CMS begins new 5-star rating calculations

The Centers for Medicare & Medicaid Services (CMS) has greenlighted the use of data from the newly added quality measures in calculating five-star ratings on the Nursing Home Compare website. The agency has activated five of the six quality measures announced in April, and new data will be included in quality scoring as of Aug. 10, 2016.

The five activated measures are:

  1. Percentage of short-stay residents who were successfully discharged to the community (based on Medicare claims and MDS)
  2. Percentage of short-stay residents who have had an outpatient emergency department visit (based on Medicare claims and MDS)
  3. Percentage of short-stay residents who were rehospitalized after a nursing home admission (based on Medicare claims and MDS)
  4. Percentage of short-stay residents who made improvements in function (based on MDS)
  5. Percentage of long-stay residents whose ability to move independently worsened (based on MDS)

The sixth new quality measure, the antianxiety/hypnotic medication measure, has not yet been activated because the agency is still exploring appropriate nursing home benchmarks, noted a CMS fact sheet.

A nursing home’s overall five-star rating comes from the combination of three score categories: health inspections, staffing and quality measures.

To learn more about the quality measure specifications, refer to the CMS Quality Measures User’s Manual.

Topics: Medicare/Medicaid