting in Evansville, IN.

5 Star, QMs, and PBJ Data Updates

Jul 27, 2021

5 Star, QM’s and PBJ data updates have been released. Last week, we shared that QRP’s were released for review. All are critical reporting which impacts our 2022 FY reimbursement and our publicly displayed information on Care Compare. There are a few small windows of time for review and correction if needed.

Marys Take: Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public

Mar 16, 2021

Nursing homes have manipulated the influential star system in ways that have masked deep problems — and left them unprepared for Covid-19. The piece, as you may have already deduced speaks to Nursing Home Compare, the Five-Star Rating System and Payroll Based Journal (PBJ).

Cutting through the COVID staffing star confusion

Oct 14, 2020

COVID-19 has dominated the news — and the senior care industry. Over the past few months, CMS has issued waivers, updated waivers, and repealed waivers. Amidst this COVID chaos is confusion over what PBJ Staffing data is currently posted on Nursing Home Compare. Is it Q1?…Q2? When do you see Q3? What about Q4?

CMS announces end of emergency blanket data waiver for nursing homes

Jun 30, 2020

Federal officials said Friday that they are ending an emergency blanket waiver intended to reduce administrative burden on nursing homes amid the continuing COVID-19 pandemic.

The Centers for Medicare & Medicare Services (CMS) said that effective August 14, nursing homes nationwide will again be required to submit staffing data through the Payroll-Based Journal (PBJ) system, which allows the agency to collect “staffing information which impacts the quality of care residents receive,” CMS said in a press release.

CMS Releases Nursing Home Staffing, Census Data to Help States Make PPE and Testing Decisions

Apr 30, 2020

The Centers for Medicare & Medicaid Services (CMS) on Friday released a public database of staffing and resident counts for nearly 15,000 nursing homes, with the goal of potentially helping states make more informed decisions about the distribution of personal protective equipment (PPE) amid the COVID-19 pandemic.

Using fourth-quarter 2019 data from the Payroll-Based Journal (PBJ) system, CMS compiled a spreadsheet that includes a variety of staffing information about each facility, including average daily nursing headcount, average daily overall staffing totals, the number of certified beds, and the average resident census.

CMS Focuses on Enforcement in Latest Statement on SNF Policies

Feb 20, 2020

n a blog post on the Trump administration’s strategies for ensuring safety and quality in skilled nursing facilities (SNFs), Seema Verma, administrator of the Centers for Medicare & Medicaid Services (CMS), focused on enhanced enforcement efforts to strengthen oversight of facilities.

On the issue of staffing, CMS is monitoring adherence to federal statute on the number of registered nurses that SNFs employ to help care for patients and residents.

Top 9 Things to Remember About PBJ

Feb 5, 2020

Accurate PBJ reporting can impact your Five-Star rating, referral patterns, census stability and overall long-term viability.

Staffing takes a front seat when driving quality of care

Dec 12, 2019

In CMS’s new rating methodology, facilities are rewarded for staffing more RNs — and punished when they don’t have enough. Ratings on the staffing domain are based on two measures: the number of RN hours per resident per day and total nursing hours (combined RN, LPN, and nurse aide hours) per resident per day, all pulled from quarterly Payroll-Based Journal reports

CMS Proposes a Host of Changes to Nursing Home Requirements for Participation

Jul 31, 2019

the Centers for Medicare and Medicare Services (CMS) on July 18 released a proposed rule that the agency estimates will achieve annual savings of nearly $644 million for providers.

The agency proposes a host of changes to the revised Medicare Requirements for Participation (“Requirements for Participation”)

CMS: Hundreds More Buildings Could Receive One-Star Staffing Ratings Under New Rules

Apr 30, 2019

The new, stricter skilled nursing staffing standards slated for implementation by the federal government next month weren’t entirely unexpected, but they raise questions about the broader problem of understaffed facilities — and hundreds of buildings could be in the crosshairs.

The drop in the threshold for days without RN staffing wasn’t a surprise to Feige; CMS had hinted at the move in various forums, he told SNN.

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