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

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

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.

read more

5 Star, QMs, and PBJ Data Updates

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.

read more

CMS Announces Updates to Five Star Quality Rating System

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.

read more

Cutting through the COVID staffing star confusion

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?

read more

CMS announces end of emergency blanket data waiver for nursing homes

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.

read more

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

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.

read more

CMS Focuses on Enforcement in Latest Statement on SNF Policies

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.

read more

Staffing takes a front seat when driving quality of care

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

read more

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

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.

read more