CMS Updates Staffing & Turnover Measures

Sep 21, 2023 | CMS' PBJ Policies, Five Star Staffing Ratings, Survey & FTags for Staffing

News Digest: Expected Staffing Hours Change for Five Star Ratings

The end of RUGS-IV (MDS’ Section G) on October 1, 2023 necessitates a change to how CMS calculates “Expected Nursing Hours” – now called Case-Mix Hours – for the Staffing Five Star rating. The early 2000’s STRIVE study for each of the 66 RUGS-IV categories are being replaced by 25 PDPM categories.

In addition, prior exceptions for reporting issues that allowed a recalculation are no longer available.  Instead, facilities will be scored with the lowest possible points on the three turnover measures when the facility failed to submit or submitted invalid PBJ data for one or more of the quarters used to calculate the turnover measures.

Pbjsubmissionstarts

Updates to Nursing Home Care Compare Staffing and Quality Measures

QSO-23-21-NH memorandum includes these changes:

Adjustment to Staffing and Quality Measures: CMS will update the staffing level case-mix adjustment methodology and replace some of the Quality Measures (QMs) used on Nursing Home Care Compare, in order to accommodate changes to the Minimum Data Set (MDS). Additionally, CMS will discontinue the CMS-672 form since the section G MDS data, used to populate this form, is being eliminated.

Penalty for Providers that Fail to Submit Staffing Data: To incentivize providers to submit accurate staffing data, CMS will revise the staffing rating methodology so providers that fail to submit staffing data or submit erroneous data receive the lowest score possible for corresponding staffing turnover measures.

READ FULL ARTICLE

Updates to Nursing Home Care Compare Staffing and Quality Measures | CMS. www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states/updates-nursing-home-care-compare-staffing-and-quality-measures.

Pbjsubmissionstarts

CMS Updates Nursing Home Care Compare Staffing and Quality Measures

This week, the Centers for Medicare & Medicaid Services (CMS) released QSO-23-21-NH regarding updates coming in April 2024 to Nursing Home Care Compare Staffing and Quality Measures. The updates accommodate previously announced changes to the Minimum Data Set (MDS) taking place October 1, 2023. This includes changes to the staffing level case-mix adjustment methodology from RUG-IV to PDPM. Additionally, CMS announced it will be removing the CMS-672 form (Resident Census and Conditions of Residents).

Other changes include:

READ FULL ARTICLE

Hunt, Hawley. CMS Updates Nursing Home Care Compare Staffing and Quality Measures. www.ahcancal.org/News-and-Communications/Blog/Pages/CMS-Updates-Nursing-Home-Care-Compare-Staffing-and-Quality-Measures.aspx.

Pbjsubmissionstarts

CMS Posts Updates to Nursing Home Care Compare Staffing and Quality Measures

The Centers for Medicare & Medicaid Services (CMS) has posted memo QSO-23-21-NH describing updates to the staffing level case-mix adjustment methodology and quality measures used in the Nursing Home Care Compare Five Star Quality Rating System. These updates are in order to accommodate changes to the Minimum Data Set (MDS) that will take effect October 1, 2023. Additionally, CMS will be discontinuing the CMS-672 form and transferring the non-MDS-related items (e.g., census information) to the CMS-671 form. Please review the memo for more details.

READ FULL ARTICLE

CMS Posts Updates to Nursing Home Care Compare Staffing and Quality Measures | AMDA  | the Society for Post-Acute and Long-Term Care Medicine. paltc.org/publications/cms-posts-updates-nursing-home-care-compare-staffing-and-quality-measures.

Pbjsubmissionstarts

CMS Outlines Changes Coming to Staffing and Quality Measures

CMS has announced changes to the staffing and quality measures displayed on Nursing Home Care Compare based on October 1 updates to the Minimum Data Set. CMS has also outlined a new scoring policy to be applied to providers that fail to submit accurate or complete staffing data.

The Centers for Medicare & Medicaid Services (CMS) released memo QSO-23-21-NH on September 20, 2023, outlining changes coming to the staffing and quality measures displayed on Nursing Home Care Compare. With the October 1 implementation of the updated Minimum Data Set (MDS), CMS will transition the case mix methodology used for Care Compare measures from RUGS-IV to a PDPM-based model. This transition impacts staffing level measures and four quality measures:

READ FULL ARTICLE

LeadingAge. “CMS Outlines Changes Coming to Staffing and Quality Measures.” LeadingAge, 26 Sept. 2023, leadingage.org/cms-outlines-changes-coming-to-staffing-and-quality-measures.

