How did CMS modify Five Star rating thresholds & put more emphasis on RN hours? (Apr 2019)

REVISED Five Star Technical Users’ Guide: April 2019

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CMS made changes to the staffing rating thresholds – with the staffing level required to receive a 5-star rating set based on the interaction between staffing levels and quality measures.

These changes Increased the importance of RN staffing by changing how the RN and total nurse ratings are combined to create the overall staffing rating.

The Guide also sets the overall and RN staffing ratings to one star for nursing homes that report 4 or more days in the quarter with no RN onsite, and stops suppressing staffing ratings for nursing homes that have 5 or more days with residents and no reported nurse hours.

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