Pbjsubmissionstarts

CMS Updates Nursing Home Care Compare Staffing and Quality Measures

This week, the Centers for Medicare & Medicaid Services (CMS) released QSO-23-21-NH regarding updates coming in April 2024 to Nursing Home Care Compare Staffing and Quality Measures. The updates accommodate previously announced changes to the Minimum Data Set (MDS) taking place October 1, 2023. This includes changes to the staffing level case-mix adjustment methodology from RUG-IV to PDPM. Additionally, CMS announced it will be removing the CMS-672 form (Resident Census and Conditions of Residents).

Other changes include:

READ FULL ARTICLE

CMS Updates Nursing Home Care Compare Staffing and Quality Measures – IHCA.” IHCA, 26 Sept. 2023, www.ihca.org/resource/cms-updates-nursing-home-care-compare-staffing-and-quality-measures.

Related CMS and PBJ Resources

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

Cms qso memorandum for pbj
QSO Memo 23-21-NH
Five star care compare technical users guide
Technical Users' Guide

September 2023

Five Star Users’ Guides

More News in this PBJ Topic

Ask the payment expert …. about the total nurse staffing measure

Q: What is the Skilled Nursing Facility Value-Based Payment Total Nurse Staffing Measure?
A: The Total Nursing Hours Per Resident Day Measure uses auditable electronic data reported to the Payroll-Based Journal system to calculate total nursing hours per resident day. It is one of two new measures that will begin affecting payments in the FY 2026 SNF VBP program year, the other being SNF Healthcare Associated Infections Requiring Hospitalization.

read more

CMS to ‘Crack Down’ on Troubled Nursing Homes Through Special Focus Facility Program Changes

In its latest move to increase scrutiny of the skilled nursing industry, the Biden administration is toughening requirements for nursing homes that fall into its Special Focus Facilities (SFF) program.

Specifically, the Centers for Medicare & Medicaid Services (CMS) is making completion requirements more challenging and increasing enforcement actions if SNFs fail to show improvement, according to a statement issued by the federal agency on Friday.

read more

3 Nursing Home Legal Issues to Watch in 2022 and Beyond

As a flurry of regulations and mandates descend upon the nursing home sector, such changes could create legal obstacles, and suggest yet another difficult and onerous year for providers.

Staffing mandates, the aftermath of the end of the public health emergency (PHE), Covid liability and the PREP Act, all create “existential threats” for skilled nursing operators, at a time when so many are still attempting to recover from the last two and a half years.

read more

CMS reveals differing opinions on minimum staffing approach

A study meant to underpin a new federal nursing home staffing minimum will last about seven months and end in December, a Centers for Medicare & Medicaid Services official said Thursday.

That confirmation came during an Open Door Forum conference call Thursday, and amid a fierce, ongoing debate how mandated staffing levels can be equitably determined at all.

read more

Thousands of nursing homes face lower Five-Star ratings

New Five-Star scoring metrics could penalize an estimated 10% to 16% of providers who have relied on staffing strengths to drive their overall ratings.

The Centers for Medicare & Medicaid Services on Thursday published new guidance for calculating staffing stars in the public-facing rating system. It incorporates total nurse staffing on weekends; annual RN and total nurse turnover; and administrator turnover.

read more

CMS Issues Significant Updates to Improve the Safety and Quality Care for Long-Term Care Residents

the Centers for Medicare & Medicaid Services (CMS) issued updates to guidance on minimum health and safety standards that Long-Term Care (LTC) facilities (often called “nursing homes”) must meet to participate in Medicare and Medicaid.

CMS also updated and developed new guidance in the State Operations Manual (SOM) to address issues that significantly affect residents of LTC facilities.

read more

State of Skilled Nursing Facilities Today, Planning for the Future

What are the four key findings and what can nursing home leaders do today to put themselves on the path of recovery? Some of the answers include strategic planning, operational assessments, and self-evaluation.

Nursing facilities should work now to determine changes that can be made – clinically, operationally, and financially – for better or more strategic outcomes.

read more

How to Boost Your Nursing Home Star Rating

For the administrator looking to improve an overall quality score quickly, the staffing score is a good place to start.

The staffing score will boost a facility’s overall score by one star if it: exceeds the health inspection score, and is either four or five stars.

read more